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J Am Acad Dermatol. 2013 Dec;69(6):898-908.e7. doi: 10.1016/j.jaad.2013.08.014. Epub 2013 Sep 24.

A phase II randomized vehicle-controlled trial of intradermal allogeneic fibroblasts for recessive dystrophic epidermolysis bullosa.

Author information

1
Department of Dermatology, St George Hospital, Sydney, Australia; University of New South Wales, Sydney, Australia.

Abstract

BACKGROUND:

Chronic wounds are a major source of morbidity and mortality in generalized severe recessive dystrophic epidermolysis bullosa (RDEB-GS).

OBJECTIVE:

This was a phase II double-blinded randomized controlled trial of intralesional allogeneic cultured fibroblasts in suspension solution versus suspension solution alone for wound healing in RDEB-GS.

METHODS:

Adult patients with RDEB-GS were screened for chronic ulcers and reduced collagen VII expression. Up to 6 pairs of symmetric wounds were measured and biopsied at baseline, then randomized to cultured allogeneic fibroblasts in a crystalloid suspension solution with 2% albumin or suspension solution alone. Ulcer size, collagen VII protein and messenger RNA expression, anchoring fibril numbers, morphology, and inflammatory markers were measured at 2 weeks and at 3, 6, and 12 months.

RESULTS:

All wounds healed significantly more rapidly with fibroblasts and vehicle injections, with an area decrease of 50% by 12 weeks, compared with noninjected wounds. Collagen VII expression increased to a similar degree in both study arms in wounds from 3 of 5 patients.

LIMITATIONS:

The number of patients with RDEB-GS who met inclusion criteria was a limitation, as was 1 trial center rather than multicenter.

CONCLUSIONS:

The injection of both allogeneic fibroblasts and suspension solution alone improved wound healing in chronic nonhealing RDEB-GS wounds independently of collagen VII regeneration. This may provide feasible therapy for wound healing in patients with RDEB-GS.

KEYWORDS:

EB; HLA; RDEB; RDEB-GS; VAS; allogeneic fibroblasts; cell therapy; collagen VII; epidermolysis bullosa; generalized severe recessive dystrophic epidermolysis bullosa; injections; mRNA; messenger RNA; phase II; quality of life; randomized controlled trial; recessive dystrophic epidermolysis bullosa; visual analog scale; wound healing

PMID:
24075228
DOI:
10.1016/j.jaad.2013.08.014
[Indexed for MEDLINE]

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