Skip to content

Advertisement

  • Meeting abstract
  • Open Access

Long term immune reconstitution after immunoablation and autologous CD34 cell therapy in autoimmune diseases

  • 1,
  • 1,
  • 1,
  • 2,
  • 3,
  • 4,
  • 2,
  • 4 and
  • 1
Arthritis Research & Therapy20024 (Suppl 1) :107

https://doi.org/10.1186/ar442

  • Received: 15 January 2002
  • Published:

Keywords

  • Systemic Lupus Erythematosus
  • Autoimmune Disease
  • Systemic Lupus Erythematosus Patient
  • Cell Therapy
  • CD34 Cell

Introduction

Immunoablation in combination with autologous stem cell transplantation (ASCT) is used as a therapy for severe autoimmune diseases. We have analysed reconstitution of the immune system in patients treated with ASCT.

Results

During a follow-up period of up to 42 months after ASCT, one polychondritis and two systemic lupus erythematosus (SLE) patients in clinical remission were analysed for reappearance of naive, activated and memory B and T lymphocytes, for reactivity against pathogens and autoantigens, and for presence of autoantibodies. Titers of disease-specific autoantibodies decreased after ASCT with the half-life of secreted antibodies, and did not reappear. NaiveT and naive Bcells reappeared and reached normal levels within one year after ASCT. T cells activated and expanded by pathogens were easily detectable, but not T cells reacting to any of an array of autoantigens tested, in a cytometric cytokine provocation test. A third SLE patient suffered from a relapse of disease after being free of any clinical and serological symptoms for 17 months. In this patient, autoantibodies with old (anti-dsDNA antibodies) and new specificities (anti-Sm and anti-U1RNP antibodies) appeared upon relapse. A sudden decrease of peripheral naive and increase of peripheral memory B and Th cells preceeded the relapse.

Conclusion

ASCT for autoimmune diseases can result in longlasting remissions. According to frequencies and phenotypes of naive lymphocytes, the reconstituted immune system resembles a 'juvenile' immune system. Our results reveal that autoreactive and plasma cells do not survive the therapy but protective immune memory has to be re-established.

Authors’ Affiliations

(1)
DRFZ Berlin, Berlin, Germany
(2)
Haematology, Charité, Berlin, Germany
(3)
Rheumaklinik, Berlin-Buch, Berlin, Germany
(4)
Rheumatology, Charité, Berlin, Germany

Copyright

© BioMed Central Ltd 2002

Advertisement