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. 2016 Sep 28;68(10):2361–2371. doi: 10.1002/art.39748

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© 2016 The Authors. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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Immune homeostasis following autologous hematopoietic stem cell transplantation (HSCT). A and B, T cell receptor (TCR) diversity in Treg cells restored after autologous HSCT in a patient with autoimmune disease (A) and in 4 healthy controls (HC) (B) 46. The number of different TCR sequences per sample and diversity (Di), where 0 = none and 1 = maximum, before and after transplantation are shown. Adapted, with permission, from ref. 46. C and D, Model of how autologous HSCT results in immune tolerance and immune homeostasis. C, Outcompetition of nonautoreactive lymphocytes results in the death of autoreactive clones. Interleukin‐2 (IL‐2) and serum BAFF (sBAFF) levels increase after lymphomyeloablation 1. The proportions of regulatory T and B cells, both known to suppress or kill effector T and B cells, are increased 2. D, Supranormal numbers of B cells and activated regulatory cells eliminate autoreactive clones during immune recovery. The surge in cell numbers abates as immune homeostasis is achieved.