Stem Cell Therapy for Lupus
Systemic lupus erythermatosus, often abbreviated to SLE or lupus, is a chronic systemic autoimmune disease (or autoimmune connective tissue disease) that can affect any part of the body. As occurs in other autoimmune diseases, the immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage. SLE most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system. The course of the disease is unpredictable, with periods of illness (called flares) alternating with remissions. The disease occurs nine times more often in women than in men, especially women in child-bearing years ages 15 to 35, and is more common in those of non-European descent.  
In SLE, the body’s immune system produces antibodies against itself, particularly against proteins in the cell nucleus. SLE is triggered by environmental factors that are unknown.
“All the key components of the immune system are involved in the underlying mechanisms [of SLE]” according to Rahman, and SLE is the prototypical autoimmune disease. The immune system must have a balance (homeostasis) between being sensitive enough to protect against infection, and being too sensitive and attacking the bodies own proteins (autoimmunity). From an evolutionary perspective, according to Crow, the population must have enough genetic diversity to protect itself against a wide range of possible infection; some genetic combinations result in autoimmunity. The likely environmental triggers include ultraviolet light, drugs, and viruses. These stimuli cause the destruction of cells and expose their DNA, histones, and other proteins, particularly parts of the cell nucleus. Because of genetic variations in different components of the immune system, in some people the immune system attacks these nuclear-related proteins and produces antibodies against them. In the end, these antibody complexes damage blood vessels in critical areas of the body, such as the glomeruli of the kidney; these antibody attacks are the cause of SLE. Researchers are now identifying the individual genes, the proteins they produce, and their role in the immune system. Each protein is a link on the autoimmune chain, and researchers are trying to find drugs to break each of those links. 
SLE is treated by addressing its symptoms by, mainly with cyclophosphamide, corticosteroids and immunosuppressants; there is currently no cure. SLE can be fatal, although with recent medical advances, fatalities are becoming increasingly rare. Survival for people with SLE in the United States, Canada, and Europe is approximately 95% at five years, 90% at 10 years, and 78% at 20 years.
The approach of treating the symptoms exclusively and primarily by utilizing drugs has been the mainstay in medical therapies for years. With the many new findings in stem cell research the autoimmune components of SLE may be reset or adequately modified to modulate this disorder. Some of the newer studies are presented below. The resetting of immune functions is also found in many of the other stem cell treatments of autoimmune diseases, which we encourage you to review.
Autologous Stem-Cell Transplant Phases :
After a review of your medical records and discussions with medical staff, a protocol is designed especially for you. Specifics of your condition are addressed along with any special needs. It may be similar to the one illustrated below:
At the clinic you will be examined by our physicians. Information including any risks and expectations concerning your treatment, plus answers to any questions you may have will be addressed. A blood draw, to determine cell counts and other chemistries will be collected and cell expansion medication may be administered. Then you will return to your hotel for a restful day or a good nights sleep.
At the clinic our physician/s will review the laboratory results, determine if the cell count is within range, and discuss the response to the stimulation. They may or may not provide additional cell expansion medications and may add adjunctive treatments. The levels of your response will determine if you would return to the hotel, with little restriction on your activities, or possibly go forward with harvesting and processing your cells.
If the cell count and viability is appropriate for harvest either a bone marrow or adipose collection will be utilized. We typically use local anesthetics for adults and general anesthesia for youngsters. The entire procedure normally takes less than 30 minutes. Although some pain is felt when the needle is inserted, most patients do not find the bone marrow or adipose collection procedure particularly painful.
We recently placed a number of videos on our website interviewing our patient’s who discuss the procedure and their lack of discomfort.
After the collection you may return to the hotel, with some restrictions. The bone marrow or adipose collected is processed in our contract State-Of-Art laboratory by trained staff, under the supervision of the lab physician.
As an alternative to the above, cord blood may be used based on the patient’s individual medical condition and options.
At the clinic or at the hospital you will be treated by IV infusion and/or a lumbar puncture, which injects the stem cells into the cerebrospinal fluid. This route transports the cells into the spinal canal and the brain directly influencing the nervous systems, thereby eliminating the brain/blood barrier. If a lumbar puncture is performed, the patient will be required to restrict their activities and potentially spend the day in the hospital or at their hotel.
At the clinic or hospital the patient will receive a post-treatment examination and evaluation prior to their release. Additional therapy and treatments may also be utilized to maximize the placement and activities of the procedure.
Day 6: Optionally there may be the use of additional ancillary therapies to enhance the procedure.
What makes our treatment different ?
Our approach includes stimulation, prior to collection, processing and expansion of the cell along with the use of growth factors, together with an integrated medical approach. This maximizes the growth and implantation potentials yielding optimized potentials of making changes in your disease.
