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Spleen's Role In Thal - Breakthrough under way? Introducing healthy cells into the spleen as a possible cure

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Sharmin:
Over the years I have thought about this idea, I entertain it for a while and then wonder if it has any merit.  Several years ago, a hemophilia patient - following a liver transplant found himself cured of hemophilia because the liver was able to produce the clotting factor which he lacked.  

This lead me to think whether the spleen, which is capable of extramedullary hematopoiesis may be helpful in the same way.  In fact, there may be two ways that it may be helpful.  Firstly, introducing donor cells into the spleen may create enough red blood cell production to reduce if not eliminate the requirement for transfusions.  Cells from the spleen often engraft in the bone marrow, where they would continue to create more red blood cells.  Also, the spleen being a significant part of the immune system, having accepted the donor cells would largely eliminate chances of the rest of the body rejecting donor cells.  This tendency brings me to the second way in which introduction of cells into the spleen may have some benefit.  If the spleen has accepted the donor cells, but the hematopoiesis is not adequate to resolve the anemia completely - at that time a bone marrow transplant from the same donor (donor of spleen cells) may be more successful because the spleen and immune system have already accepted this donor as 'self'.  My hope being that the bmt not be required, and the tissue transplant to the spleen would be enough.... Sometimes I wonder if a spleen transplant would be helpful.

I know that the spleen is not a vital organ for survival, which is why spleen transplants have not been investigated but in thalassemia and sickle cell anemia it could be beneficial in more ways than one...the faulty, enlarged spleen would be removed - an healthy, donor spleen would be transplanted possibly restoring normal immune function to the recipient, reducing the risk of clots and destruction of red blood cells and possibly resolving their thalassemia or sickle cell anemia....

Am I the only one who is able to see the potential in this?  

Sharmin

Manal:
Sharmin
Correct me if I am wrong . What I know is that the spleen enlarges in thal because it is ""eating"" the muted red blood of patients dealing with them as if they are microbs. So how is the spleen producing blood too?
Is it doing two opposite functions?..
Manal

Sharmin:
Hi Manal,

The spleen does actually serves two functions - one is an immune function and the other is extramedullary hematopoiesis.  The spleen increases it's surface area for either purpose.  While serving its immune function it increases in surface area (enlarges) in order to be more effective in removing debris and old red blood cells from circulation in the plasma.  In a non thalassemia individual this would not be a problem as they would quickly produce more blood cells.  In a thalassemia patient this is a problem because the red blood cells are not being replaced.  

Another function of the spleen is actually extramedullary hematopoiesis.  In thalassemia the spleen often increases its surface area in response to anemia - and by expanding its surface area - much like bone marrow - it 'hopes' to increase red blood production.  In thalassemia these efforts are futile - therefore the larger surface area in fact becomes 'too efficient' in its first function (the immune function) thereby quickly recycling red blood cells and exacerbates the anemia.    I can see how these two functions can seem contradictory to one another - yet in a non thal individual they work well - in thalassemia they can become problematic.  

Because the spleen serves these two functions - immune and red blood cell production - I do think that there may be some potential in investigating the spleen in thalassemia and sickle cell anemia.  

Does that make sense?  lol I tend to get a wordy when trying to explain  :wink

Sharmin

Manal:
Very confusing and overlaping jobs,but I understood your explanation.

Hope a doctor can answer these possibilities even on a theoretical basis

Just thinking.....
What could be a source for these transplants? Would donors give part of their spleens as in liver transplant, is this medically possible?
Is the mechanism of producing blood by spleen is the same as in the bone marrow? Would engrafment be easy without getting rid of the old marrow?

Manal

Dori:
Shall I ask this in Antayla? I do dare to ask this. May I post it on my wall or pass it on to others?
May I print this out (deleting names and any personal information) to put it under some doctors nose?

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