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• W2201227263 abstract "Psoriasis is an incurable immune-mediated disease, which affects approximately 2% of the world's population. Current treatments, including newly emerged biologic agents, have some limitations.1Menter A. Griffiths C.E. Current and future management of psoriasis.Lancet. 2007; 370: 272-284Abstract Full Text Full Text PDF PubMed Scopus (270) Google Scholar Here, we report 2 cases of psoriasis vulgaris treated by umbilical cord-derived mesenchymal stem cells (UC-MSCs). In these 2 cases, both of the patients remained relapse free for 4 or 5 years. Patient 1: On July 7, 2009, a 35-year-old man, who had suffered psoriasis for 12 years and was newly diagnosed with diffuse large B-cell lymphoma (stage IV), came to our hospital. Three cycles of standard lymphoma chemotherapies and 2 autologous hematopoietic stem cell transplantations (auto-HSCT) were performed. Before the first transplantation, the physical examination showed numerous erythematous plaques with adherent silvery scales symmetrically distributed throughout the patient's body (Figure A.1). The distribution of the plaques clearly decreased after both conditioning regimens were performed 2 times, yet new skin lesions appeared within 6 weeks. Moreover, after the second transplantation, the patient suffered repeated infections, with continuous fever around 38°C and unstable blood counts (white cell count was 5.27 × 109/L with use of granulocyte colony-stimulating factor, hemoglobin was 107 g/L, platelet count was 55 × 109/L). After the patient's infection had been controlled, we gave him one dose (1 × 106/kg) of UC-MSCs to support engraftments. Unexpectedly, his skin lesions, as well as engraftment, recovered day by day. Six months later, the patient's lymphoma underwent complete remission and his psoriasis was significantly relieved (Figure A.2). The skin returned to normal within 12 months (Figure A.3). Now the patient has been monitored for nearly 5 years. His condition remains stable, with no recurrence of lymphoma or psoriasis. Patient 2: A 26-year-old woman, who was diagnosed with psoriasis vulgaris when she was 8 years old, came to our hospital in October 2011. She described how her symptoms got worse every autumn and winter after suffering psoriasis. Although topical steroidal agents could temporarily relieve her symptoms, the psoriasis still relapsed every year. Physical examinations after the patient had been admitted to our hospital showed that salmon-pink plaques were covered by silvery scales and were distributed all over the body (Figure B.1). Initially, we gave her 3 infusions of UC-MSCs (1 × 106/Kg each time) over 3 successive weeks. Gradually, her whole body surface turned smooth (Figure B.2). Three months later, we gave her 2 more UC-MSC infusions as consolidating therapies. The psoriasis has been relapse free for 4 years now. MSCs are heterogeneous cells that can differentiate into various types of cells and secrete cytokines.2Zhao Q. Ren H. Han Z. et al.Mesenchymal stem cells: immunomodulatory capability and clinical potential in immune diseases.J Cell Immunother. 2015; (in press). Available at: (Accessed November 16, 2015)http://dx.doi.org/10.1016/j.jocit.2014.12.001Crossref Scopus (201) Google Scholar We gave the first patient MSCs based on 2 reasons: one is that MSCs could support hematopoiesis,3Jaganathan B. Tisato V. Vulliamy T. et al.Effects of MSC co-injection on the reconstitution of aplastic anemia patient following hematopoietic stem cell transplantation.Leukemia. 2010; 24: 1791-1795Crossref PubMed Scopus (27) Google Scholar the other is that MSCs have already been used in autoimmune diseases.4Wang Y. Chen X. Cao W. Shi Y. Plasticity of mesenchymal stem cells in immunomodulation: pathological and therapeutic implications.Nat Immunol. 2014; 15: 1009-1016Crossref PubMed Scopus (921) Google Scholar Although auto-HSCT may have played a part in the release of the first patient's psoriasis, it is still under the risk of relapse.5Hinterberger W. Hinterberger-Fischer M. Marmont A. Clinically demonstrable anti-autoimmunity mediated by allogeneic immune cells favorably affects outcome after stem cell transplantation in human autoimmune diseases.Bone Marrow Transplant. 2002; 30: 753-759Crossref PubMed Scopus (86) Google Scholar The patient who underwent auto-HSCT and UC-MSCs infusion showed no symptoms of psoriatic relapse after nearly 5 years. In addition, MSCs have a unique advantage in terms of safety. We assume that MSCs may be involved in the following 4 aspects: migration to skin lesions, immunomodulation, limitation of autoimmunity, and local paracrine effects. However, more cases are needed to determine the efficacy of MSCs and their infusion dose, method, and delivery time." @default.
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• W2201227263 date "2016-03-01" @default.
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• W2201227263 title "Treatment of Psoriasis with Mesenchymal Stem Cells" @default.
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• W2201227263 doi "https://doi.org/10.1016/j.amjmed.2015.11.001" @default.
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