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自体造血干细胞移植(AHSCT):多发性硬化症中不断发展的治疗途径。

Autologous Hematopoietic Stem Cell Transplantation (AHSCT): An Evolving Treatment Avenue in Multiple Sclerosis.

作者信息

Mohammadi Reihane, Aryan Alisam, Omrani Mir Davood, Ghaderian Sayyed Mohammad Hossein, Fazeli Zahra

机构信息

Department of Medical Genetics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Biologics. 2021 Mar 2;15:53-59. doi: 10.2147/BTT.S267277. eCollection 2021.

Abstract

Autologous hematopoietic stem cell transplantation (AHSCT) is considered as the novel approach to improve multiple sclerosis (MS) patients with disease-modifying therapies (DMTs)-resistance. The results obtained from different studies indicate that AHSCT increases the life quality of MS patients. Several factors are known to be influenced on the successful rate of AHSCT in patients with MS. The individuals aged <40 years with a short duration of MS disease have been demonstrated to show a better response to AHSCT administration. Furthermore, this treatment approach was more effective in relapsing remitting MS (RRMS) patients than progressive MS (PMS). Different clinical trials revealed that AHSCT with a low density conditioning regimen could be suggested as a suitable candidate approach in the management of MS. Several molecular and cellular mechanisms are known to be involved in the resetting of the immune system following the AHSCT infusion in MS patients. These mechanisms play a role in the depletion of auto-reactive lymphocytes and immune system renewal. In the present review, we discuss different clinical and molecular aspects of AHSCT application in the alleviation of MS symptoms.

摘要

自体造血干细胞移植(AHSCT)被认为是改善对疾病修饰疗法(DMTs)耐药的多发性硬化症(MS)患者的新方法。不同研究得出的结果表明,AHSCT提高了MS患者的生活质量。已知有几个因素会影响MS患者AHSCT的成功率。已证明年龄小于40岁且MS病程较短的个体对AHSCT治疗的反应更好。此外,这种治疗方法在复发缓解型MS(RRMS)患者中比进展型MS(PMS)更有效。不同的临床试验表明,低密度预处理方案的AHSCT可被认为是MS治疗中一种合适的候选方法。已知在MS患者接受AHSCT输注后,几种分子和细胞机制参与了免疫系统的重置。这些机制在自身反应性淋巴细胞的消耗和免疫系统更新中发挥作用。在本综述中,我们讨论了AHSCT应用于缓解MS症状的不同临床和分子方面。

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