Chmiel Joanna, Stasiak Mariusz, Skrzypkowska Maria, Samson Lucjan, Łuczkiewicz Piotr, Trzonkowski Piotr
University Clinical Centre in Gdańsk, Second Clinic of Orthopaedics and Kinetic Organ Traumatology, Poland.
Faculty of Medicine, Medical University of Gdańsk, Poland.
Heliyon. 2024 Aug 30;10(17):e36512. doi: 10.1016/j.heliyon.2024.e36512. eCollection 2024 Sep 15.
Cellular therapies utilizing regulatory T cells (Tregs) have flourished in the autoimmunity space as a new pillar of medicine. These cells have shown a great promise in the treatment of such devastating conditions as type 1 diabetes mellitus (T1DM), systemic lupus erythematosus (SLE) and graft versus host disease (GVHD). Novel treatment protocols, which utilize Tregs-mediated suppressive mechanisms, are based on the two main strategies: administration of immunomodulatory factors affecting Tregs or adoptive cell transfer (ACT). ACT involves extraction, expansion and subsequent administration of Tregs that could be either of autologous or allogeneic origin. Rheumatoid arthritis (RA) is another autoimmune candidate where this treatment approach is being considered. RA remains an especially challenging adversary since it is one of the most frequent and debilitating conditions among all autoaggressive disorders. Noteworthy, Tregs circulating in RA patients' blood have been proven defective and unable to suppress inflammation and joint destruction. With this knowledge, adoptive transfer of compromised autologous Tregs in the fledgling clinical trials involving RA patients should be reconsidered. In this article we hypothesize that incorporation of healthy donor allogeneic Tregs may provide more lucid and beneficial results.
利用调节性T细胞(Tregs)的细胞疗法作为医学新支柱,在自身免疫领域蓬勃发展。这些细胞在治疗1型糖尿病(T1DM)、系统性红斑狼疮(SLE)和移植物抗宿主病(GVHD)等严重疾病方面显示出巨大潜力。利用Tregs介导的抑制机制的新型治疗方案基于两种主要策略:施用影响Tregs的免疫调节因子或过继性细胞转移(ACT)。ACT包括提取、扩增并随后施用自体或异体来源的Tregs。类风湿性关节炎(RA)是正在考虑采用这种治疗方法的另一种自身免疫性疾病。RA仍然是一个特别具有挑战性的对手,因为它是所有自身攻击性疾病中最常见且使人衰弱的疾病之一。值得注意的是,RA患者血液中循环的Tregs已被证明存在缺陷,无法抑制炎症和关节破坏。基于这一认识,在涉及RA患者的初期临床试验中,对受损自体Tregs进行过继性转移应重新考虑。在本文中,我们假设引入健康供体的异体Tregs可能会带来更清晰和有益的结果。