UCSF researchers, through a series of mouse model experiments, have determined that a mother's immune response prevents a fetus from accepting transplanted blood stem cells, and yet this response can be overcome simply by transplanting cells harvested from the mother herself.
Scientists have long viewed in utero blood stem cell transplantation as a promising treatment strategy for many genetic diseases diagnosed as early as the first trimester of pregnancy, including sickle cell disease and certain immune disorders. Fetal stem cell transplantation involves taking healthy cells from the bone marrow of a donor and transplanting them into the fetus through ultrasound-guided injections. When successful, the implanted cells, or graft, replenish the patient's supply of healthy blood-forming cells.
In theory, the developing fetus with an immature immune system should be a prime target for successful transplantation, since the risk of graft rejection is low and the need for long-term immunosuppressive therapy may be avoided. However, most previous attempts to transplant blood stem cells into a human fetus have been unsuccessful, prompting some researchers to lose interest in this promising field, according to MacKenzie, who also is an investigator with the Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research.
"The surprising finding in our study is that the mother's immune system is to blame," said co-senior author Qizhi Tang, an assistant professor of transplant surgery and director of the UCSF Transplantation Research Lab.