Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Cells. 2022 Jul 11;11(14):2165. doi: 10.3390/cells11142165.
: Since the 1990s, transplantations of hematopoietic and mesenchymal stem cells (HSCT and MSCT) and dendritic cell (DCT) have been investigated for the treatment of neurological autoimmune disorders (NADs). With the growing number of transplanted patients, awareness of neuroimmunolgical complications has increased. Therefore, an overview of SCT for the most common NADs and reports of secondary immunity after SCT is provided. : For this narrative review, a literature search of the PubMed database was performed. A total of 86 articles reporting on different SCTs in NADs and 61 articles dealing with immune-mediated neurological complications after SCT were included. For multiple sclerosis (MS), only registered trials and phase I/II or II studies were considered, whereas all available articles on other disorders were included. The different transplantation procedures and efficacy and safety data are presented. : In MS patients, beneficial effects of HSCT, MSCT, and DCT with a decrease in disability and stabilization of disease activity have been reported. These effects were also shown in other NADs mainly in case reports. In seven of 132 reported patients with immune-mediated neurological complications, the outcome was fatal. : Phase III trials are ongoing for MS, but the role of SCT in other NADs is currently limited to refractory patients due to occasional serious complications.
自 20 世纪 90 年代以来,人们一直在研究造血和间充质干细胞(HSCT 和 MSCT)以及树突状细胞(DCT)移植,以治疗神经自身免疫性疾病(NAD)。随着接受移植的患者数量不断增加,人们对神经免疫并发症的认识也有所提高。因此,本文概述了最常见的 NAD 中 SCT 的应用,并报告了 SCT 后继发免疫的情况。
在这项叙述性综述中,对 PubMed 数据库进行了文献检索。共纳入了 86 篇关于 NAD 中不同 SCT 的文章和 61 篇关于 SCT 后免疫介导的神经并发症的文章。对于多发性硬化症(MS),仅考虑了已注册的试验以及 I/II 期或 II 期研究,而纳入了其他疾病的所有可用文章。介绍了不同的移植程序以及疗效和安全性数据。
在 MS 患者中,已经报道了 HSCT、MSCT 和 DCT 可改善疾病,减少残疾和稳定疾病活动,其他 NAD 也主要通过病例报告显示出这些效果。在报告的 132 例免疫介导的神经并发症患者中,有 7 例患者的结局是致命的。
MS 的 III 期临床试验正在进行中,但由于偶尔会出现严重并发症,SCT 在其他 NAD 中的作用目前仅限于难治性患者。