Hematopoietic Stem Cells (continued)
B. TREATMENTS
1. Autism Spectrum Disorder
Several processes are associated with autism spectrum disorder, including oxidative stress, decreased methylation capacity, limited production of glutatione, mitochondrial dysfunction, intestinal dysbiosis, toxic metal burden, and immune abnormalities. The rationale for immune interventions such as hematopoietic stem cells (HSCs) relate to the stem cell's capacity for controlling chronic inflammation and restoring immune balance.
Siniscalco D, Bradstreet JJ, Antonucci N. Therapeutic role of hematopoietic stem cells in autism spectrum disorder-related inflammation. Front Immunol 2013;4:140. on-line reference
2. Bone Regeneration
Failures in fracture healing after bone grafting are often due to poor vascular circulation. The authors used hematopoietic progenitor and endothelial progenitor cells that can promote angiogenesis (stimulating new blood vessel growth) and new bone growth. The procedure proved to be safe and effective on tibial and femoral nonunions.
Kuroda R, Matsumoto T, Kawakami Y, Fukui T, Mifune Y, Kurosaka M. Clinical impact of circulating CD34-positive cells on bone regeneration and healing. Tissue Eng Part B Rev 2014;20(3):190-9. on-line reference
3. Gastrointestinal Transplants
The authors state that hematopoietic stem cell transplants have been successful in treating refractory Crohn's disease. In refractory autoimmune gastrointestinal disease, high-dose chemotherapy followed by HSC transplantation seems feasible and safe and may result in long-term improvement. Mesenchymal stem cell transplantation for a selected group of Crohn's disease is promising and may be an alternative in treating fistulas.
Al-toma A, Nijeboer P, Bouma G, Visser O, Mulder CJ. Hematopoietic stem cell transplantation for non-malignant gastrointestinal diseases. World J Gastroenterol 2014;20(46):17368-75. on-line reference
4. Heart Repair
Hematopoietic stem cells (HSCs) possess the ability to transdifferentiate and acquire the cardiomyocyte, vascular endothelial, and smooth muscle cell lineages for heart repair. Both cardiac and hematopoietic stem cells may be used therapeutically to reverse the consequences of chronic heart failure of ischemic and non-ischemic origin.
Anversa P, Kajstura J, Rota M, Leri A. Regenerating new heart with stem cells. J Clin Invest 2013; 123(1):62-70. on-line reference
5. Hodgkin's Lymphoma
The authors recommend that patients younger than 60-65 years with relapsed Hodgkin's lymphoma or refractory to first-line therapy should receive a second-line chemotherapy followed by high dose chemotherapy and autologous (same donor and recipient) hematopoietic progenitor cell transplantation.
Moscato T, Fedele R, Messina G, Irrera G, Console G, Martino M. Hematopoietic progenitor cells transplantation for recurrent or refractory Hodgkin's lymphoma. Expert Opin Biol Ther 2013;13(7):1013-27. on-line reference
6. Human Immunodeficiency Virus (HIV)
An estimated 35 million people are infected with HIV worldwide. Anti-retroviral therapy has reduced the morbidity and mortality of HIV-infected patients but the treatment is not curative and for some, the drugs can be toxic. Hematopoietic stem cell-based gene therapy may eventually become an alternative that may provide a cure for the disease. Recent results from preclinical research and early-stage clinical trials support the feasibility and safety of this novel strategy.
Herrera-Carrillo E, Berkhout B. Potential mechanisms for cell-based gene therapy to treat HIV/AIDS. Expert Opin Ther Targets 2015;19(2):245-63. on-line reference
7. Leukemia (Myeloid)
Acute and chronic myeloid leukemia are hematologic malignancies arising from transformed hematopoietic stem/progenitor cells known as leukemia stem cells (LSCs). LSCs are resistant to various forms of therapy including irradiation and cytotoxic drugs. While dendritic cells can also become malignant. However, the antigens that can induce anti-leukemic T cell responses. The authors provide suggest methods for increasing the effectiveness of dendritic cells for anti-leukemic cytotoxic T cell responses.
Schürch CM, Riether C, Ochsenbein AF. Dendritic cell-based immunotherapy for myeloid leukemias. Front Immunol 2013,4:496. on-line reference
8. Multiple Sclerosis
Over 600 hematopoietic stem cell transplants have been published in the medical literature. The immune system is regenerated from the infused autologous hematopoietic stem cells. The treatment can also reduce or eliminate ongoing clinical relapses, halt further progression and reduce the burden of disabilty in some of the patients.
Atkins HL, Freedman MS. Hematopoietic stem cell therapy for multiple sclerosis: top 10 lessons learned. Neurotherapeutics 2013;10(1):68-76. on-line reference
9. Systemic Lupus Erythematosus
With systemic lupus erythematosis, research shows that hematopoietic and mesenchymal stem cell functions are disrupted. Transplantation with both of these stem cells offer a safe and effective therapy that results in improved organ function and clinical remission.
Sui W, Hou X, Che W, Chen J, Qu M, Xue W, Dai Y. Hematopoietic and mesenchymal stem cell transplantation for severe and refractory systemic lupus erythematosus. Clin Immunol 2013;148(2):186-97. on-line reference
