Autoimmune Diseases and Stem Cell Transplantation

  At the end of the 19th century, most scholars believed that the immune phenomenon was only a defensive response of the organism to the invasion of external infectious factors, and that the body did not produce antibodies to its own tissue components, which was called immune tolerance. With the development of immunology, the concept of antigens and antibodies has been developed and perfected, and the modern view is that autoimmune tolerance is relative. This phenomenon should be regarded as a normal physiological reaction of the body. Only those who have disorders of immune regulation, causing uncontrolled and excessive autoimmune reactions, resulting in organic damage and dysfunction of the body, are called autoimmune diseases.  Current treatment for a variety of autoimmune diseases includes the systematic use of anti-infective drugs, effective immunosuppressive and immunomodulatory drugs (i.e., steroids and inhibitory proteins that block the action of inflammatory cytokines). However, in addition to the strong effect of these treatments on the normal immune response, these treatments in some cases do not protect patients from reoccurrence of the disease. In recent years, scholars have been exploring how stem cells can be used to treat autoimmune abnormalities. The rationale for this approach has focused on experimental stem cell therapy for lupus, rheumatoid arthritis, and type I diabetes.  There are currently two main types of stem cell transplantation: autologous stem cell transplantation and allogeneic stem cell transplantation.  The general approach to autologous (i.e., from “self”) stem cell transplantation is as follows: First, the patient receives an injection of a growth factor that causes a large number of blood stem cells to enter the bloodstream from the bone marrow. These cells are then collected from the blood, separated from the mature immune cells, and then stored. When a sufficient amount of stem cells is obtained, the patient is treated with cytotoxic (cell-killing) drugs and/or radiation to remove the mature immune cells. The hematopoietic stem cells are then introduced into the circulating bloodstream by transfusion, where they will then migrate to the bone marrow and begin to differentiate into mature immune cells. The body’s immune system is then rebuilt. There is a risk of disease recurrence with this approach.  BURT and his colleagues conducted a long-term follow-up (1-3 years) of seven patients with lupus who underwent this treatment and found that the patients had no active lupus and continued to improve without the use of immune resistance therapy after transplantation.  Allogeneic stem cell transplantation involves harvesting allogeneic stem cells by mating later, and when a sufficient amount of stem cells is obtained, the patient is treated with cytotoxic (cytocidal) drugs and/or radiation to remove mature immune cells. The hematopoietic stem cells are then transfused into the circulating blood, where they will then migrate to the bone marrow and begin to differentiate into mature immune cells. The body’s immune system is thus rebuilt. The main disadvantage of this method is the rejection reaction.