间充质干细胞移植可逆转系统性红斑狼疮小鼠和人类的多器官功能障碍。
Mesenchymal stem cell transplantation reverses multiorgan dysfunction in systemic lupus erythematosus mice and humans.
作者信息
Sun Lingyun, Akiyama Kentaro, Zhang Huayong, Yamaza Takayoshi, Hou Yayi, Zhao Shengnan, Xu Ting, Le Anh, Shi Songtao
机构信息
Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
出版信息
Stem Cells. 2009 Jun;27(6):1421-32. doi: 10.1002/stem.68.
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that, despite the advances in immunosuppressive medical therapies, remains potentially fatal in some patients, especially in treatment-refractory patients. Here, we reported that impairment of bone marrow mesenchymal stem cells (BMMSCs) and their associated osteoblastic niche deficiency contribute in part to the pathogenesis of SLE-like disease in MRL/lpr mice. Interestingly, allogenic BMMSC transplantation (MSCT) is capable of reconstructing the bone marrow osteoblastic niche and more effectively reverses multiorgan dysfunction when compared with medical immunosuppression with cyclophosphamide (CTX). At the cellular level, MSCT, not CTX treatment, was capable to induce osteoblastic niche reconstruction, possibly contributing to the recovery of regulatory T-cells and reestablishment of the immune homeostasis. On the basis of the promising clinical outcomes in SLE mice, we treated four CTX/glucocorticoid treatment-refractory SLE patients using allogenic MSCT and showed a stable 12-18 months disease remission in all treated patients. The patients benefited an amelioration of disease activity, improvement in serologic markers and renal function. These early evidences suggest that allogenic MSCT may be a feasible and safe salvage therapy in refractory SLE patients.
系统性红斑狼疮(SLE)是一种多系统自身免疫性疾病,尽管免疫抑制药物治疗取得了进展,但在一些患者中,尤其是治疗难治性患者中,仍可能致命。在此,我们报告骨髓间充质干细胞(BMMSC)功能受损及其相关成骨细胞龛缺陷在一定程度上促成了MRL/lpr小鼠中SLE样疾病的发病机制。有趣的是,与环磷酰胺(CTX)药物免疫抑制相比,同种异体BMMSC移植(MSCT)能够重建骨髓成骨细胞龛,并更有效地逆转多器官功能障碍。在细胞水平上,MSCT而非CTX治疗能够诱导成骨细胞龛重建,这可能有助于调节性T细胞的恢复和免疫稳态的重建。基于SLE小鼠中令人鼓舞的临床结果,我们对4例CTX/糖皮质激素治疗难治性SLE患者进行了同种异体MSCT治疗,所有治疗患者均实现了12至18个月的疾病稳定缓解。患者的疾病活动度得到改善,血清学指标和肾功能有所提高。这些早期证据表明,同种异体MSCT可能是难治性SLE患者一种可行且安全的挽救治疗方法。