Experiences with In Utero Transplantation of Mesenchymal Stem Cells

  • Carolyn Troeger
  • Irina Perahud
  • Eva Visca
  • Wolfgang Holzgreve
Chapter

Abstract

In utero stem cell transplantation (IUT) has become a valuable therapeutic option in fetuses with congenital immunologic disorders, such as severe combined immunodeficiency (SCID) or bare lymphocyte syndrome [1, 2]. However, other diseases such as thalassemias, storage defects, or osteogenesis imperfecta have either resulted in no detectable engraftment or microchimerism with uncertain effect on the phenotype. Although IUT was performed as early as the end of first trimester, neither bone marrow nor fetal liver cells resulted in relevant engraftment. It can be postulated that the fetal immune system deletes the allogeneic stem cells since several studies suggest that the fetal thymus is colonized in the first third of gestation [3]. A fetal T-cell-mediated alloresponse is evident as early as the second trimester and has cleared most allogeneic cells by term [4, 5]. In principle, IUT could result in long-term chimerism when performed early enough in pregnancy since, for instance, persistent blood group chimerism has been demonstrated for dizygotic twins [6]. But obviously, also the “transmaternal” traffic of cells from a first born to the next infant in a later pregnancy leads to tolerance induction within the T-cell population [7]. The early presentation of allogeneic cells to the developing fetal thymus results in specific tolerance, whereas later appearance (for instance, due to IUT of allogeneic hematopoietic stem cells at embryonic day 14 post conception/E14) leads to clearance of allogeneic cells from the circulation within months by the recipient’s immune system [8].

Keywords

Migration Anemia CD105 Thalassemia Mucopolysaccharidosis 

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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Carolyn Troeger
    • 1
  • Irina Perahud
    • 1
  • Eva Visca
    • 1
  • Wolfgang Holzgreve
    • 1
  1. 1.Laboratory for Prenatal MedicineUniversity Women’s HospitalBaselSwitzerland

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