Immune cell reconstitution following autologous hematopoietic stem cell transplantation in multiple sclerosis.

Q2 Medicine

Handbook of clinical neurology Pub Date : 2024-01-01 DOI:10.1016/B978-0-323-90242-7.00003-1

Alice Mariottini, Maria Teresa Cencioni, Paolo Antonio Muraro

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引用次数: 0

Abstract

Hematopoietic stem cell transplantation (HSCT) is a multistep procedure aimed at eradicating the immune system and replacing it with a new one reconstituted from hematopoietic stem cells which in autologous HSCT (AHSCT) have previously been harvested from the same individual. Over the last two decades, AHSCT has been developed as a treatment option for people affected by aggressive multiple sclerosis (MS), and it exerts a long-standing effect on new inflammation-driven disease activity. The rationale for the use of AHSCT in MS will be discussed, starting from the first observations on experimental models. The mechanisms and kinetics of repopulation (i.e., quantitative recovery) and reconstitution (i.e., qualitative changes) of the immune cell populations will be explored, focusing on immune reconstitution of the T and B cells compartments and briefly covering changes in the innate immune system. Finally, potential immunologic markers of response to treatment will be reviewed. Insights into the supposed mechanism(s) of action of AHSCT will be provided, discussing the leading hypothesis of the "rebuilding" of a newly tolerant immune system, and examining the apparent paradox of the long-standing control of disease activity despite a relatively short-term immunosuppressive effect of the procedure.

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多发性硬化症患者自体造血干细胞移植后的免疫细胞重建。

造血干细胞移植（HSCT）是一个多步骤的过程，旨在消除免疫系统，并用一个由造血干细胞重组的新系统取而代之，而在自体造血干细胞移植（AHSCT）中，造血干细胞之前是从同一个人身上采集的。在过去的二十年里，自体造血干细胞移植已被开发为治疗侵袭性多发性硬化症（MS）患者的一种选择，它对新的炎症驱动的疾病活动具有长期效果。我们将从对实验模型的首次观察开始，讨论在多发性硬化症中使用 AHSCT 的理由。将探讨免疫细胞群的再填充（即量的恢复）和重建（即质的变化）的机制和动力学，重点是 T 细胞和 B 细胞的免疫重建，并简要介绍先天性免疫系统的变化。最后，还将回顾治疗反应的潜在免疫学标志物。还将深入探讨 AHSCT 的假定作用机制，讨论 "重建 "新的耐受性免疫系统的主要假说，并研究尽管治疗过程具有相对短期的免疫抑制作用，但疾病活动仍能得到长期控制这一明显的悖论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Handbook of clinical neurology Medicine-Neurology (clinical)

CiteScore

4.10

自引率

0.00%

发文量

302

期刊介绍： The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.