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Mesenchymale Stamm-/Stromazellen

Therapeutisches Potenzial in der Behandlung von Autoimmunerkrankungen

Mesenchymal stem/stroma cells

Therapeutic potential in the treatment of autoimmune diseases

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Zusammenfassung

Mesenchymale Stamm- oder Stromazellen (MSC) werden zur Behandlung autoimmuner und autoinflammatorischer Prozesse propagiert. Die Gewinnung dieser Zellen ist relativ einfach aus unterschiedlichen Geweben möglich. In vitro sowie in Tiermodellen haben MSC antiinflammatorische und immunsuppressive Eigenschaften. Es liegen erste Daten zum Einsatz von MSC bei unterschiedlichen Erkrankungen vor, teils mit vielversprechenden Resultaten, wobei bislang praktisch keine Toxizität berichtet wird. Allerdings fehlen Daten aus Phase-III-Studien. Viele Fragen zur Verwendung von MSC sind aber noch nicht geklärt. Die verwendeten MSC-Präparationen sind heterogen und unterscheiden sich auch je nach Ursprungsgewebe. Es ist nicht endgültig geklärt, ob autologe (eigene) oder allogene (fremde) MSC besser für den therapeutischen Einsatz geeignet sind. Langzeitfolgen wie eine mögliche maligne Transformation und die Begünstigung des Wachstums endogener Tumoren sind nicht gänzlich ausgeschlossen. Letztlich werden diese Fragen nur über kontrollierte randomisierte Studien für definierte klinische Indikationen mit definierten MSC beantwortet werden können.

Abstract

Mesenchymal stem and stromal cells (MSC) are propagated for the treatment of autoimmune and autoinflammatory processes. These cells can be relatively easily obtained from various tissues. The MSC feature anti-inflammatory and immunosuppressive properties in vitro as well as in animal models. Initial reports on the clinical application of MSC for various diseases are available, some with promising results and so far no reported toxicity; however, data from phase III studies are still lacking and crucial questions are still unanswered. The MSC preparations used are heterogeneous and also differ depending on the source and it is unclear whether autologous (own) or allogeneic (foreign) MSC are more suitable for therapeutic use. Long-term consequences, such as possible malignant transformation and possible endogenous tumor growth stimulation cannot be completely excluded. Ultimately, these questions can only be answered through randomized controlled trials for defined clinical indications with defined MSC.

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Authors and Affiliations

  1. Institut für Transfusionsmedizin und Immunhämatologie, DRK Blutspendedienst Baden-Württemberg-Hessen GmbH, Klinikum der Goethe Universität, Sandhofstr. 1, 60528, Frankfurt/Main, Deutschland

    R. Schäfer

  2. Rheumatologische Klinik, Universitätsspital Basel, Petersgraben 4, 4031, Basel, Schweiz

    T. Daikeler

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Correspondence to T. Daikeler.

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R. Schäfer und T. Daikeler geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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J. Henes, Tübingen

I. Kötter, Hamburg

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Schäfer, R., Daikeler, T. Mesenchymale Stamm-/Stromazellen. Z Rheumatol 75, 786–794 (2016). https://doi.org/10.1007/s00393-016-0161-8

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  • DOI: https://doi.org/10.1007/s00393-016-0161-8

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