Mesenchymal stem cells (MSCs) are multipotent cells derived from many adult tissues, which can differentiate into cells of the mesodermal lineage, such as adipocyte, osteocyte and chondrocyte, as well as cells of other embryonic lineages. They are a promising tool for tissue engineering. In addition, MSC interacts with immune system, suppressing T cell, B cell and NK cell function and dendritic cell activities. MSC migrates to injured tissue to promote the survival of damaged cells and induces peripheral immune tolerance. The role of MSC in reducing the incidence and severity of graft versus host disease (GVHD) clinically has recently been reported. The immunoregulatory function of MSCs also shows a growing promise in the therapeutic application in autoimmune diseases. This review discusses the mechanism of MSC immunomodulatory ability and its therapeutic potential in autoimmune diseases.
Autoimmune Diseases ; surgery ; Humans ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; immunology

INTRODUCTIONAutologous haematopoietic stem cell transplantation (auto-HSCT) has been performed for severe multiple sclerosis (MS) refractory to standard therapy with increasing frequency worldwide. However, experience in Asia employing this modality in MS has been limited. In this review, we explored the pathophysiology of autoimmunity and the underlying rationale for auto-HSCT in treating autoimmune diseases including MS, as well as existing published pre-clinical and clinical data. We aimed thereby to better understand the utility of treating MS with auto-HSCT and the feasibility of this procedure in Singapore.

METHODSA Medline search was performed with the terms "haematopoietic stem cell transplantation", "multiple sclerosis" and "autoimmune diseases" from 1996 to 2005. Both original papers and review articles were considered.

MAIN FINDINGSThe majority of publications were from Europe or the United States and most clinical series from single centres had relatively small numbers of patients. Worldwide, the number of patients reported has been less than 300 since 1997. Existing data support the feasibility and promise of this procedure and ongoing Phase III trials may serve to confirm this initial experience.

CONCLUSIONPre-clinical and early clinical data support the rationale for immunoablative therapy for autoimmune disorders. Auto-HSCT for severe MS is a feasible procedure and can be safely performed in centres with experience managing HSCT patients.

Autoimmune Diseases ; surgery ; Hematopoietic Stem Cell Transplantation ; Humans ; Multiple Sclerosis ; physiopathology ; surgery ; Singapore ; Transplantation, Autologous ; Treatment Outcome

Lymphocytic hypophysitis is a rare inflammatory disorder which is caused by autoimmune destruction of the pituitary gland. Almost all reported cases have been in women and the disease is often associated with pregnancy. We describe here the first male case of lymphocytic hypophysitis in Korea. The patient presented with headache, impotence, decreased libido, and deteriorated vision. Endocrinologic studies showed panhypopituitarism, and pituitary MRI imaging revealed a homogeneously enhanced pituitary mass with a thickened stalk. Treatment with prednisolone and thyroid hormone for five months was ineffective. Transsphenoidal resection of the pituitary mass was performed successfully with normalization of the visual field defect. Histologic examination revealed diffuse lymphocytic infiltration with dense collagenous fibrosis, consistent with lymphocytic hypophysitis. Lymphocytic hypophysitis should be considered in differential diagnosis even in men with hypopituitarism and an enlarged pituitary gland.
Adult ; Autoimmune Diseases/diagnosis* ; Autoimmune Diseases/pathology ; Autoimmune Diseases/surgery ; Eosinophilia ; Female ; Human ; Korea ; Lymphocytes/cytology ; Lymphocytes/immunology* ; Lymphocytes/metabolism ; Magnetic Resonance Imaging ; Male ; Pituitary Diseases/diagnosis* ; Pituitary Diseases/pathology ; Pituitary Diseases/surgery ; Pituitary Gland/pathology* ; Pituitary Gland/surgery ; Pituitary Hormones/metabolism ; Pregnancy

Human adjuvant disease means the autoimmune disease or autoimmune disease like syndrome developed after plastic surgery using foreign body implantation. After first report of HAD by Miyoshi at 1964, a number of cases have been reported especially from Japan. Silicone has been known as biologically inert material, but a couple of side reaction and experimental data argue against such conventional idea. It is impossible to identify the exact role of implanted substance in the occurrence of autoimmune disease, but there are a few indirect evidences for adjuvant effect of silicone. The spectrum of HAD are as follows: unclassifiable connective disease like syndrome, rheumatoid arthritis, SLE, polymyositis, adult Still's disease, ITP, Hashimoto's thyroiditis, etc. We experienced two cases of HAD manifesting as SLE who had been injected with silicone fluid with for augmentation mammoplasty and report this with a review of the literature.
Adult ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Female ; Foreign Bodies ; Humans* ; Japan ; Mammaplasty ; Polymyositis ; Silicones ; Surgery, Plastic ; Thyroid Gland ; Thyroiditis

Aged ; Autoimmune Diseases ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis ; diagnosis ; drug therapy ; surgery ; Prednisone ; therapeutic use

Autoimmune Diseases ; diagnosis ; immunology ; pathology ; surgery ; Humans ; Immunoglobulin G ; blood ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pancreatectomy ; Pancreatitis ; diagnosis ; immunology ; pathology ; surgery

