About the Cell Therapy Department

The cell therapy department of the hospital is under the collection of Ayat Al Taleghani of hematopoietic stem cell transplantation, which has started its official activity since 1400. This department was established by the efforts of the head of the hematopoietic stem cell transplant department,Dr. Haji Fathali, and Dr. Roshandel, and other physicians s of the hematopoietic stem cell transplant department.

Due to the fact that cell therapy and cell products are new treatments and treatments all over the world. Ataleghani’s cell therapy department plans to provide treatment services to patients in line with the world’s current knowledge.

What is Cell Therapy?

Cell therapy is a process in which living cells are used as medicine for treatment. Today, this branch of medical science has made many advances. Cell therapy is used in various fields of medicine, including regenerative medicine, immunotherapy, and cancer treatment.

There are two types of cells used in cell therapy; Stem cells and non-stem cells, which are also called somatic and body cells.

Fibroblast cells, keratinocytes, chondrocytes, and immune cells such as T cells, NK cells, and dendritic cells (DC) are among the main non-stem cells used in cell therapy. In addition, in the process of cell therapy, only a specific cell or a set of cells may be used for treatment.

Today, cell therapy is used as the main treatment or as a complementary treatment along with other treatments for a wide range of diseases.

Cell therapy applications

Today, cell therapy is used in regenerative medicine, immunotherapy and cancer treatment.

Regenerative medicine: in this branch of medicine, which is also called regenerative medicine; Cells or their products, such as growth factors derived from cells, are used to repair tissues and organs or restore their function. Among the uses of cell therapy in regenerative medicine, which are approved by reputable medical organizations, the following can be mentioned.

Using keratinocytes or fibroblasts to treat diabetic foot ulcers and burns.The use of cell scaffolds containing keratinocytes and fibroblasts for the treatment of vascular wound beds created by surgery in the oral cavity. Intradermal injection of fibroblast to improve wrinkles Using chondrocytes to treat knee cartilage defects Use of PRP and MSC for osteoarthritis of the knee or hip.

Immunotherapy: Immune system disorders mainly occur in the form of autoimmune diseases or overreaction of the immune system. For this reason, immunotherapies are performed with two main goals; The first goal of immunotherapies is the initial treatment of the disease by reducing the level of inflammation, minimizing the symptoms of the disease and preventing the recurrence of the disease. The second and more important goal is to reset the immune system as a definitive and permanent treatment; This goal goes beyond suppressing or strengthening the immune system to control the disease. In immunotherapies based on cell therapy, different immune cells are used with different therapeutic goals.

Most of the immune cells that are used in cell therapy today; NK cells, T cells and CART cells.

Cancer treatment: The use of cell therapy in cancer treatment provides the possibility of treating this disease with a more targeted and specific approach. Today, anti-cancer vaccines using APC cells and CAR-T cells are being produced and investigated for a wide range of cancers in animal and human trials.

The process of performing cell therapy in the cell therapy department of Ayat… Taleghani Hospital:

In the cell therapy department of Ayat Taleghani Hospital, cell therapy services are mainly provided using immune cells, adult stem cells such as mesenchymal cells (MSC and DSC) and products derived from cells.

.Cellular services of this center include:

NK therapy
DLI therapy
Treatment with mesenchymal cells including MSC and DSC
T cell depletion αβ
Exosome therapy

NK therapy

NK cells are a group of peripheral blood lymphocytes and the first line of defense against viral infections and tumors. These cells are able to kill tumor cells and infected with microbes, and in this sense, it is a suitable option for treatment, especially in cancers. in leukemia patients who receive hematopoietic stem cell transplantation; NK cells are the first lymphocytes that are produced in the human body and prevent the recurrence of the disease by performing anti-tumor activity. These cells also produce compounds called cytokines; They accelerate the production of other immune cells such as T cells, which also play a role in controlling cancer cells.

Due to these characteristics, nowadays NK cells are used alone or in combination with other drugs to treat cancer. NK therapy can be autologous (from the individual) or allogeneic (from the donor, umbilical cord, iPSC cells). NK therapy is a safe treatment method and the incidence of immunological reactions after the injection of NK cells is very low.

In addition, some studies have shown that NK therapy is not only associated with the risk of graft-versus-host disease (GVHD), but can also prevent its onset. Also, clinical studies have shown that the administration of several courses of NK cells can increase the effectiveness of hematopoietic stem cell transplantation.

In the cell therapy department of Ayat Taleghani Hospital, in patients who have received a stem cell transplant and the risk of disease recurrence is high, NK therapy is used to prevent disease recurrence, strengthen the individual’s immune system, and accelerate the regeneration process of other immune cells. is used

Exosome

Exosomes are compounds that are naturally released from different cells and are responsible for communicating between cells. In fact, these compounds are intercellular messengers that carry various substances, including genetic materials, growth factors, proteins, and other substances. Due to their structure, these compounds are easily exchanged between cells and deliver their contents to the target cell by integrating into the cell membrane. Today, exosomes are used in the diagnosis and treatment of many diseases, including cancer treatment, regenerative medicine, and immune system modulation.

