Center for Allogeneic Stem Cell Transplantation, Division of Clinical Immunology, and Hematology Center, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, F79, SE-141 86 Stockholm, Sweden.
Best Pract Res Clin Haematol. 2011 Mar;24(1):65-72. doi: 10.1016/j.beha.2011.01.003. Epub 2011 Feb 25.
Mesenchymal stem cells (MSCs) have immunomodulatory effects and low immunogenicity. MSCs inhibit T-cell alloreactivity in vitro. Immune inhibition is caused by soluble factors. MSCs affect almost all cells of the immune system. They are safe to infuse in humans with no acute toxicity and no ectopic tissue formation. We treated patients with life-threatening acute graft-versus-host disease (GVHD) not responding to conventional immunosuppressive therapy with MSCs. Approximately half of the patients responded. HLA-identical or third party MSCs were equally effective. Children tended to have a better response compared to adults. MSCs have also been used for chronic GVHD with positive effects. MSCs also reversed tissue toxicity such as hemorrhagic cystitis, pneumomediastinum and colon perforation with peritonitis. A patient with extensive hemorrhages was successfully treated with repeated doses of MSCs pooled from two donors. This may indicate that MSCs apart from wound healing may stimulate clotting and vasoconstriction. To conclude, MSCs is a novel treatment that may be used for GVHD, tissue toxicity and hemorrhages because of its immune inhibitory and anti-inflammatory effects.
间充质干细胞（MSCs）具有免疫调节作用和低免疫原性。MSCs 在体外抑制 T 细胞同种异体反应。免疫抑制是由可溶性因子引起的。MSCs 影响免疫系统的几乎所有细胞。它们在人类中输注是安全的，没有急性毒性，也没有异位组织形成。我们用 MSCs 治疗对常规免疫抑制治疗无反应的危及生命的急性移植物抗宿主病（GVHD）患者。大约一半的患者有反应。HLA 相同或第三方 MSCs 同样有效。儿童的反应比成人好。MSCs 也用于慢性 GVHD，效果良好。MSCs 还逆转了组织毒性，如出血性膀胱炎、纵隔气肿和伴有腹膜炎的结肠穿孔。一名广泛出血的患者成功地接受了来自两名供体的 MSCs 重复剂量治疗。这可能表明 MSCs 除了伤口愈合外，还可能刺激凝血和血管收缩。总之，MSCs 是一种新型治疗方法，由于其免疫抑制和抗炎作用，可用于 GVHD、组织毒性和出血。
