Allogenic mesenchymal stem cells transplantation in refractory systemic lupus erythematosus: a pilot clinical study
Allogenic mesenchymal stem cells transplantation in refractory systemic lupus erythematosus: a pilot clinical study
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同种异体间充质干细胞移植治疗难治性系统性红斑狼疮：一项初步临床研究
DOI：
10.1136/ard.2009.123463
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发表时间：
2010-08-01
影响因子：
27.4
通讯作者：
Sun, Lingyun
中科院分区：
文献类型：
--
作者：
Liang, Jun;Zhang, Huayong;Sun, Lingyun
目的探讨异基因间充质干细胞移植（MSCT）治疗难治性系统性红斑狼疮（SLE）的安全性和有效性。方法对15例持续活动性SLE患者行MSCT检查。通过SLE疾病活动指数（SLEDAI）、血清学特征（抗核抗体和抗双链DNA（抗dsDNA））、肾功能和外周血调节性T细胞百分比的变化来评估结局。结果2007年3月11日至2008年11月4日，15例持续活动性SLE患者入选并接受MSCT检查。平均随访时间为17.2±9.5个月。共有13名患者接受了超过12个月的随访。所有患者在用间充质干细胞治疗后临床改善，SLEDAI评分和24小时蛋白尿显著降低。在12个月随访时，SLEDAI评分从12.2±3.3降至3.2±2.8，蛋白尿从2505.0±1323.9降至858.0±800.7 mg/24 h（所有p<0.05，通过配对t检验，n=12）。在13例患者的1年随访中，2例蛋白尿复发，而其他11例在最小治疗下疾病活动度继续降低。抗dsDNA水平降低。在进行正式测试的两名患者中，肾小球滤过率有所改善。非肾脏相关表现也显著改善。未报告严重不良事件。结论难治性狼疮患者行同种异体MSCT治疗后，病情活动性明显改善，血清学指标明显改善，肾功能稳定。多层螺旋CT似乎有益于治疗传统治疗方法难治的SLE患者。
Objective To determine the safety and efficacy of allogeneic mesenchymal stem cell transplantation (MSCT) in refractory systemic lupus erythematosus (SLE). Methods A total of 15 patients with persistently active SLE underwent MSCT. Outcome was evaluated by changes in the SLE disease activity index (SLEDAI), serological features (anti-nuclear antibodies and anti-double-stranded DNA (anti-dsDNA)), renal function and percentage of peripheral blood regulatory T cells. Results From 11 March 2007 to 4 November 2008, 15 patients with persistently active SLE were enrolled and underwent MSCT. The mean follow-up period was 17.2±9.5 months. A total of 13 patients have been followed for more than 12 months. All patients clinically improved following treatment with mesenchymal stem cells with a marked decrease in the SLEDAI score and 24 h proteinuria. At 12-month follow-up, SLEDAI scores decreased from 12.2±3.3 to 3.2±2.8 and proteinuria decreased from 2505.0±1323.9 to 858.0±800.7 mg/24 h (all p<0.05, by paired t test, n=12). At 1-year follow-up in 13 patients, 2 had a relapse of proteinuria, while the other 11 continue to have decreased disease activity on minimal treatment. Anti-dsDNA levels decreased. Improvement in glomerular filtration rate was noted in two patients in which formal testing was performed. Non-renal-related manifestations also improved significantly. No serious adverse events were reported. Conclusion Allogeneic MSCT in patients with refractory lupus resulted in amelioration of disease activity, improvement in serological markers and stabilisation of renal function. MSCT appears beneficial in treatment of patients with SLE refractory to conventional treatment options.