Promising Therapy for Lupus Nephritis Based on Stem Cell Transplantation

A recent study published in the journal Cell Transplantation revealed encouraging data on animal models for stem cell transplantation as a therapy for systemic lupus erythematosus (SLE). The study was led by researchers at the Hanyang University in Korea and is entitled “Infusion of human bone marrow-derived mesenchymal stem cells alleviates autoimmune nephritis in a lupus model by suppressing follicular helper T cell development”.

SLE, commonly referred to as lupus, is a severe autoimmune disease in which the body’s own immune system overreacts and attacks through autoantibodies healthy joints and organs, resulting in inflammation, swelling, pain, disability and often in tissue destruction in multiple organs. When the immune system attacks the kidney in lupus patients, the organ suffers inflammation, a process also called nephritis. Lupus nephritis is a severe complication affecting approximately 60% of the SLE patients. When left untreated, it can lead to long-term damage and even kidney failure with consequent need for dialysis.

It is known that the bone marrow generates mesenchymal stem cells (MSCs), which are capable of counteracting the effects caused by an overreaction of the immune system. In the study, researchers analyzed the impact of human bone marrow derived MSCs (hBM-MSCs) in a rodent SLE model.

Researchers found that infusion of hBM-MSCs into SLE rodent models decreased the levels of autoantibodies, reduced inflammation, mitigated glomerulonephritis (kidney disease) and improved survival. This therapy was also found to decrease the levels of follicular helper T cells (Tfh), cells that are involved in the generation of harmful lupus autoantibodies. The team reported that hBM-MSCs directly suppressed the differentiation of naive CD4+ T cells into Tfh cells.

“SLE can be refractory to traditional treatments and be life threatening, especially when major organs are invaded” explained the study’s senior author Dr. Jeehee Youn in a news release. “Our study suggests that MSCs suppress the development of cells that help activate the immune components.”

The research team concluded that MSCs represent a promising therapy for the attenuation of lupus nephritis and other autoimmune diseases, most likely through the suppression of Tfh cells’ development. “The immodulatory potential of MSCs, along with their low immunogenicity, seems to offer a promising treatment for severe refractory autoimmune diseases,” concluded Dr. Youn.

“Though the survival rate for patients diagnosed with SLE is improving, there is still no cure and risk of fatality is still a concern. Currently, the disease is treated by immunosuppression, achieved by the administration of immunosuppressants that can cause deleterious side effects,” noted the section editor for Cell Transplantation, Dr. Maria Carolina de Oliveira Rodrigues. “Stem cell therapy is an attractive treatment option in that it is associated with fewer side effects than pharmacotherapy and, as the researchers suggested, it may actually slow the progression of the disease rather than merely alleviate symptom severity. Before transplantation of MSCs or any other type of cell therapy can be implemented in medical practice, further studies should evaluate whether the risk of immune rejection of the cells, if not autologous, would necessitate concomitant treatment with immunosuppressants.”