Our staff physicians are all board certified, in their field with years of experience. Your team includes both primary and ancillary care professionals devoted to maximizing your benefits from the procedures. We enroll you in an open registry to track your changes independently, for up to 20 years.
As our patient we also keep you abreast of the newest developments in stem cell research. This is an ongoing relationship to maintain and enhance your health.
Our promise is to provide you with travel and lodging support, access to bilingual staff members throughout the entire process and most importantly the best medical care possible.
References and Articles:
Stem Cells. 2009 Jun;27(6):1421-32. doi: 10.1002/stem.68.
Mesenchymal stem cell transplantation reverses multiorgan dysfunction in systemic lupus erythematosus mice and humans.
Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that, despite the advances in immunosuppressive medical therapies, remains potentially fatal in some patients, especially in treatment-refractory patients. Here, we reported that impairment of bone marrow mesenchymal stem cells (BMMSCs) and their associated osteoblastic niche deficiency contribute in part to the pathogenesis of SLE-like disease in MRL/lpr mice. Interestingly, allogenic BMMSC transplantation (MSCT) is capable of reconstructing the bone marrow osteoblastic niche and more effectively reverses multiorgan dysfunction when compared with medical immunosuppression with cyclophosphamide (CTX). At the cellular level, MSCT, not CTX treatment, was capable to induce osteoblastic niche reconstruction, possibly contributing to the recovery of regulatory T-cells and reestablishment of the immune homeostasis. On the basis of the promising clinical outcomes in SLE mice, we treated four CTX/glucocorticoid treatment-refractory SLE patients using allogenic MSCT and showed a stable 12-18 months disease remission in all treated patients. The patients benefited an amelioration of disease activity, improvement in serologic markers and renal function. These early evidences suggest that allogenic MSCT may be a feasible and safe salvage therapy in refractory SLE patients.
Stem Cell Infusions Reverse Lupus Complications
Songtao Shi, associate professor at the USC School of Dentistry Published on Mar 19, 2009 Stem Cells
In all of the patients, organ function improved greatly, with two patients lessening their dosages of immunosuppressive drugs to low maintenance levels, and the other two stopping their immunosuppression regimen entirely. Short-term follow-up at 18 months post-mesenchymal stem cells infusion indicated no problems with either organ function or reactions to the transplanted cells, Shi said.
“Neurotoxic lupus autoantibodies alter brain function through two distinct mechanisms”
Thomas W. Faust, Eric H. Chang, Czeslawa Kowal, RoseAnn Berlin, Irina G. Gazaryan, Eva Bertini, Jie Zhang, Jorge Sanchez-Guerrero, Hilda Fragoso-Loyo, Bruce T. Volpe, Betty Diamond, and Patricio T. HuertaImmunology
Self-generated antibodies could explain neurological symptoms of lupus
Some patients with the autoimmune disorder systemic lupus erythematosus (SLE) suffer neurological symptoms, which range from emotional imbalance and anxiety to cognitive impairment and psychosis. Previous research has tied the onset of neurological symptoms in some patients to high levels of self-generated antibodies against the NMDA receptor (NMDAR)—which is involved in synaptic transmission in the brain—in the patients’ cerebrospinal fluid. To determine how antibodies against the receptor produce neurological symptoms of SLE, Thomas Faust et al. tested the effect of mouse and human antibodies that bind to subunits of the receptor on slices of mouse hippocampus in the laboratory. At low concentration the antibodies activated the receptor, enhancing its synaptic excitatory potential above normal, the authors found. At high concentration the antibodies caused neuronal death by triggering irreversible swelling and collapse of the cells’ mitochondria. Further, the level of NMDAR-reactive antibodies in the cerebrospinal fluid of different patients with SLE corresponded to that required to cause synaptic changes or mitochondrial defects, the authors report. The findings suggest that the level of NMDAR-reactive antibodies and their ability to reach the brain across the blood–brain barrier might determine the severity and duration of the neurological symptoms in patients with SLE, according to the authors.
Comment: We use cognitive testing with many of the autoimmune disease patients and now hav a mechanism to address these unsettling findings.
Immunosuppression by mesenchymal stem cells: mechanisms and clinical applications
Soufiane Ghannam, Carine Bouffi, Farida Djouad, Christian Jorgensen and Danièle Noël
|Published:||15 March 2010|
© 2010 BioMed Central Ltd
Overall, the current data indicate that MSCs represent a promising alternative strategy in the treatment of various immune-mediated diseases. Encouraging results have already been obtained from the clinics. Many questions remain to be addressed, however, in order to provide better ways to control and optimize the immune response for the benefit of the patient. This implies a better understanding of the underlying mechanisms of immunosuppression as well as satisfying safety concerns as regards the in vivo survival, formation of ectopic tissue and malignant transformation.
Comment: This review article highlights some of the mechanisms and is an excellent piece to consult along with our index of 178 other articles on autoimmune function and stem cell therapy.