Review on hematopoitic stem cell transplantation in rheumatic autoimmune disease
Journal name: World Journal of Pharmaceutical Research
Original article title: Review on hematopoitic stem cell transplantation in rheumatic autoimmune disease
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Thati Sravani, Sumaiya Saleem, Indurthi Bharathi, Devagupthapu Kunthitha Devi, Purushothama Reddy K. and Kantamaneni Padmalatha
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Review on hematopoitic stem cell transplantation in rheumatic autoimmune disease
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr20229-24711
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Summary of article contents:
Introduction
Hematopoietic stem cell transplantation (HSCT) involves the use of stem cells to treat various autoimmune diseases, particularly refractory autoimmune rheumatic disorders (AIRD). Stem cells, which can self-renew and differentiate into various cell types, play a significant role in tissue regeneration. Hematopoietic stem cells (HSC) specifically generate blood and immune cells. This review examines the role of HSCT in autoimmune conditions, highlighting the mechanisms by which it resets the immune system and explores its clinical implications.
Immune Reset Mechanism
An essential concept within HSCT is the process of "immune reset." After lymphocyte destruction induced by chemotherapy, new self-tolerant immune cells are generated, which helps alleviate persistent autoimmune responses caused by autoreactive lymphocytes. Autologous HSCT relies on this principle, wherein the use of a patient’s own stem cells minimizes the risk of graft-versus-host disease (GVHD). Improved understanding of patient selection, conditioning methods, and supportive care has enhanced the applicability of HSCT in treating AIRD, allowing for better evaluation of its efficacy and safety across various patient profiles.
Preclinical and Clinical Data
Preclinical studies using various animal models have shown the effectiveness of HSCT in addressing autoimmune diseases. Research has indicated that outcomes may vary based on disease stage and model type, with HSCT demonstrating protective and therapeutic effects in specific conditions. Clinical data further illustrate that autologous HSCT is the most common method employed, with a comparatively low transplant-related mortality (TRM) rate under optimal clinical conditions. However, early studies reported TRM rates between 7% and 23%, necessitating careful patient management and regimen adjustments to improve safety.
Variability in Efficacy Across Diseases
The success of HSCT has exhibited variability across different autoimmune rheumatic diseases. For instance, while patients with systemic sclerosis (SSc) have shown better post-transplant outcomes, patients with rheumatoid arthritis (RA) experience limited long-term remission durations. Although HSCT leads to improved responses to traditional treatments in RA, the success in maintaining progression-free survival remains low. Notably, the overall survival rate for RA patients post-HSCT is high, yet achieving durability in treatment responses is a significant challenge.
Conclusion
HSCT's role in managing autoimmune diseases represents a growing field within regenerative medicine, with significant advancements in understanding stem cell biology and treatment protocols. Continued research is crucial to further elucidate the immunological mechanisms underlying HSCT, particularly regarding graft-versus-tumor and graft-versus-host responses. The evolution of reduced-intensity conditioning (RIC) regimens provides promising avenues for older patients or those previously considered unfit for HSCT, underscoring the need for ongoing investigation and refinement of HSCT strategies.
FAQ section (important questions/answers):
What are hematopoietic stem cells and their role in the body?
Hematopoietic stem cells (HSC) are adult stem cells that produce blood and immune cells, playing a crucial role in replenishing the body's blood supply and supporting immune functions.
What is autologous hematopoietic stem cell transplantation (HSCT)?
Autologous HSCT is a procedure where a patient's own hematopoietic stem cells are harvested, treated, and reintroduced after chemotherapy to treats autoimmune diseases by resetting the immune system.
What are the challenges and risks associated with HSCT?
Challenges include transplant-related mortality (TRM), infections, and the side effects of high-dose chemotherapy. TRM varies based on the conditioning regimen used.
How does HSCT affect autoimmune diseases like rheumatoid arthritis (RA)?
HSCT has shown variable effectiveness in RA, leading to temporary remission. However, many patients relapse or require reintroduction of DMARDs after a period.
What is the significance of preclinical studies in HSCT research?
Preclinical studies using animal models provide essential insights into HSCT's protective and therapeutic effects, guiding future clinical applications and understanding mechanisms involved.
What future developments are anticipated in HSCT for autoimmune diseases?
Future trends include optimizing regimens to enhance efficacy while minimizing side effects, improving treatment for older patients and understanding immune mechanisms behind graft-versus-host disease (GvHD).
