Mesenchymal Stem Cell Applications in Graft Versus Host Disease

Abstract

Allogeneic hematopoietic stem cell transplantation stands as a promising cure for a variety of diseases. However, the potential of acute or chronic graft-versus-host disease (GvHD), which leads to significant morbidity and mortality, remains a cause for concern. GvHD occurs due to the complex interactions of immune cells from the graft and the host cells. Despite the existence of prophylactic treatments, GvHD may still occur, and the resistance to conventional therapies necessitates novel approaches and treatments. Mesenchymal stem cells, which are pluripotent stem cells capable of self-renewal and multilineage differentiation, have gained attention for their low immunogenicity and ability to be sourced from various origins. They have shown promise as therapeutic tools for the cell-based treatment of inflammatory, immune-mediated, and degenerative diseases owing to their remarkable abilities in immunomodulation, immunosuppression, and tissue regeneration. In GvHD, MSCs have demonstrated therapeutic potential through paracrine activity and organelle transfer via nanotubes, microvesicles, or exosomes. The emergence of MSCs as a treatment for severe steroid-resistant GvHD gained attention in the early 2000s. While initial studies have demonstrated encouraging results in the use of MSCs for the prevention of GvHD, there is still a need for further investigation. Therefore, in this current review, we aim to delve deeper into MSC’s features and their clinical applications in the case of GvHD treatment.

Keywords

• Mesenchymal stem cell
• Hematopoietic stem cell
• Immunomodulation
• Stem cell transplantation
• Graft-versus-host disease

Graft Versus Host Hastalığı'nda Mezenkimal Kök Hücre Uygulamaları

Abstract

Allojenik hematopoetik kök hücre transplantasyonu, pek çok hastalık için umut verici bir tedavi yöntemidir. Ancak tedavinin bir komplikasyonu olabilen akut veya kronik greft-versus-host hastalığı (GvHH) mortalite ve morbidite riskini önemli ölçüde artırabilmektedir. GvHH, donörden gelen bağışıklık hücreleri ile konak hücreleri arasındaki uygunsuz immün yanıttan kaynaklanmaktadır. Profilaktik tedavilerin varlığına rağmen, GvHH hala görülebilmekte olup konvansiyonel tedavilere direnç, yeni tedavi çalışmalarının gerekliliğini ortaya koymaktadır. Mezenkimal kök hücreler (MKH), kendini yenileyebilme, farklı doku hücrelerine farklılaşma, düşük immunojenite özelliklerine sahip olup çeşitli dokulardan elde edilebilirler. İmmünomodülasyon, immünsüpresyon ve doku rejenerasyonu özelliklerinden dolayı, inflamatuar, immün aracılı, dejeneratif hastalıkların tedavisinde umut vaat etmektedirler. GvHH'de, MKH’ler, parakrin aktivite ve nanotüpler, mikroveziküller veya eksozomlar yoluyla terapötik potansiyel gösterebilmektedirler. Steroid tedavisine dirençli GvHH'nin tedavisi için MKH’ler 2000'lerin başında kullanılmaya başlanmış olup, yapılan çalışmalar MKH’lerin etkili bir teröpötik araç olduğunu göstermiştir, ancak daha fazla araştırmaya ihtiyaç duyulmaktadır. Bu derlemede MKH'lerin özelliklerini ve GvHH tedavisindeki klinik uygulamalarını incelemeyi amaçladık.

Keywords

• mezenkimal kök hücre
• graft versus host hastalığı
• kök hücre nakli
• hematopoetik kök hücre
• immunmodülasyon

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