जर्नल ऑफ़ स्टेम सेल रिसर्च एंड थेरेपी

अमूर्त

Allogenic Mesenchymal Stem Cell Transplantation For Refractory Severe Pyoderma Gangrenosum

Xi Yang, Dandan Wang, Jun Liang, Jinyun Chen, Xuebing Feng and Lingyun Sun

Background: Pyoderma Gangrenosum (PG) is a rare and an idiopathic, inflammatory ulcerative condition, which is a diagnosis of exclusion and the treatment are empirical and based on small series or local experience. Mesenchymal stem cells (MSCs) have immunomodulatory and tissue-repairing effects in autoimmune diseases.
Objectives: This study aimed to assess the efficacy of UC-MSCT and define whether there is remission of wounded skin in refractory severe PG patient.
Methods: Twenty nine year old male PG patient was recuited. UC-MSCs were prepared by the Stem Cell Center of Jiangsu Province (Beike Bio-Technology). The patient underwent two times of UC-MSCT on June 13th, 2012 and June 27th, 2012. The protocol was approved by our Ethics Committee and informed consent was signed from the patient.
Results: The PG patient presented with pustules over the lower limbs and was refractory to oral prednisolone (initially 60 mg per day, tapered in 8 weekly steps to 5 mg per day) , pulse intravenous cyclophosphamide (0.6 g per month for 6 months) and he also underwent two times unsuccessful of skin grafting for the lower extremity ulcers. There are no adverse events during the UC-MSCT treatment. After one week, he was free of intense pain and the exudation significantly reduced. Auto-skin grafting was given 4 weeks after UC-MSCT and the grafts came from his back and inner thigh. His ulcers significantly healed with complete resolution of pain 2 months after UC-MSCT. Maintenance therapy followed transplantation included prednisone 5 mg per day and intravenous cyclophosphamide 0.6 g per month.
Conclusions: This is the first reported case of successful allogenic UC-MSCT for refractory severe PG. Although additional studies are needed to confirm this finding, we believe that UC-MSCT may be considered a therapeutic option in large area ulcerative PG patients unresponsive to conventional treatments.