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Autologous stromal vascular fraction cells: A tool for facilitating tolerance in rheumatic disease
Authors:Thomas E. Ichim  Robert J. Harman  Boris Minev  Fabio Solano  Doru T. Alexandrescu  Xiang Hu  Neil H. Riordan
Affiliation:a Medistem Inc., San Diego, CA, USA
b Vet-Stem, Inc. Poway, CA, USA
c Department of Surgery, University of Western Ontario, London, Ontario, Canada
d Moores Cancer Center, University of California, San Diego, CA, USA
e Department of Medicine, Division of Neurosurgery, University of California San Diego, San Diego, CA, USA
f Cell Medicine Institutes, San Jose, Costa Rica
g The Stem Cell Institute, Panama City, Panama
h Georgetown Dermatology, Washington DC, USA
i Shenzhen Beike Cell Engineering Institute, Shenzhen, China
j Department of Surgery, University of Nebraska Medical Center, USA
Abstract:Since the days of Medawar, the goal of therapeutic tolerogenesis has been a “Holy Grail” for immunologists. While knowledge of cellular and molecular mechanisms of this process has been increasing at an exponential rate, clinical progress has been minimal. To provide a mechanistic background of tolerogenesis, we overview common processes in the naturally occurring examples of: pregnancy, cancer, oral tolerance and anterior chamber associated immune deviation. The case is made that an easily accessible byproduct of plastic surgery, the adipose stromal vascular fraction, contains elements directly capable of promoting tolerogenesis such as T regulatory cells and inhibitory macrophages. The high content of mesenchymal and hematopoietic stem cells from this source provides the possibility of trophic/regenerative potential, which would augment tolerogenic processes by decreasing ongoing inflammation. We discuss the application of this autologous cell source in the context of rheumatoid arthritis, concluding with some practical examples of its applications.
Keywords:Stem cell therapy   Immune modulation   Adipose stem cells   Tolerance induction   T regulatory cells
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