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Mesenchymale Stammzelltherapie bei Autoimmunerkrankungen

Mesenchymal stem cell treatment in autoimmune diseases

  • Leitthema
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Zeitschrift für Rheumatologie Aims and scope Submit manuscript

Zusammenfassung

Mesenchymale Stroma- oder Stammzellen (MSC) besitzen starke immunmodulierende Eigenschaften. Durch ihr großes Potenzial zur Differenzierung in verschiedene Zellformen sind sie zudem in der Lage, die Reparatur von Gewebeschäden in Gang zu setzen. Bei einer Reihe von rheumatischen Erkrankungen haben sich in vitro Einschränkungen der MSC-Funktion darstellen lassen, auch wenn die Bedeutung dieser Phänomene für die Pathogenese jener Krankheiten nicht abschließend geklärt ist. Dennoch könnte v. a. die allogene, möglicherweise auch die autologe MSC-Transplantation (MSCT) ein interessantes Instrument für die Therapie schwerer rheumatologischer Autoimmunerkrankungen darstellen. Erste klinische Studien haben positive Effekte bei systemischem Lupus erythematodes, der systemischen Sklerodermie, dem Sjögren-Syndrom und anderen Erkrankungen des rheumatischen Formenkreises berichtet. Allerdings sind die Fragen nach der langfristigen Wirkung und Sicherheit ebenso unbeantwortet wie die Frage nach der besten Quelle von MSC, der optimalen Kultivierungstechnik und der effektivsten Applikationsart.

Abstract

Mesenchymal stromal or stem cells (MSC) possess strong immunomodulatory properties. Due to their impressive potential to differentiate into various cell types they are capable of inducing mechanisms of tissue repair. Experimental data have demonstrated impaired MSC function in several rheumatic diseases in vitro; however, the relevance of these phenomena for the pathogenesis of rheumatic disorders has not been convincingly demonstrated. Nevertheless, allogeneic MSC transplantation (MSCT), and possibly autologous MSCT as well, could prove to be an interesting instrument for the treatment of autoimmune rheumatic diseases. The first clinical trials have demonstrated positive effects in systemic lupus erythematosus, systemic sclerosis and Sjogren’s syndrome; however, questions regarding the long-term benefits and safety as well as the best source, the optimal cultivation technique and the most effective way of application of MSC are still unanswered.

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  1. Department für Innere Medizin, Klinik für Innere Medizin II, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland

    Gernot Keyßer

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Keyßer, G. Mesenchymale Stammzelltherapie bei Autoimmunerkrankungen. Z Rheumatol 79, 437–445 (2020). https://doi.org/10.1007/s00393-020-00790-7

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