Understanding the biological mechanisms of autologous hematopoietic stem cell transplantation in the treatment of multiple sclerosis
Multiple sclerosis (MS) is a demyelinating autoimmune disease of the central nervous system, and the most common cause of neurological disability in young adults. One available treatment for MS is autologous hematopoietic stem cell transplantation (AHSCT), where bone marrow stem cells are collected from the patient and re-infused after immune cell-depleting treatment with cytotoxic drugs. This is thought to “reset” the immune system. In our group, neurologists and immunologists are working in close collaboration to understand the mechanisms behind the therapeutic effect.
To elucidate the changes in immune cell function and how this affects the therapeutic effect of AHSCT in patients with multiple sclerosis.
In Sweden 20 000 persons suffer from MS, and worldwide an estimated 2.5 million. Untreated, it often leads to severe disability and premature death. Autologous hematopoietic stem cell transplantation (AHSCT) is a well-proven treatment commonly used for various malignancies and has also been implemented as a treatment for multiple sclerosis. Uppsala University Hospital has been among the pioneers in this clinical field. Since 2004, more than 70 patients have undergone AHSCT in Uppsala, enabling the collection of a significant amount of research samples from patients before and after AHSCT. About 70% of multiple sclerosis patients experience no relapses, new lesions or disability progression during follow up. Though the long-term follow up results are promising, little is known about the biological mechanisms through which AHSCT has its effects in multiple sclerosis.
We are using a combination of methods in which cells are stimulated with potential autoantigens, including e.g. flow cytometry and fluorospot analysis, in order to better understand the immune cell function in MS and how it is affected in a beneficial way from AHSCT in comparison to other treatments.
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