We discussed late last year how the injection of stem cells seems to help heart patients recover. Not because the stem cells are growing and rebuilding the heart. No, they are helping because they are stimulating an immune response that helps the heart recover.
That’s the opposite problem we face when an organ transplant is provided a patient. They need life-long administration of immunosuppressive drugs, to make sure the new organ isn’t rejected by the body. These drugs, while precluding organ rejection, can let the patient succumb to infection- or cancer.
But, maybe there’s a better way. Think the opposite way the injection of stem cells into the heart works.
This time, it’s mesenchymal stromal cells (MSC), often obtained from bone marrow. They don’t really qualify as stem cells- but they can differentiate into different sorts of cells- bone, cartilage, tendons, ligaments, adipocytes, dermis, muscle, connective tissue.
Dr. Giuseppe Remuzzi (at the Mario Negri Institute for Pharmacological Research, Milan) has been involved in dialysis and transplantation for some time. One of his current projects has involved the injection of the mesenchymal stromal cells the day before a patient received a kidney transplant. That injection seems to be effective in toning down the body’s immune response, perhaps educating the body to live with the allograft. (His recent paper, co-authored by Federica Casiraghi [Current Opinion in Nephrology and Hypertension], Mesenchymal stromal cells in kidney transplantation gives more information about this concept. The rest of his team, Drs. N. Perico, M. Todeschini, M. Cortenovis, E Gotti, V. Portalupi, M. Mister, F. Gaspari, A. Villa, S. Fiori, M. Introna, E. Longhi, joined him in an earlier paper, Long-Term Clinical and Immunological Profile of Kidney Transplant Patients Given Mesenchymal Stromal Cell [MSC] Immunotherapy.)
The MSC were taken from the recipient’s bone marrow and were grown in vitro (in the lab), after which they were injected back into the patient.
The issue- at least for now- is that the cell injection only attenuates the need for immunosuppressive therapy. Except for one patient who was able to completely discontinue the immunosuppressive therapy. The biomarkers in his body after 2 years indicated this would be a viable process- but the protection tapered off slowly over 5 years.
But other patients did not show tolerance in their blood tests. And, some patients have developed tolerance to organ transplants without any such injections.
Another team of Dutch physicians, Dr. MEJ Reinders and TJ Rabelnk, with their associates Drs. JW de Fijter, H Roelofs, IM Bajema, DK de Vries, AF Schaapherder, FHJ Claas, PPMC van Miert, DL Roelen, C van Kooten, and WE Fibbe published results about 6 patients in Holland. (The journal: Stem Cells Translational Medicine). Here, the patients did NOT receive MSC injections pre-emptively, but only after they were experiencing allograft rejection. The patients were injected twice, months post-transplantation with 1-2 million MSC per kilogram of body weight. Systemic immunosuppression was noted, but no regenerative effects from the MSC injections were found.
So, we need to learn way more about the MSC mechanistic action- plus a more complete evaluation of the biomarkers involved before we attempt to cease immunosuppressive treatments for all patients.
Here’s to hope. And, science, of course!
Very innovative use of the MSC cells. Look forward to more work in this field.
You did see all those clinical trials that are trying to verify this hypothesis- right, Dr. A?
Yes, Roy, here’s to science! 🙂 The MSC injection is an interesting concept. I’ve heard of using bone marrow injections to aid healing, but didn’t know it could potentially help in organ acceptance. I’m just amazed. Thanks for sharing your knowledge of science.
Aletha McManama recently posted..Top 10 Strategies to Sell Your Course
The issue- at least for now- is that this may be wishful thinking. We scientists are just as guilty as the rest of the world at seeking one indication of success and being elated. But, unless we can find a significant portion of folks achieving success, this is way too expensive (and extensive) a process
I had sepsis in October which impacted quite a few of my organs and their function. Naturally this made my interest in different solutions to such health situations. Thank you for keeping people thinking.
Julie JordanScott recently posted..I Gave it All Up Until…..
Whoa! I am so glad that you’ve passed that situation!
I have a friend who had sepsis and she was ill for some time. Once she started recovering, she actually had to learn how to walk all over again. Let’s hope that something can be done to help people who live with these systemic infections.
Alice Gerard recently posted..A haunted house that speaks to our reality
That’s true- but not quite related to a transplant. We need a panoply of new antibiotics with which to treat those microbial invasions.
I feel like I’m in a classroom when I read your posts Roy. I’m learning so much! Thank you.
You can take the professor out of the classroom just so long, Martha!