Immunoglobulin G4 (IgG4)-related disease is a newly recognized condition characterized by fibroinflammatory lesions with dense lymphoplasmacytic infiltration, storiform-type fibrosis and obliterative phlebitis. The pathogenesis is not fully understood but multiple immune-mediated mechanisms are believed to contribute. This rare disease can involve various organs and pleural involvement is even rarer. We report a case of IgG4-related disease involving pleura. A 66-year-old man presented with cough and sputum production for a week. Chest radiography revealed consolidation and a pleural mass at right hemithorax. Treatment with antibiotics resolved the consolidation and respiratory symptoms disappeared, but the pleural mass was unchanged. Video-assisted thoracoscopic surgery was performed. Histopathology revealed dense lymphoplasmacytic infiltration and storiform fibrosis with numerous IgG4-bearing plasma cells. The serum IgG4 level was also elevated. Further examination ruled out the involvement of any other organ. The patient was discharged without further treatment and there is no evidence of recurrence to date.
Aged ; Anti-Bacterial Agents ; Autoimmune Diseases ; Cough ; Fibrosis ; Humans ; Immunoglobulin G ; Immunoglobulins* ; Phlebitis ; Plasma Cells ; Pleura ; Pleural Neoplasms ; Radiography ; Rare Diseases ; Recurrence ; Sputum ; Thoracic Surgery, Video-Assisted ; Thorax

diseases. Because of the relatively frequent recurrences of PTGC, follow-up and repeat biopsy are indicated. Although PTGC is not considered to be a premalignant condition, PTGC may occur prior to, concurrent with or following NLPHD. This emphasizes the need for ongoing follow-up and repeat biopsy. Although PTGC is reported in 3.5% to 10% of the cases of chronic nonspecific lymphadenopathy, oral & maxillofacial surgeons are not widely aware of this condition and its clinical implications. Herein, we present a case of PTGC. A 24-year-old male without any history of immunodeficiency or autoimmune disease was admitted to the Department of Oral & Maxillofacial surgery at Ulsan University Hospital for evaluation of a right submandibular swelling. He had another mass on the right thigh that was noticed about 1 year ago. The submandibular lesion was completely resected and biopsied. The histological findings and immunohistochemical stains (CD3, CD15, CD20, CD30, CD57, BCL-2, EMA) were consistent with PTGC. He was followed up without any other complaints for 9 months.]]>
Autoimmune Diseases ; Biopsy ; Cell Transformation, Neoplastic ; Coloring Agents ; Follow-Up Studies ; Germinal Center ; Hodgkin Disease ; Humans ; Lymphatic Diseases ; Lymphocytes ; Lymphoma ; Male ; Recurrence ; Surgery, Oral ; Thigh ; Young Adult

autoimmune disease of unknown etiology characterized by the triad of necrotizing granulomatous lesion in the upper and lower respiratory tracts or both, disseminated vasculitis involving both small arteries and veins, and necrotizing glomerulonephritis. The most common oral lesions associated with WG are ulceration and strawberry gingivitis. A 47-years old man in medical care associated WG was consulted our Division of Oral and Maxillofacial Surgery for the chief complaint of toothaches. Pre-operative panorama showed the alveolar radiolucency and the loss of lamina dura regarding the left upper teeth. An oropharyngeal magnetic resonance imaging also revealed the increased bone marrow signal intensity on the left maxilla. Under the impression of maxillary osteonecrosis due to WG, maxillary saucerization with removal of involved teeth was performed. We obtained good results and report the first case of WG in Korea, with the review of literatures regarding oral and general systemic features.]]>
Arteries ; Autoimmune Diseases ; Bone Marrow ; Fragaria ; Gingivitis ; Glomerulonephritis ; Korea ; Magnetic Resonance Imaging ; Maxilla ; Osteonecrosis ; Respiratory System ; Surgery, Oral ; Tooth ; Toothache ; Ulcer ; Vasculitis ; Veins ; Wegener Granulomatosis

The primary ovarian lymphoma is a rare disease with poor prognosis. The incidence of autoimmune hemolytic anemia in patients with non-Hodgkin's lymphoma is estimated at 3%. However, a substantial portion of the previously reported cases of ovarian lymphoma actually represented ovarian involvement by more diffuse lymphomatous process. If stringent criteria are used for case selection, true primary ovarian lymphoma usually carries a favorable prognosis. We present a primary malignant lymphoma of ovary accompanied by autoimmune hemolytic anemia in a 29-yr-old patient. After ablative surgery, the hemoglobin level and the reticulocyte count were normalized. One year following surgery and chemotherapy, the patient is alive and disease free.
Adult ; Anemia, Hemolytic/*immunology ; Antineoplastic Agents, Hormonal/therapeutic use ; Autoimmune Diseases/immunology ; Combined Modality Therapy ; Female ; Human ; Lymphoma, Non-Hodgkin/*complications/drug therapy/pathology/surgery ; Ovarian Neoplasms/*complications/drug therapy/pathology/surgery ; Prednisolone/therapeutic use