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Resetting the T Cell Compartment in Autoimmune Diseases With Autologous Hematopoietic Stem Cell Transplantation: An Update

Autologous hematopoietic stem cell transplantation (aHSCT) for autoimmune diseases has been applied for two decades as a treatment for refractory patients with progressive disease. The rationale behind aHSCT is that high-dose immunosuppression eliminates autoreactive T and B cells, thereby resetting...

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Autores principales: Lutter, Lisanne, Spierings, Julia, van Rhijn-Brouwer, Femke C. C., van Laar, Jacob M., van Wijk, Femke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5920130/
https://www.ncbi.nlm.nih.gov/pubmed/29731752
http://dx.doi.org/10.3389/fimmu.2018.00767
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author Lutter, Lisanne
Spierings, Julia
van Rhijn-Brouwer, Femke C. C.
van Laar, Jacob M.
van Wijk, Femke
author_facet Lutter, Lisanne
Spierings, Julia
van Rhijn-Brouwer, Femke C. C.
van Laar, Jacob M.
van Wijk, Femke
author_sort Lutter, Lisanne
collection PubMed
description Autologous hematopoietic stem cell transplantation (aHSCT) for autoimmune diseases has been applied for two decades as a treatment for refractory patients with progressive disease. The rationale behind aHSCT is that high-dose immunosuppression eliminates autoreactive T and B cells, thereby resetting the immune system. Post-aHSCT the cytotoxic CD8(+) T cells normalize via clonal expansion due to homeostatic proliferation within a few months. CD4(+) T cells recover primarily via thymopoiesis resulting in complete renewal of the T cell receptor (TCR) repertoire which requires years or never normalize completely. The increase in naïve T cells inducing immune tolerance, renewal of especially the regulatory TCR repertoire, and a less pro-inflammatory functional profile of the CD4(+) T cells seem essential for successful immune reconstitution inducing long-term remission. There is currently a knowledge gap regarding the immune response in tissue sites post-aHSCT, as well as disease-specific factors that may determine remission or relapse. Future studies on lymphocyte dynamics and function may pave the way for optimized conditioning regimens with a more individualized approach.
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spelling pubmed-59201302018-05-04 Resetting the T Cell Compartment in Autoimmune Diseases With Autologous Hematopoietic Stem Cell Transplantation: An Update Lutter, Lisanne Spierings, Julia van Rhijn-Brouwer, Femke C. C. van Laar, Jacob M. van Wijk, Femke Front Immunol Immunology Autologous hematopoietic stem cell transplantation (aHSCT) for autoimmune diseases has been applied for two decades as a treatment for refractory patients with progressive disease. The rationale behind aHSCT is that high-dose immunosuppression eliminates autoreactive T and B cells, thereby resetting the immune system. Post-aHSCT the cytotoxic CD8(+) T cells normalize via clonal expansion due to homeostatic proliferation within a few months. CD4(+) T cells recover primarily via thymopoiesis resulting in complete renewal of the T cell receptor (TCR) repertoire which requires years or never normalize completely. The increase in naïve T cells inducing immune tolerance, renewal of especially the regulatory TCR repertoire, and a less pro-inflammatory functional profile of the CD4(+) T cells seem essential for successful immune reconstitution inducing long-term remission. There is currently a knowledge gap regarding the immune response in tissue sites post-aHSCT, as well as disease-specific factors that may determine remission or relapse. Future studies on lymphocyte dynamics and function may pave the way for optimized conditioning regimens with a more individualized approach. Frontiers Media S.A. 2018-04-20 /pmc/articles/PMC5920130/ /pubmed/29731752 http://dx.doi.org/10.3389/fimmu.2018.00767 Text en Copyright © 2018 Lutter, Spierings, van Rhijn-Brouwer, van Laar and van Wijk. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Lutter, Lisanne
Spierings, Julia
van Rhijn-Brouwer, Femke C. C.
van Laar, Jacob M.
van Wijk, Femke
Resetting the T Cell Compartment in Autoimmune Diseases With Autologous Hematopoietic Stem Cell Transplantation: An Update
title Resetting the T Cell Compartment in Autoimmune Diseases With Autologous Hematopoietic Stem Cell Transplantation: An Update
title_full Resetting the T Cell Compartment in Autoimmune Diseases With Autologous Hematopoietic Stem Cell Transplantation: An Update
title_fullStr Resetting the T Cell Compartment in Autoimmune Diseases With Autologous Hematopoietic Stem Cell Transplantation: An Update
title_full_unstemmed Resetting the T Cell Compartment in Autoimmune Diseases With Autologous Hematopoietic Stem Cell Transplantation: An Update
title_short Resetting the T Cell Compartment in Autoimmune Diseases With Autologous Hematopoietic Stem Cell Transplantation: An Update
title_sort resetting the t cell compartment in autoimmune diseases with autologous hematopoietic stem cell transplantation: an update
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5920130/
https://www.ncbi.nlm.nih.gov/pubmed/29731752
http://dx.doi.org/10.3389/fimmu.2018.00767
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