Treatment for salivary gland hypofunction at both initial and advanced stages of Sjögren-like disease: a comparative study of bone marrow therapy versus spleen cell therapy with a 1-year monitoring period

Cytotherapy. 2014 Mar;16(3):412-23. doi: 10.1016/j.jcyt.2013.10.006. Epub 2014 Jan 9.

Abstract

Background aims: Non-obese diabetic mice (NOD) exhibit autoimmune Sjögren-like disease (SS-like). We reported previously that a combined-therapy consisting of immuno- and cell-based therapy rescued NOD from SS-like. However, therapies tested to date on NOD mice were aimed at the initial phase of SS-like. It is unknown whether therapies are effective in restoring salivary function when given at an advanced phase of SS-like.

Methods: The efficacy of two therapies (bone marrow versus spleen cells) was compared head-to-head for halting/reversing salivary hypofunction at two critical time points of SS-like (7-week-old NOD with normal saliva output and 20-week-old NOD with minimal saliva). NOD mice were divided into four groups: (i) control, (ii) complete Freund's adjuvant (CFA), (iii) bone marrow transplants with CFA or (iv) spleen cell transplants with CFA. Mice were monitored 8-12 months after therapy.

Results: Both cell therapies were effective during the initial phase of SS-like; salivary flow rates were maintained between 80-100% of pre-symptomatic levels. Spleen cell therapy was better than bone marrow when administered in the initial phase of SS-like. When cell therapies were given at an advanced phase of SS-like (20 weeks and older), salivary flow rates improved but were at best 50% of pre-symptomatic levels. Both cell therapies decreased tumor necrosis factor-α, transforming growth factor-β1 levels and T and B cells while increasing epidermal growth factor and regulatory T cells. Elevated serum epidermal growth factor levels were measured in spleen-treated mice.

Conclusions: A therapeutic effect in advanced phase disease, albeit in mice, holds promise for humans in which Sjögren syndrome is generally not diagnosed until a late stage.

Keywords: Sjögren syndrome; autoimmune disease; cell therapy; immunotherapy; salivary gland; xerostomia.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bone Marrow / immunology*
  • Disease Models, Animal
  • Disease Progression
  • Follow-Up Studies
  • Humans
  • Mice
  • Mice, Inbred NOD
  • Salivary Gland Diseases / complications
  • Salivary Gland Diseases / therapy*
  • Sjogren's Syndrome / complications
  • Sjogren's Syndrome / therapy*
  • Spleen / immunology*
  • T-Lymphocytes, Regulatory / immunology*
  • Time Factors
  • Tumor Necrosis Factor-alpha

Substances

  • Tumor Necrosis Factor-alpha