Division of Clinical Immunology, 3rd Department of Medicine, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary.
Scand J Rheumatol. 2010;39(1):1-11. doi: 10.3109/03009740903030324.
Autoimmune diseases have a multifactorial origin. Because of disturbances of the immune system, autoreactive T and B cells target self-antigens, leading to permanent organ damage. Despite novel therapeutic protocols, the disease course is chronic and in many instances the outcome is lethal. The efficacy of stem cell therapy has been observed in autoimmune animal models and in autoimmune diseases related to haematological abnormalities. Although the therapy is more than 30 years old, its broad spread has been delayed by the serious side-effects due to the conditioning treatments based on oncological protocols. Evaluation of the data of patients who have undergone autologous stem cell therapy reinforced the view that protocols used for conditioning treatments, mostly causing lymphoablation, and procedures carried out in specialist centres significantly reduced mortality, with an almost optimal therapeutical efficacy. New, multicentre investigations have been launched to compare the efficacy of various protocols. In this review, we summarize certain aspects of the molecular background of autologous stem cell transplantation and also depict the response to therapy in various autoimmune and rheumatic diseases.
自身免疫性疾病具有多因素的起源。由于免疫系统的紊乱，自身反应性 T 和 B 细胞针对自身抗原，导致永久性器官损伤。尽管有新的治疗方案，但疾病的进程是慢性的，在许多情况下，结局是致命的。干细胞治疗在自身免疫性动物模型和与血液学异常相关的自身免疫性疾病中已被观察到。尽管该疗法已有 30 多年的历史，但由于基于肿瘤学方案的强化疗导致严重的副作用，其广泛应用受到了阻碍。对接受自体干细胞治疗的患者的数据进行评估，强化了这样一种观点，即用于强化疗的方案（主要导致淋巴细胞耗竭）以及在专科中心进行的程序，大大降低了死亡率，具有近乎最佳的治疗效果。新的多中心研究已经启动，以比较各种方案的疗效。在这篇综述中，我们总结了自体干细胞移植的某些分子背景方面，并描述了各种自身免疫性和风湿性疾病的治疗反应。
