October 25, 2024, Immune Tolerance
Immune tolerance has always been a major research challenge and goal.
A few months ago, the journal Stem Cells Translational Medicine reported the case of an Italian kidney transplant recipient who received an autologous mesenchymal stem cell infusion to induce immune tolerance; the transplanted organ was fully tolerated for 18 months after gradually reducing and discontinuing immunosuppressive drugs. The study described a 37-year-old man with IgA nephropathy who progressed to end-stage renal disease and underwent a living donor kidney transplant in October 2010; he also participated in a pilot study evaluating the safety and feasibility of infusing ex vivo-expanded autologous bone marrow mesenchymal stem cells prior to transplantation. The day before the transplant, the patient received an infusion of autologous bone marrow mesenchymal stem cells and was treated with a low-dose intravenous infusion of rabbit anti-human thymocyte immunoglobulin for six days post-transplant. The patient’s kidney function recovered and remained stable following the transplantation. A kidney biopsy revealed no evidence of clinical rejection. The patient’s immunosuppressant dosage was gradually tapered until complete discontinuation. At the time of the report, the patient had been free of immunosuppressants for 18 months and maintained normal kidney function.
This study provides evidence of mesenchymal stem cells’ effectiveness in addressing organ rejection in living donor kidney transplantation; autologous bone marrow mesenchymal stem cells are linked to post-transplant safety, complete withdrawal of immunosuppressive drugs, and eventual immune tolerance, offering new insights into the underlying mechanisms. Although the study was limited to a single patient, the researchers are confident that the observed post-transplantation phenomenon can be attributed to the sustained tolerogenic environment fostered by mesenchymal stem cell therapy. The infused mesenchymal stem cells may exhibit long-term immunosuppressive and tolerogenic activity, potentially through the release of extracellular vesicles, which persist even after the mesenchymal stem cells are no longer present.
Numerous basic experimental studies have demonstrated that mesenchymal stem cells significantly influence the regulation of immune cell function, establishing a solid theoretical foundation for using mesenchymal stem cells to treat organ transplantation rejection. It is believed that the application of mesenchymal stem cell therapy in transplantation will mature in the future.
Notice: Our survey on the importance of immunosuppressant adherence among kidney transplant patients is ongoing. We warmly welcome your active participation. If you have any questions about immunosuppressants, you can leave a comment at the end of the questionnaire, and we will respond periodically via WeChat posts.
Click on the image, scan the QR code below to participate in the survey, and thank you for your cooperation.
References:
Casiraghi F, Perico N, Gotti E, et al. Kidney transplant tolerance associated with remote autologous mesenchymal stromal cell administration[J]. Stem Cells Translational Medicine, 2020, 9(4): 427-432.
Written by | Zhuo Ran, Illustrations | Zou Juan
This article is an original publication of the “Kidney Transplantation, Zhongshan Hospital, Fudan University” WeChat public account. Reproduction requires authorization from this account and the original author, with proper attribution. To care for your kidneys, begin by following the “Kidney Transplantation, Zhongshan Hospital, Fudan University” WeChat public account. You can also click [Read the Original] to explore Soybeans and Their Products: Do Kidney Patients Really Know How to Eat Them?
