Renewing the T cell repertoire to arrest autoimmune aggression.
There is now evidence that high-dose immune ablation and autologous hematopoietic stem cell transplantation in humans triggers a reconstitution program that leads to the comprehensive renewal of the T cell repertoire. We argue here that several features of this program help to explain how autologous hematopoietic stem cell transplantation can induce long-term clinical remission from organ-specific-, as well as systemic, autoimmune diseases. We propose a model envisioning a coordinated sequence of events, rebuilding an immune system that is competent against infection but that is substantially reconfigured in a way that is less likely to redevelop autoimmunity.
Muraro
Paolo A
PA
Neuroimmunology Branch, NINDS/NIH, Bldg. 10, Room 5B16, 10 Center Drive, MSC1400, Bethesda, MD 20892-1400, USA. murarop@ninds.nih.gov
Douek
Daniel C
DC
D000818:Animals; D001327:Autoimmune Diseases / Q000276:immunology; D015551:Autoimmunity / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D013601:T-Lymphocytes / Q000166:cytology* / Q000276:immunology*; D013950:Thymus Gland / Q000166:cytology / Q000276:immunology; D014184:Transplantation, Homologous / Q000276:immunology