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Open Access 01-11-2007

Resetting the Adaptive Immune System After Autologous Stem Cell Transplantation: Lessons from Responses to Vaccines

Authors: D. M. C. Brinkman, C. M. Jol-van der Zijde, M. M. ten Dam, P. A. W. te Boekhorst, R. ten Cate, N. M. Wulffraat, R. Q. Hintzen, J. M. Vossen, M. J. D. van Tol

Published in: Journal of Clinical Immunology | Issue 6/2007

Abstract

Autologous stem cell transplantation (ASCT) to treat autoimmune diseases (AID) is thought to reset immunological memory directed against autoantigens. This hypothesis can only be studied indirectly because the exact nature of the pathogenetic autoantigens is unknown in most AID. Therefore, 19 children with juvenile idiopathic arthritis (JIA) or systemic lupus erythematodes (SLE) and 10 adults with multiple sclerosis (MS) were vaccinated with the T-cell-dependent neoantigen rabies and the recall antigen tetanus toxoid after, respectively before, bone marrow harvest. Both vaccinations were repeated after ASCT. All except two of the responders mounted a primary antibody response to rabies after revaccination, and 44% of the responders mounted a primary antibody response to tetanus boost after ASCT. These data show that immunological memory to a neoantigen is lost in most patients with AID after immunoablative pretreatment; however, memory to a recall antigen boosted before bone marrow harvest is only lost in part of the patients. Disease progression was arrested in all patients with JIA/SLE except one, but only in a minority of MS patients. Clinical outcome on a per case basis was not associated with the profile of the immune response toward the vaccination antigens after ASCT.

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Title: Resetting the Adaptive Immune System After Autologous Stem Cell Transplantation: Lessons from Responses to Vaccines
Authors: D. M. C. Brinkman
C. M. Jol-van der Zijde
M. M. ten Dam
P. A. W. te Boekhorst
R. ten Cate
N. M. Wulffraat
R. Q. Hintzen
J. M. Vossen
M. J. D. van Tol
Publication date: 01-11-2007
Publisher: Springer US
Published in: Journal of Clinical Immunology / Issue 6/2007
Print ISSN: 0271-9142
Electronic ISSN: 1573-2592
DOI: https://doi.org/10.1007/s10875-007-9120-0

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