Un nuovo studio (vedi QUI) condotto da ricercatori SM in tre principali centri canadesi farebbe capire perché il trapianto di midollo osseo (BMT) ha risultati positivi nei pazienti con forme particolarmente aggressive di SM. Il trapianto, che viene eseguito nell'ambito di uno studio clinico che comporta dei rischi potenzialmente gravi, ferma praticamente tutte le nuove attività recidivanti come osservato dopo l'esame clinico e scansioni del cervello con RM. Lo studio rivela come cambia il sistema immunitario come risultato del trapianto. Specificamente, un sottoinsieme di cellule T nel sistema immunitario conosciuto come cellule Th17, riducono la loro attività dopo il trattamento.
Fonte: www.ccsviitalia.org
Objective
To define changes in phenotype and functional responses of reconstituting T cells in patients with aggressive multiple sclerosis (MS) treated with ablative chemotherapy and autologous hematopoietic stem cell transplantation (HSCT).
Methods
Clinical and brain magnetic resonance imaging measures of disease activity were monitored serially in patients participating in the Canadian MS HSCT Study. Reconstitution kinetics of immune-cell subsets were determined by flow cytometry, whereas thymic function was assessed using T-cell receptor excision circle analyses as well as flow cytometry measurements of CD31+ recent thymic emigrants (RTEs). Functional assays were performed to track central nervous system–autoreactive antigen-specific T-cell responses, and the relative capacity to generate Th1, Th17, or Th1/17 T-cell responses.
Results
Complete abrogation of new clinical relapses and new focal inflammatory brain lesions throughout the 2 years of immune monitoring following treatment was associated with sustained decrease in naive T cells, in spite of restoration of both thymic function and release of RTEs during reconstitution. Re-emergence as well as in vivo expansion of autoreactive T cells to multiple myelin targets was evident in all patients studied. The reconstituted myelin-specific T cells exhibited the same Th1 and Th2 responses as preablation myelin-reactive T cells. In contrast, the post-therapy T-cell repertoire exhibited a significantly diminished capacity for Th17 responses.
Interpretation
Our results indicate that diminished Th17 and Th1/17 responses, rather than Th1 responses, are particularly relevant to the abrogation of new relapsing disease activity observed in this cohort of patients with aggressive MS following chemoablation and HSCT. ANN NEUROL 2012;
To define changes in phenotype and functional responses of reconstituting T cells in patients with aggressive multiple sclerosis (MS) treated with ablative chemotherapy and autologous hematopoietic stem cell transplantation (HSCT).
Methods
Clinical and brain magnetic resonance imaging measures of disease activity were monitored serially in patients participating in the Canadian MS HSCT Study. Reconstitution kinetics of immune-cell subsets were determined by flow cytometry, whereas thymic function was assessed using T-cell receptor excision circle analyses as well as flow cytometry measurements of CD31+ recent thymic emigrants (RTEs). Functional assays were performed to track central nervous system–autoreactive antigen-specific T-cell responses, and the relative capacity to generate Th1, Th17, or Th1/17 T-cell responses.
Results
Complete abrogation of new clinical relapses and new focal inflammatory brain lesions throughout the 2 years of immune monitoring following treatment was associated with sustained decrease in naive T cells, in spite of restoration of both thymic function and release of RTEs during reconstitution. Re-emergence as well as in vivo expansion of autoreactive T cells to multiple myelin targets was evident in all patients studied. The reconstituted myelin-specific T cells exhibited the same Th1 and Th2 responses as preablation myelin-reactive T cells. In contrast, the post-therapy T-cell repertoire exhibited a significantly diminished capacity for Th17 responses.
Interpretation
Our results indicate that diminished Th17 and Th1/17 responses, rather than Th1 responses, are particularly relevant to the abrogation of new relapsing disease activity observed in this cohort of patients with aggressive MS following chemoablation and HSCT. ANN NEUROL 2012;
perché non verificano su pazienti SM, il GLIVEC o Gleevec, della Novartis, unico vero medicinale anticancro su tumori LEUCEMIA MIELOIDE CRONICA , Cromosoma Philadelfia, con principio attivo "Apigenina", presente in prezzemolo e sedano!! che evita la sostituzione del midollo spinale !, perchè agisce come antiangiogenico ed apoptosi cellule tumorali !! L'India, ai primi di questo mese, ha rigettato il suo brevetto, perché molecola non brevettabile, oltre al costo annuo di 70.000€ contro i 2.000_2.500 € ,prodotto da case farmaceutiche indiane !!! differenza_furto_bussin€€€€$$$$$ evidentissimi !!!!
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