Systemic Sclerosis

An Update

Uwe-Frithjof Haustein, MD, PhD

Disclosures

Lab Med. 2011;42(9):562-572. 

In This Article

Cellular Therapy

Cellular Therapy Targets Immune System and Fibrosis

The rationale of hematopoietic stem cell transplantation (HSCT) is to reset the dysregulated immune system with immunoablative therapy (cytostatic agents, anti-lymphocyte globulin, total body irradiation) followed by reinfusion of previously isolated hematopoietic stem cells. The main mechanism is achieved by eradication of autoaggressive "effector T and B cells" and the induction of regulatory T cells. The idea is to restore tolerance despite the use of autologous cells. With allogenic HSCT, the postulated graft vs autoimmunity effect may contribute to better results but also to more significant side effects. The patients treated with HSCT represent a negative selection of severe cases of short history and involvement of internal organs. Skin thickening and performance status were improved markedly and organ dysfunction stabilized.[104] The early evidence that fibrosis can, in principle, be reversed provides a hopeful outlook for future therapeutic advances.

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