Thursday, April 19, 2007

Mixed Chimerism autoimmune "cure" in the news

Below is an article describing a procedure that established a mixture of donor and patient bone marrow living together in the bones of autoimmune patients.

A few healthy bone marrow cells were added in a ‘gentle’ fashion to the bone marrow of autoimmune patients. While the donor cells lived, the autoimmune disease was cured.

Remember: all autoimmune disease is bone marrow disease; fix the bone marrow, fix the disease.

‘Gentle’ bone marrow transplants with ‘gentle’ treatments to make recipient bone marrow ready for adding bone marrow from a donor were done on patients with two seemingly very different autoimmune diseases—Pemphigus (blistered skin) and SLE (lupus).

“Gentle” means establishing some bone marrow donor cells mixed in among a patient’s bone marrow in a way that has fewer complications and deaths. This method results in far fewer problems compared to the traditional bone marrow transplant which is ‘harsh.’ Traditional bone marrow transplant means a complete destruction and replacement of patient’s bone marrow.

Pemphigus patients maintained both their own bone marrow cells and the donor’s bone marrow cells inside their bones. The two grew happily together for the over four years that follow up studies were done. The extra bone marrow cells from the donor cured the Pemphigus patients. Apparently they are still cured as you read this. Can anyone say life time cure?

Lupus patients were not able to maintain the donated cells in their bone marrow. When the donor cells died, their lupus came back. While the donor cells lived, the lupus was cured.

If the donor cells could be maintained, lupus could stay cured. (see my previous post on Dr. Ildstad and her amazing 'facilitating cells'. Yes, there is hope for a mixed chimerism cure for you, no matter your autoimmune disease if Dr. Ildstad is correct.)

Wouldn't you like to see massive testing of her technique. I would love to see my son run again.

What can you do today to make those cures happen now not later? Perhaps this partial list of things to think about doing might give you an idea or two.
Call the NIH demand more funding for an expansion of Dr. Ildstad to all autoimmune disease. Call the FDA demand loosing the rules for human clinical trials. Demand they fund clinical trials of potential new cures on a massive scale.
Call your US senator or US Representative and demand action from the NIH and FDA.

What are you willing to do now for a possible life-time cure?

Note: sorry no B cell cures blog today. I am having carpal tunnel issues. The B cell cures blog will be a lot of typing.

Key words for understanding article below:
Nonmyeloablative= “gentle” the patient’s original bone marrow is not completely destroyed. As opposed to myeloablative where it is totally destroyed and then replaced
Hematopoietic stem cell transplant (HSCT)= bone marrow cells from another person
Lymphohematopoietic=tissue which makes both the blood and lymph system [related to blood system, It is a series of “tubes” in your body carrying clear fluid (similar to fluid in blister)]
Chimerism=tissues of two different ‘animals’ mixed together

URL or
Transplant Proc, Vol 39, pp703-708, 2007
REVIEW: Hematopoietic Stem Cell Transplantation in Autoimmune Diseases: The Ahmedabad ExperienceVanikar AV, et al
Autoimmune disease represents a (AD) breakdown of natural tolerance against autoreactive antigens leading to a high mortality and morbidity. The reaction is usually polyclonal; T- and B-cell components of the hematopoietic system are responsible for disease progression. Allogeneic/autologous hematopoietic stem cell transplantation (HSCT) are the current modalities for treating drug-resistant AD.

Patients and Methods
We present a single-center retrospective evaluation of allogeneic HSCT with nonmyeloablative, low-intensity conditioning in nine patients (five males, four females) with pemphigus vulgaris (PV) and 27 patients with systemic lupus erythematosus (SLE; 3 males, 24 females). The mean follow-up period was 4.24 years for PV and 4.9 years for SLE. Cytokine-mobilized HSC from unmatched related donors, with mean dose of 21.3 × 108 nucleated cells/kg body weight (BW; mean CD34+ count, 6 × 106/kg BW) was administered in to the thymus as well as the portal and peripheral circulations of recipients. Cyclosporine (4 ± 1 mg/kg BW per day) and prednisolone (10 mg/kg BW per day) were administered for 6 months to protect mixed chimerism. A subset of patients with cross-gender donors were analyzed for peripheral blood chimerism at 1 month post-HSCT and every 3 months thereafter.

Sustained clinical remission with peripheral lymphohematopoietic chimerism of 0.7 ± 0.3% was observed in PV, whereas SLE relapsed after mean of 7.35 months of disease-free interval associated with fall in chimerism from 5 ± 3% to ≤0.08 ± 0.03%.

HSCT was effective to achieve early clinical remission of PV; and in SLE relapsed after a 7.35-month disease-free interval accompanied by a fall in mixed lymphohematopoietic chimerism.

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