hope aganist lupus

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Stem cell transplants offer hope against lupus
21:00 31 January 2006
NewScientist.com news service
Roxanne Khamsi

Scientists claim that they have achieved landmark success with an experimental approach, using a patient?s own stem cells, to fight the life-threatening autoimmune disease lupus.

The treatment substantially improved the condition of about half of the lupus patients, all of whom had stopped responding to standard therapy. But the treatment still carries real risks and medical experts caution against calling it a cure.

The study offers ?a potential ray of hope? for lupus sufferers who do not respond to standard measures, says Duane Peters at the Lupus Foundation of America. ?We hope to see a follow-up study that can determine whether this treatment is superior to other aggressive types of care and to compare the safety of these alternatives,? he adds.

Systemic lupus erythematosus is an autoimmune disorder in which patients? immune cells start attacking their own tissues. Symptoms range from joint pains to organ failure. Doctors have tried treating the disease with drugs that suppress the immune system, but not all patients respond to such medications.

High-dose chemotherapy
Richard Burt of the Northwestern School of Medicine in Chicago, US, and his colleagues recruited 50 people with severe lupus for which standard treatment had failed.

In an attempt to ?reset? the immune system, researchers first harvested and separated bone marrow stem cells from the patient?s own blood. These cells develop into immune cells.

The next step of the process ? called autologous hematopoietic stem cell transplantation, or HSCT ? involved intensive chemotherapy sessions. This high-dose chemotherapy destroys a person?s immune response and requires hospitalisation to avoid catching any viruses or bugs during this vulnerable period.

Next, medical experts reintroduced the patient?s immune cells into their body intravenously. Only 48 of the 50 participants in the study made it to this step ? one died of the illness itself before beginning HSCT and another died due to complications following the first step of the procedure.

Mortality rate
Once returned to the body, the stem cells repopulated the bone marrow and reform a functioning immune system. According to Burt, the transplanted stem cells can avoid developing into cells with dangerous autoimmune traits because their genes do not necessarily predetermine the disease.

Of the patients who received this full treatment, the overall five-year survival was 84% and the probability of disease-free survival during those five years was 50%.

This is not the first time that researchers have attempted HSCT therapy to fight lupus. A European trial published in 2004 reported similar levels of remission, but it also involved a much higher treatment-related mortality rate of 13%. The new study reports a treatment-related mortality rate of 2%.

Burt and his colleagues attribute their success to a careful adaptation of the chemotherapy ? typically used for cancer patients ? to meet the specific needs of people with lupus. The team says that these preliminary results provide the justification for a randomised trial to compare HSCT for lupus with standard treatment.

 

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Rheunatic diseases

New Hope for Tissue Regeneration and Joint Repair
Study Indicates Therapeutic Promise of Adult Human Multipotent Stem Cells Derived from the Thick Membrane Covering the Surface of Bones

Inflammation, cartilage and bone erosions, joint destruction?that?s the typical progression of arthritis and most rheumatic diseases. While inflammation may be controlled, and perhaps even eliminated, with early aggressive treatment, few therapeutic approaches offer hope for repairing tissue once the damage has been done. One promising strategy is the use of mesenchymal stem cells (MSCs). MSCs are capable of extensive self-renewal and adaptable to forming all kinds of connective tissues. While detected in several adult human tissues, MSCs have traditionally been obtained from bone marrow, an invasive, painful, and costly process.

Researchers in the United Kingdom and Belgium set out to investigate the characteristics of cells in the periosteum, the dense membrane at the boundary between the bone and the surrounding soft tissues. Their study, featured in the April 2006 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), is the first to identify periosteal cells as MSCs, with multipotent properties at the single cell level and the potential to regenerate cartilage, muscle, and bone in patients with inflammatory and degenerative rheumatic diseases.

Samples of periosteal cells were obtained from the tibia of 12 human donors, ranging in age from 24 to 83 years. Following enzymatic release and culture expansion, cell populations were tested for telltale markers of MSCs, as well as for their growth and differentiation potential. To assess their multipotency beyond the laboratory, the periosteal cells were then injected into one of three animal models: mice, with the goal of muscle regeneration; goats, with the goal of developing cartilage; and mice, with the goal of bone formation.

Regardless of donor age, periosteal cells expanded extensively, steadily maintaining growth curves over at least 30 population doublings. They also displayed the hallmarks of MSCs, including long telomeres, the sections of DNA at the end of a chromosome. What?s more, the results of the animal experiments proved that expanded periosteal MSCs can contribute to muscle regeneration and form cartilage when implanted into a joint surface defect. The bone tissue retrieved from the last group of mice was partly human, which indicates the potential of these cells to build bone as well.

?Like MSCs derived from bone marrow, periosteal MSCs rapidly adhere to plastic and can be expanded for several passages, preserving their multipotency,? notes study leader Dr. Cosimo De Bari, an MRC clinician scientist and consultant rheumatologist at King?s College London, UK. ?A small periosteal biopsy represents a relatively easily accessible source of MSCs.?

This groundbreaking study calls attention to the need for more research into MSCs?in the periosteum and other tissues?and their practical therapeutic benefits for late-stage arthritis sufferers.

 

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sct eliminates lupus

Stem Cell Treatment Eliminates Lupus
A Huge Step Forward
June 5 - KGO - We've all heard a lot about the promise of stem cells in medicine. Now researchers say they have taken a huge step forward, using a type of these cells to treat a devastating disease. Surprisingly, the cells are taken directly from the patient.

Edjuana can once again enjoy shopping after beating lupus. She battled the disease for more than a decade.

Edjuana Ross, lupus patient: "Extreme joint pain, and every single day, sick and tired."

Lupus attacked her immune system and scarred her face. It damaged her heart and caused three strokes.

The treatment was almost as hard as the disease. Cortisone caused her to gain 100 pounds.

Edjuana Ross, lupus patient: "It took a lot for me just to get out of bed."

Edjuana's doctor, Richard Burt, recommended an adult stem-cell transplant. The goal was to fix her immune system.

Richard Burt, MD, immunotherapist: "What we're doing is rebooting the computer. So the computer's gone on the blitz. And we've rebooted it, and now it's working."

First, patients have blood removed to harvest the stem cells. Next, chemotherapy destroys the existing, broken immune system. Patients are then given stem cells to build a new immune system.

Richard Burt, MD, immunotherapist: "The patients we've treated, many of them have their lives back."

In Dr. Burt's study, about half of patients who have the procedure are now lupus-free. Edjuana is one of them.

Edjuana Ross, lupus patient: "It changed my life and it made my life better, and it made me appreciate a lot of other things."

Slimmed down and feeling better, Edjuana is now looking forward to her future -- one free of lupus.

The treatment is now being tested in individuals with other diseases, like MS and diabetes. However, there are risks, including possible blood transfusions, infection, nausea, and an effect on fertility. So it should be weighed very carefully.

This was a small study of only 50 patients. Now the goal is to expand the research to more patients and other diseases