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Stem Cell Res Ther. 2018 May 30;9(1):150. doi: 10.1186/s13287-018-0901-6.

Sequential intravenous allogeneic mesenchymal stromal cells as a potential treatment for thromboangiitis obliterans (Buerger's disease).

Author information

1
Department of Hematology, Cell Therapy Unit, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007, Salamanca, Spain.
2
Faculty of Medicine, Universidad de Salamanca, Salamanca, Spain.
3
Department of Angiology and Vascular Surgery, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain.
4
Centro en Red de Medicina Regenerativa y Terapia Celular de Castilla y Leon, Salamanca, Spain.
5
Department of Radiology, Hospital de Leon, Leon, Spain.
6
Department of Angiology and Vascular Surgery, Hospital de Leon, Leon, Spain.
7
Department of Hematology, Cell Therapy Unit, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007, Salamanca, Spain. ferminsg@usal.es.
8
Faculty of Medicine, Universidad de Salamanca, Salamanca, Spain. ferminsg@usal.es.
9
Centro en Red de Medicina Regenerativa y Terapia Celular de Castilla y Leon, Salamanca, Spain. ferminsg@usal.es.

Abstract

Thromboangiitis obliterans (TAO), also known as Buerger's Disease, is an occlusive vasculitis linked with high morbidity and amputation risk. To date, TAO is deemed incurable due to the lack of a definitive treatment. The immune system and inflammation are proposed to play a central role in TAO pathogenesis. Due to their immunomodulatory effects, mesenchymal stromal cells (MSCs) are the subject of intense research for the treatment of a wide range of immune-mediated diseases. Thus far, local intramuscular injections of autologous or allogeneic MSCs have shown promising results in TAO. However, sequential intravenous allogeneic MSC administration has not yet been explored, which we hypothesized could exert a systemic anti-inflammatory effect in the vasculature and modulate the immune response. Here, we report the first case of a TAO patient at amputation risk treated with four sequential intravenous infusions of bone marrow-derived allogeneic MSCs from a healthy donor. Following administration, there was significant regression of foot skin ulcers and improvements in rest pain, Walking Impairment Questionnaire scores, and quality of life. Sixteen months after the infusion, the patient had not required any further amputations. This report highlights the potential of sequential allogeneic MSC infusions as an effective treatment for TAO, warranting further studies to compare this approach with the more conventionally used intramuscular MSC administration and other cell-based therapies.

KEYWORDS:

Allogeneic mesenchymal stromal cells; Cell transplantation; Thromboangiitis obliterans

PMID:
29848379
PMCID:
PMC5977545
DOI:
10.1186/s13287-018-0901-6
[Indexed for MEDLINE]
Free PMC Article

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