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新的治疗角度:造血干细胞移植
New therapeutic aspects: haemopoietic stem cell transplantation. Primary systemic vasculitis responds well to
intensive immunosuppression, particularly with cyclophosphomide. Use of
the latter is restricted by side-effects, particularly in relapsing disease.
Techniques which allow more complete immunosuppression have an obvious
attraction in autoimmune disease. They are particularly suitable for vasculitis
which can go into long-lasting remission even with standard therapy in
many cases. The conditioning used for stem cell transplantation allows
more complete deletion of auto aggressive T-cell clones, with subsequently
haemopoietic rescue by previously harvested stem cell precursors. The
procedure also has immune potentiating effects, perhaps by promoting peripheral
suppressor mechanisms. These may be important even though immune ablation
is not achieved. With rigorous patient selection, experience with this
technique in vasculitis may be broadened. Copyright 2001 Harcourt Publishers
Ltd. |