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Therapy

 

Resetting the immune system with immunoablation and autologous haematopoietic stem cell transplantation in autoimmune diseases


1, 2, 3, 4

 

  1. Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin; and German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Autoimmunology Group, Berlin, Germany. tobias.alexander@charite.de
  2. Department of Haematology, Oncology and Tumorimmunology, Charité University Medicine Berlin, Germany.
  3. Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin; and German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Autoimmunology Group, Berlin, Germany.
  4. German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Cell Biology Group, Berlin, Germany.

CER9693
2016 Vol.34, N°4 ,Suppl.98
PI 0053, PF 0057
Therapy

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PMID: 27586805 [PubMed]

Received: 28/06/2016
Accepted : 29/06/2016
In Press: 20/07/2016
Published: 03/08/2016

Abstract

Over the past 20 years, immunoablation followed by transplantation of autologous haematopoietic stem cells (ASCT) has emerged as a promising treatment option for patients with severe forms of autoimmune diseases (ADs) that insufficiently respond to standard immunosuppressive or novel biologic treatment. Meanwhile, mechanistic studies have provided the proof-of-concept that the long-term, treatment-free remissions achieved by ASCT are associated with the eradication of the autoreactive immunologic memory and a fundamental reconfiguration of the immune system. The latter comprises regeneration of naive B cells and a stable thymic reactivation with re-emergence of thymic-derived naive T cells, including Foxp3+ regulatory T cells, with new antigen receptors, i.e. immune reset. In this article, we discuss mechanistic studies that investigated how such immune renewal after ASCT may rewire a faulty immune system in ADs into a self-tolerant state, to induce long-term remissions.

Rheumatology Article