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Review on hematopoitic stem cell transplantation in rheumatic autoimmune disease”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Disease:
Diseases impact health by disrupting normal bodily functions and causing various symptoms. Research into diseases, particularly autoimmune diseases, is vital for understanding their mechanisms and developing targeted therapies, such as hematopoietic stem cell transplantation, which aims to restore immune balance and improve patient health outcomes.
2) Shravani (Sravani):
Sravani is likely the first author of the research paper, indicating a pivotal role in the study on hematopoietic stem cell transplantation. Authors like Sravani contribute significantly to advancing scientific knowledge and detailing therapies for complex diseases, thereby enhancing understanding and treatment strategies in the field of medicine.
3) Animal:
Animals are often used in experimental research for their physiological and genetic similarities to humans. Their role in studies concerning hematopoietic stem cell transplantation is crucial for evaluating therapeutic effects, safety, and understanding disease progression, thereby paving the way for effective treatments in human patients.
4) Blood:
Blood is a vital fluid in the body responsible for transporting oxygen and nutrients, participating in immune responses. Hematopoietic stem cells, derived from blood, play a crucial role in producing various blood cells, which is significant for treatments concerning autoimmune diseases and other blood-related conditions requiring intervention.
5) Vijayawada (Vijayavada, Vijaya-vada):
Vijayawada, a city in Andhra Pradesh, is home to institutions like the Vijaya Institute of Pharmaceutical Sciences for Women, where research related to health and pharmaceutical sciences is conducted. As part of the geographical context, it highlights the importance of local facilities in advancing medical research and education in India.
6) Science (Scientific):
Scientific pertains to the systematic study of the natural world, emphasizing evidence-based approaches. In medical research, such as studies on stem cell transplantation, scientific rigor ensures the validity and reliability of findings, informing advancements in therapies and fostering the development of effective treatment strategies.
7) Vijaya:
Vijaya is part of the name of the Vijaya Institute of Pharmaceutical Sciences for Women in Vijayawada. This institute plays a significant role in pharmaceutical education and research. Institutions like Vijaya contribute to training professionals and fostering advancements in pharmaceutical sciences and medication development.
8) Chemotherapy:
Chemotherapy refers to a type of cancer treatment that uses drugs to kill or inhibit the growth of cancer cells. In the context of stem cell transplantation, chemotherapy is utilized to eliminate autoreactive cells, providing a therapeutic reset for the immune system in autoimmune diseases.
9) Toxicity:
Toxicity describes the degree to which a substance can harm organisms. In stem cell transplantation, understanding toxicity is crucial as patients may experience adverse effects from treatments, including chemotherapy. Managing and minimizing toxicity is key to improving patient outcomes and treatment efficacy in various medical conditions.
10) Andhra (Amdhra):
Andhra refers to the state of Andhra Pradesh in India, where significant medical and pharmaceutical research occurs. The state's educational institutes, like the Vijaya Institute, contribute to research advancements in healthcare, including studies on hematopoietic stem cell transplantation for autoimmune diseases, showcasing regional contributions to science.
11) India:
India represents a vast and diverse nation, home to various scientific institutions conducting significant health-related research. The research on hematopoietic stem cell transplantation in autoimmune diseases exemplifies India's growing role in the global medical science community, contributing essential findings and advancements in treatment methodologies.
12) Study (Studying):
A study refers to a systematic investigation aimed at acquiring new knowledge, such as the research on hematopoietic stem cell transplantation. In the medical context, studies provide crucial insights, evidence, and data that inform clinical practice, influence treatment protocols, and guide future research directions.
13) Repair:
Repair refers to the process of restoring tissues or organs to their original state following damage or disease. In the context of stem cell research, understanding how hematopoietic stem cells contribute to tissue repair and regeneration is essential for developing effective treatments for various autoimmune diseases.
14) Hand:
Hands symbolize the skills and expertise required in medical practice, particularly in performing procedures like hematopoietic stem cell transplantation. The quality of care is often determined by the hands-on capabilities of healthcare professionals, impacting patient safety and the overall success of medical interventions.
15) Human body:
The human body is an intricate biological system composed of various cells, tissues, and organs. Understanding its functioning is essential in medical research, especially in studies on stem cells, as they play a pivotal role in regeneration and immune function, relevant to many diseases treated with advanced therapies.
16) Pharmacology:
Pharmacology is the study of drugs and their effects on biological systems. It is integral to understanding the therapeutic mechanisms behind treatments, such as those involving hematopoietic stem cell transplantation, and informs the development of effective and safe medications tailored to individual patient needs.
