Lymphocyte counts may predict a good response to mesenchymal stromal cells therapy in graft versus host disease patients

Abstract

Steroid-resistant GvHD is one of the most significant causes of mortality following allogeneic Hematopoietic Stem Cell Transplantation (HSCT). Treatment with mesenchymal stromal cells (MSC) seems to be a promising solution, however the results from clinical studies are still equivocal. Better selection of candidate patients and improving monitoring of patients following MSC administration can increase treatment effectiveness. In order to determine which characteristics can be used to predict a good response and better monitoring of patients, blood samples were taken prior to therapy, one week and one month after therapy, from 26 allogeneic HSCT patients whom contracted GvHD and were treated with MSCs. Samples were examined for differential blood counts, bilirubin levels and cell surface markers. Serum cytokine levels were also measured. We found that the level of lymphocytes, in particular T and NK cells, may predict a good response to therapy. A better response was observed among patients who expressed low levels of IL-6 and IL-22, Th17 related cytokines, prior to therapy. Patients with high levels of bilirubin prior to therapy showed a poorer response. The results of this study may facilitate early prediction of success or failure of the treatment, and subsequently, will improve selection of patients for MSC therapy.

Current status of clinical trials assessing mesenchymal stem cell therapy for graft versus host disease: a systematic review

“…Another approach is to monitor cellular pathways that have been reported to be mediators of MSC immunosuppression. Hinden et al [ 72 ] reported that the number of lymphocytes, especially T cells and NK cells, was significantly higher in responders than in non-responders before MSC administration. The more inflammatory milieu of responders is conducive to MSC “licensing” and thus is beneficial for MSCs to play an immunomodulatory role [ 73 ].…”

Therapeutic Potential of Human Umbilical Cord-Derived Mesenchymal Stem Cells in Recovering From Murine Pulmonary Emphysema Under Cigarette Smoke Exposure

“…MSCs transiently activate T cells to preserve the antiapoptotic function ( 44 ). For example, higher lymphocyte counts were more efficient in activating MSCs in the treatment of graft vs. host disease ( 45 ). A previous study showed that that hUC-MSCs recruited the regulatory T cells in the damaged lung ( 46 ).…”

Translating MSC Therapy in the Age of Obesity

“…Furthermore, interactions between MSCs and immune cells are of utmost importance in dictating response to MSC therapy. A small study investigating differences between responders and non-responders to MSC therapy for GvHD found that patients with high peripheral blood lymphocyte counts (CD3 + T cells and CD56 + NK cells) before MSC therapy responded better ( 73 ). In addition strong cytotoxicity towards MSCs by peripheral blood mononuclear cells (PBMCs) from GvHD patients ( 74 ) was associated with a better response to MSC therapy.…”