Autologous stromal vascular fraction cells: a tool for facilitating tolerance in rheumatic disease.
Since the days of Medawar, the goal of therapeutic tolerogenesis has been a "Holy Grail" for immunologists. While knowledge of cellular and molecular mechanisms of this process has been increasing at an exponential rate, clinical progress has been minimal. To provide a mechanistic background of tolerogenesis, we overview common processes in the naturally occurring examples of: pregnancy, cancer, oral tolerance and anterior chamber associated immune deviation. The case is made that an easily accessible byproduct of plastic surgery, the adipose stromal vascular fraction, contains elements directly capable of promoting tolerogenesis such as T regulatory cells and inhibitory macrophages. The high content of mesenchymal and hematopoietic stem cells from this source provides the possibility of trophic/regenerative potential, which would augment tolerogenic processes by decreasing ongoing inflammation. We discuss the application of this autologous cell source in the context of rheumatoid arthritis, concluding with some practical examples of its applications.
Ichim
Thomas E
TE
Medistem Inc., San Diego, CA, USA. thomas.ichim@gmail.com
Harman
Robert J
RJ
Min
Wei-Ping
WP
Minev
Boris
B
Solano
Fabio
F
Rodriguez
Jorge Paz
JP
Alexandrescu
Doru T
DT
De Necochea-Campion
Rosalia
R
Hu
Xiang
X
Marleau
Annette M
AM
Riordan
Neil H
NH
D000273:Adipose Tissue / Q000473:pathology* / Q000601:surgery / Q000637:transplantation; D000368:Aged; D000818:Animals; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D001323:Autoantibodies / Q000096:biosynthesis / Q000097:blood / Q000235:genetics; D002478:Cells, Cultured; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007596:Joints / Q000378:metabolism / Q000473:pathology*; D015187:Lipectomy; D059630:Mesenchymal Stem Cells / Q000276:immunology; D009043:Motor Activity; D010456:Peptides, Cyclic / Q000276:immunology; D012217:Rheumatoid Factor / Q000096:biosynthesis / Q000097:blood / Q000235:genetics; D055153:Stem Cell Niche; D017154:Stromal Cells / Q000473:pathology* / Q000637:transplantation; D050378:T-Lymphocytes, Regulatory / Q000276:immunology
D001323:Autoantibodies; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D012217:Rheumatoid Factor