Different cells of the body are able to produce exosomes with different contents, but among the most important cells that have the ability to produce high exosomes with therapeutic effects; are mesenchymal cells (MSC). Studies have shown that exosomes derived from mesenchymal cells have anti-inflammatory properties, immune system regulation and other therapeutic effects. Today, exosomes are used in laboratory and clinical stages to treat the following diseases;
– Nervous disease
– Pulmonary diseases such as pulmonary fibrosis and complications caused by – COVID-19
– Cardiovascular diseases such as: heart attack and heart failure
– kidney Diseases
– Diseases related to the pancreas
– Gastrointestinal disease such as IBD
– All kinds of inflammatory diseases, including rheumatism
– Immunological disorders
In the cell therapy department of Aita Taleghani Hospital, exosomes derived from mesenchymal cells are used to reduce inflammation and regulate immune responses in patients who have received stem cell transplants and have complications after transplantation. patients who are candidates to receive exosome; as follows:
– Patients who have liver failure after transplantation and their liver enzymes are increased.
– Patients with acute GVHD
– Patients with increased inflammatory factors in their body.

Mesenchymal stem cells

Mesenchymal stem cells (MSC), which are also called mesenchymal stromal cells, are a group of mature stem cells that have the ability to produce cells similar to themselves and can also differentiate into several different cell lines.
These cells exist in different tissues of the body including: bone marrow, fat tissue, muscle, peripheral blood, hair follicle, tooth, placenta and umbilical cord.
Mesenchymal cells can differentiate into different cells, including fat cells, chondrocytes (cartilage cells), osteocytes (bone cells), nerve cells, hepatocytes (liver cells), and cardiocytes (heart cells).

With this characteristic, these cells are very important in regenerative medicine today, and many studies are being conducted to use these cells in tissue repair.

In addition, these studies have shown that MSC cells migrate to areas of the body that have damage or inflammation, and through the production of growth factors, cytokines, extracellular vesicles (such as exosomes), causing anti-inflammatory effects, inhibiting the system Immunity, stimulation of cell survival and induction of angiogenesis.

Today, numerous laboratory and clinical studies are being conducted on the use of MSC cells to treat diseases.

Patients who have been treated using MSCs so far include:

GVHD disease
Crohn’s disease (an autoimmune disease of chronic inflammation of the gastrointestinal tract)
Cardiovascular diseases such as: heart attack, congenital heart diseases, children’s cardiomyopathy
Autoimmune diseases such as systemic lupus erythematosus (SLE), type 1 diabetes, multiple sclerosis (MS)
Joint and bone diseases

MSC cells are used for treatment in patients who have received hematopoietic stem cell transplants and have acute GVHD and do not respond to steroid treatment in the cell therapy department of Ayat Taleghani Hospital. These cells are injected intravenously in one or more times depending on the patient’s needs.

Donor lymphocyte infusion (DLI)

DLI is a cell product that contains peripheral blood lymphocytes of the hematopoietic stem cell donor and is injected into the transplant recipient. If the transplant recipient has cancer recurrence (recurrence), DLI injection is performed depending on the patient’s condition. Lymphocytes are a subgroup of white blood cells and important components of the immune system; These cells are responsible for identifying and destroying cancer cells.

The goal of DLI is to cure cancer by a process called graft-versus-tumor effect (GVT), in which the donor’s lymphocytes (donor T cells) attack the remaining cancer cells in the patient’s body and destroy them and control the disease.
DLI is mainly used to treat relapsed chronic myeloid leukemia (CML); But other diseases that have been successfully treated with DLI include:
Relapsing acute leukemia
chronic lymphocytic leukemia (CLL)
Myelodysplasia (MDS)
Non-Hodgkin lymphoma (NHD)
Hodgkin’s disease (HD)
Multiple myeloma (MM)
T cell depletion αβ
Reduction of alpha/beta cells (T cell depletion αβ) is one of the hematopoietic stem cell transplantation techniques. In this method, immune cells derived from the donor, which are called αβ T cells, are removed from the bag containing the stem cells (graft) using magnetic beads before injecting hematopoietic stem cells into the recipient’s body. αβ T cells have the potential to cause inflammation and graft-versus-host disease (GVHD) in the body of the transplant recipient. Therefore, removing αβ T cells from the infused cell product significantly minimizes the risk of GVHD, increases the chance of engraftment, and reduces the need for immunosuppressive drugs after transplantation. to give
In this way, the αβ T cells that increase the risk of GVHD are removed from the content of the transplanted cells, but other beneficial immune cells (such as gamma delta T cells, NK cells, monocytes, and dendritic cells) are preserved in the graft for the ability to fight. with viral infections and residual cancer cells in the transplant recipient.
Therefore, this innovative approach to transplantation can not only cure cancer, but also reduce the risk of life-threatening infections and recurrence after transplantation.
In the Cell Therapy Department of Ayat Taleghani Hospital, depending on the patient’s condition and the opinion of the medical team, the cell product containing hematopoietic stem cells may be first reduced in alpha/beta cells, and then the final product is transplanted to the patient.