Auto-Immune Remission & Stem Cells

Auto-Immune Remission & Stromal Vascular Fraction

This study discusses the use of SVF ( Stromal Vascular Fraction).

What is SVF?

SVF is the cellular mix obtained from your adipose tissue (body fat). It contains multiple strands of cells inclusive of;

  • pericytes
  • adipocytes
  • fibroblasts
  • endothelial cells
  • vascular progenitorts
  • supra adventicial cells
  • mesencymal stem cells
  • haematopoietic stem cells
  • endothelial progenitor cells
  • haematopoietic progenitors

SVF is what we use right here in Macquarie Stem Cells.

In the published literature, the clinical use of systemically administered SVF cells has been reported in two pilot studies.  The first was a description of 3 patients suffering from multiple sclerosis who received intravenous administration of SVF as part of a cellular cocktail. All 3 patients reported significant improvement neurologically, and demonstrated an excellent safety profile. Additionally, a patient case report described remission of RA subsequent to administration of autologous SVF.

Lets look closer at the MSC’s (mesenchymal stem cells)
What can they do?

  1. Migrate to injured tissue
    Migration involves the ability to travel through out vasculatory system, homing to areas of damage.
  2. Differentiate into multiple tissues
    Differentiation: the process by which a less specialized cell becomes a more specialized cell type, eg: stem cell becomes a cartilage cell or muscle cell.
  3. Release of trophic factors
    Trophic Factors: help develop a neuron and maintain connections with its neighbours. These small proteins work through their receptors on the surface of the nerve cells. Trophic is to support by feeding and helping to grow. Not just neurons but all the cells in the body.
  4. Inhibit apoptosis
    Apoptosis: the death of cells which occurs as a normal and controlled part of an organism’s growth or development.
  5. Stimulate angiogenesis
    Angiogenesis is the formation of new blood vessels, involving migration, growth, and differentiation of endothelial cells.
  6. Inhibit inflammation
    Inflammation:
    biological response of body tissues to harmful stimuli eg: feeling pain when there is a problem in the local area.
    Inflammation is the common pathway for all chronic degenerative disorders.
  7. Stimulate Treg activity
    Treg activity: T regulatory cells are a component of the immune system that suppresses immune responses of other cells.

Comparison of immunological properties led to the conclusion that adipose derived MSC appear to have similar properties in terms of suppressing mixed lymphocyte reactions, inhibiting release of type 1 and inflammatory cytokines, as well as generating progeny cells that appear to be relatively immune privileged. These data were confirmed by the group of Zhang et al. who compared cord blood, bone marrow, and adipose MSC and found almost identical ability to inhibit immune response.

What happens when the Treg cells are introduced?

Numerous autoimmune conditions enter remission as a result of increased Treg number and/or activity, whereas relapse is associated with reduction in number and/or activity. Specifically, this has been demonstrated in multiple sclerosis, rheumatoid arthritis and lupus. Given the importance of Treg cells in the control of autoimmunity, it would be useful to possess sources of Treg cells that are easily accessible and can be reintroduced into the patient for immune modulation.

It is known that the adipose derived cytokines leptin and TNF-alpha inhibit Treg proliferation and activity.  The local effects of these cytokines would conceptually, be negated by liberating Treg from fat tissue followed by systemic re-administration, resulting in enhanced Treg activity.

Thus one conceptual advantage of utilizing SVF therapy would be not only the MSC content, which possesses various regenerative properties, but also Treg, which would enhance anti-inflammatory/tolerance inducing properties. Given that both MSC and Treg are considered to be tolerance-promoting, it may be feasible to consider that synergy of tolerance induction may be occurring when the two cell populations are co-administered in the form of SVF.

Riordan previously reported remission in a patient with rheumatoid arthritis who was treated with autologous SVF. Animal studies using the collagen II model of RA have demonstrated that administration of MSC is associated with immune modulation, disease remission and regeneration of cartilage. Additionally, Riordan’s group and others have reported that Treg cells are associated with induction of disease remission.

 

Full Published Document Reference:

Paz Rodriguez, J., Murphy, M., Hong, S., Madrigal, M., March, K., Minev, B., Harman, R., Chen, C., Timmons, R., Marleau, A. and Riordan, N. (2012). Autologous stromal vascular fraction therapy for rheumatoid arthritis: rationale and clinical safety. International Archives of Medicine, 5(1), p.5.