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Abstrakt
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.