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Tolerising Cellular Therapies: What Is Their Promise for Autoimmune Disease?

Lookup NU author(s): Dr Chijioke Mosanya, Professor John IsaacsORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

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.

Publication metadata

Author(s): Mosanya CH, Isaacs JD

Publication type: Review

Publication status: Published

Journal: Annals of the Rheumatic Diseases

Year: 2019

Volume: 78

Issue: 3

Pages: 297-310

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

URL: https://doi.org/10.1136/annrheumdis-2018-214024

DOI: 10.1136/annrheumdis-2018-214024

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