Tolerance regeneration by T regulatory cells in autologous haematopoietic stem cell transplantation for autoimmune diseases


Autologous haematopoietic stem cell transplantation shows increasing promise as a therapeutic option for patients with treatment-refractory autoimmune disease, particularly systemic sclerosis and multiple sclerosis. However, this intensive chemotherapy-based procedure is not always possible due to potential treatment toxicities and comorbidities. The biological mechanisms of how this procedure induces long-term remission in autoimmune disease are increasingly understood. The focus of this review is on recent research findings on the role of CD4+ T regulatory cells (Tregs) in resetting the immune system leading to the eradication of the autoimmune disease after transplantation. Discovery of the precise mechanisms of this process will allow development of novel Treg-based therapies and thus avoid the need for intensive chemotherapy-based treatment for these autoimmune diseases in the future.

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KH is supported by a scholarship from the National Health and Medical Research Council. JM, DDFM and MV are supported by the St Vincent’s Foundation Clinic Grant, Reset Australia, SVH Haematology Research Fund, Maple-Brown Family Foundation, John Kirkpatrick Family Foundation, Medich Family Foundation and NSW Health Australia.

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Correspondence to John J. Moore.

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DDFM receives a research grant from Phebra Pty Ltd outside of submitted work. The remaining authors declare that they have no conflict of interest.

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Hendrawan, K., Visweswaran, M., Ma, D.D.F. et al. Tolerance regeneration by T regulatory cells in autologous haematopoietic stem cell transplantation for autoimmune diseases. Bone Marrow Transplant (2019).

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