17) Purushottama (Purusottama, Purusha-uttama):
Purushothama is acknowledged as one of the authors contributing to the research on hematopoietic stem cell transplantation. Contributions from individuals like Purushothama highlight collaborative efforts in advancing scientific knowledge and developing effective therapies for managing complex diseases, representing collective expertise in healthcare.
18) Inflammation:
Inflammation is a biological response to harmful stimuli, often chronic in autoimmune diseases. Understanding inflammation's role in pathophysiology is crucial in medical research, including studies on hematopoietic stem cell transplantation, as mitigating excessive inflammation can improve treatment outcomes and manage disease progression effectively.
19) Surrounding:
Surrounding refers to the environment or conditions that influence biological processes, including disease progression and treatment efficacy. It is significant in medical studies, where external factors may affect patient responses to therapies and the overall effectiveness of interventions like hematopoietic stem cell transplantation.
20) Observation:
Observation is a fundamental aspect of scientific research, involving the careful examination of phenomena. In studying hematopoietic stem cell transplantation, observation is essential for gathering data, understanding effects, and refining treatment approaches based on patient responses to therapies, guiding future research directions.
21) Stiffness:
Stiffness is a common symptom in various autoimmune diseases, often indicating joint or muscle involvement. Understanding stiffness in the context of disease assessments and during clinical studies of treatments like hematopoietic stem cell transplantation is vital for evaluating patient comfort, mobility, and the overall effectiveness of interventions.
22) Bharathi:
Bharathi, mentioned as one of the authors, signifies an essential contribution to the research on hematopoietic stem cell transplantation. Collaborative efforts from individuals like Bharathi are vital in elucidating complex medical issues and enhancing scientific discourse, resulting in improved treatment strategies and better patient care.
23) Medicine:
Medicine encompasses the science and practice of diagnosing, treating, and preventing diseases. Research on hematopoietic stem cell transplantation contributes to advancing medical knowledge, refining therapeutic approaches, and addressing the needs of patients with autoimmune diseases, reflecting medicine's ongoing evolution to improve health outcomes.
24) Activity:
Activity refers to the physiological functions or behaviors of cells or organisms. Understanding activity in the context of immune responses and disease mechanisms is key in studies related to hematopoietic stem cell transplantation, helping to elucidate how treatments modify immune activity and potentially restore health.
25) Death:
Death represents the cessation of biological functions in an organism, often as a result of disease progression or complications. In medical research, understanding factors that lead to mortality is critical for developing effective treatments, such as hematopoietic stem cell transplantation, aimed at prolonging life and improving patient quality.
26) Devi:
Devi, mentioned as part of the research team, signifies key contributions to studies on hematopoietic stem cell transplantation. Collaborative research efforts from individuals like Devi enhance findings and insights into effective treatments, emphasizing the importance of teamwork in addressing complex medical challenges.
27) Food:
Food plays a crucial role in human health, directly influencing general well-being and disease processes. Although not directly related to stem cell transplantation, nutrition is an essential aspect of patient care, often impacting recovery and overall health, thereby warranting attention in holistic medical treatment approaches.
28) Sign:
Sign refers to any indicator of a condition or disease observed during medical assessments. In autoimmune disease research, understanding various signs is essential for accurate diagnosis and treatment evaluation, guiding interventions such as hematopoietic stem cell transplantation for effective patient management.
29) Pain:
Pain is a perceptual experience that signals harm or injury, commonly reported in various diseases, including autoimmune conditions. Understanding pain mechanisms and addressing pain effectively is a critical area of research, including studies involving hematopoietic stem cell transplantation aimed at improving patient quality of life.
30) Post:
Post is often used in a temporal context to indicate a state or condition following an event, essential in clinical studies where outcomes are assessed after treatments like hematopoietic stem cell transplantation. Evaluating post-treatment responses helps gauge the effectiveness and safety of medical interventions.
31) Drug:
Drug refers to any substance used to diagnosis, treat, or prevent disease. Drugs are integral to medical therapies, including those involving hematopoietic stem cell transplantation, highlighting the importance of pharmacology in developing safe and effective treatments tailored to enhance patient outcomes.
32) Pur:
Poor quality of health or response to treatment can often characterize patients with chronic or advanced diseases. Understanding factors contributing to poor outcomes is essential in medical research, leading to refined treatment protocols, such as optimizing hematopoietic stem cell transplantation strategies to improve patient experiences.