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Lookup NU author(s): Dr Chijioke Mosanya,
Professor John IsaacsORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
The current management of autoimmunity involves the administration of immunosuppressive drugs coupled to symptomatic and functional interventions such as anti-inflammatory therapies and hormone replacement. Given the chronic nature of autoimmunity, however, the ideal therapeutic strategy would be to re-induce self-tolerance before significant tissue damage has accrued. Defects in, or defective regulation of, key immune cells such as regulatory T cells, have been documented in several types of human autoimmunity. Consequently, it has been suggested that the administration of ex vivo generated, tolerogenic immune cell populations could provide a tractable therapeutic strategy. Several potentially tolerogenic cellular therapies have been developed in recent years; concurrent advances in cell manufacturing technologies promise scalable, affordable interventions if safety and efficacy can be demonstrated. These therapies include mesenchymal stromal cells, tolerogenic dendritic cells and regulatory T cells. Each have advantages and disadvantages, particularly in terms of the requirement for a bespoke vs an ‘off-the-shelf’ treatment but also their suitability in particular clinical scenarios. In this review we examine the current evidence for these three types of cellular therapy, in the context of a broader discussion around potential development pathway(s), and their likely future role. A brief overview of preclinical data is followed by a comprehensive discussion of human data.
Author(s): Mosanya CH, Isaacs JD
Publication type: Review
Publication status: Published
Journal: Annals of the Rheumatic Diseases
Print publication date: 01/03/2019
Online publication date: 02/11/2018
Acceptance date: 06/10/2018
ISSN (print): 0003-4967
ISSN (electronic): 1468-2060