Department: Medicine, University of Ottawa
Multiple sclerosis and other autoimmune diseases result from the dysregulation of the immune response in individuals with permissive immunogenetics exposed to poorly identified environmental initiating factors. Thus, the removal of a diseased immune organ using systemic therapy (chemotherapy, antibody therapy and radiotherapy) and replacement with a healthy new organ derived from purified hematopoietic stem cells could be a potentially valuable and curative treatment for patients with autoimmune diseases. This paradigm is currently being tested in clinical studies of patients with Multiple sclerosis.
I have initiated a multicenter trial to study the effects of dose-intensive immunosuppression on the immunological activity of MS using autologous T cell depleted hematopoietic stem cell support. Changes in the immune system are being monitored using both clinical and laboratory assays of immune function. Data on the changes in CNS destruction, lymphocyte subpopulations, repertoire complexity and antigen directed immune cell repopulation are being collected and will be correlated with clinical indicators of immune and MS activity. The alterations detected in the immune system will provide vital information about the immunological changes necessary for disease response and disease control. In the event that this therapy fails to curb recurrent MS activity in a patient, these studies will provide knowledge of the earliest immune alterations in the renewed activity of this disease.