Аңдатпа
Introduction and Aims: Systemic lupus erythematosus (SLE) is characterized by the overproduction of organ-specific autoantibodies to various components of cell nucleus. The pathogenesis is determined by predominance of polyclonal immune response (B cell) and activation of antigen-specific immunity (T-cell). The prognosis of treatment-refractory SLE is still negative: immunological injury of tissue and internal organs may lead to a fatal income.Regenerative medicine seems like a promising direction to decrease the disease activity.Our aim was to determine the efficacy of autologous hematopoietic stem cell transplantation (AHSCT) for refractory SLE. Methods: 30 female patients with active SLE, refractory to immunosuppressive therapy, aged 20 to 58 years underwent AHSCT. Mean disease duration was 9,91±2,37. Patients were treated with AHSCT four times - 0-3-6-12 months. The operation was conducted in two stages: 1) mieloexfusion through a puncture of an iliac crest and biotechnological separation of hematopoietic stem cells; 2) intravenous cells transplantation (quantity 80×106). Results were evaluated by changes in ESR, CRP, anti-nuclear antibodies (ANA), anti-double-stranded DNA (anti-dsDNA), C3, C4, glomerular filtration rate (GFR), 24h proteinuria, serum creatinine and albumin. To understand the therapeutic mechanisms of AHSCT stem cells were immunophenotyped by flow cytometry (CD3, CD4, CD8, CD20, CD16, CD4+, CD25+, Foxp3, CD38). We also estimated cytokines IL-1, IL-6, IL-8, TNFα, IFNγ. Clinical activity was assessed by Systemic lupus erythematosus disease activity index (SLEDAI).The clinical trial was allowed by Ethics Committee.