Institute of Basic Medical Sciences & School of Basic Medicine, Center of Excellence in Tissue Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Biol Blood Marrow Transplant. 2010 Mar;16(3):403-12. doi: 10.1016/j.bbmt.2009.11.006. Epub 2009 Nov 17.
The success of treatment for sclerodermatous chronic graft-versus-host disease (ScGVHD) remains disappointing. The immunomodulatory ability of bone marrow (BM)-derived mesenchymal stem cells (MSCs) shows promise in treating GVHD, especially given its previous success in treating patients with acute GVHD (aGVHD). The potential efficacy and safety issues for treating cGVHD, particularly ScGVHD, remain to be clarified, however. Here, we report 4 patients with ScGVHD who received MSCs expanded ex vivo from unrelated donors by intra-BM injection. After MSC infusion, the ratio of helper T lymphocyte (Th) 1 cells to Th2 cells was dramatically reversed, with an increase in Th1 and a decrease in Th2 achieving a new balance. Correspondingly, symptoms gradually improved in all 4 patients. During the course of MSC treatment, the patients' vital signs and laboratory results remained normal. At the time of this report, none of the 4 patients had experienced recurrence of leukemia. Although this study alone cannot guarantee the application of MSCs in ScGVHD, our findings strongly suggest that this treatment is therapeutically practicable, with no detectable side effects. This approach may provide new insight into the clinical treatment of ScGVHD, with the aim of greatly increasing the survival rate in patients with leukemia who undergo allogeneic BM transplantation (BMT).
硬皮病样慢性移植物抗宿主病（ScGVHD）的治疗成功率仍然令人失望。骨髓（BM）来源的间充质干细胞（MSCs）的免疫调节能力在治疗移植物抗宿主病（GVHD）方面显示出前景，特别是鉴于其在治疗急性移植物抗宿主病（aGVHD）方面的先前成功。然而，用其治疗 cGVHD，特别是 ScGVHD 的潜在疗效和安全性问题仍需阐明。在这里，我们报告了 4 例接受无关供体通过 BM 内注射体外扩增的 MSCs 治疗的 ScGVHD 患者。MSC 输注后，辅助性 T 淋巴细胞（Th）1 细胞与 Th2 细胞的比例明显逆转，Th1 增加，Th2 减少，达到新的平衡。相应地，所有 4 例患者的症状逐渐改善。在 MSC 治疗过程中，患者的生命体征和实验室结果保持正常。在本报告时，4 例患者均未复发白血病。尽管这项研究本身不能保证 MSCs 在 ScGVHD 中的应用，但我们的发现强烈表明这种治疗是可行的，没有可检测到的副作用。这种方法可能为 ScGVHD 的临床治疗提供新的思路，旨在大大提高接受同种异体 BM 移植（BMT）的白血病患者的生存率。
