Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
Mod Rheumatol. 2010 Jun;20(3):263-72. doi: 10.1007/s10165-010-0274-x. Epub 2010 Feb 19.
We examined the efficacy and safety of autologous transplantation of bone-marrow-derived cells in patients with intractable ulcers caused by systemic sclerosis. Eight patients with ulcers resistant to treatment were enrolled. Bone marrow cells were gathered from the bilateral iliac crests with multiple repositioning bone marrow needles, and bone-marrow-derived mononuclear cells were isolated and injected into skeletal muscles of the ischemic limb. Visual analog scale (VAS), Sclerosis Health Assessment Questionnaire (SHAQ), modified Rodnan total skin score (mTSS), and the size and depth of the ulcer were examined. Thermography, capillaroscopy, intra-arterial digital subtraction angiography (IA-DSA), and laser Doppler flowmetry were also examined before and after transplantation. In all patients, reduction of ulcer size and improvement of VAS were observed after treatment. Elevation of surface temperature, increase of blood flow volume, and new capillaries of the nail bed were also found after our treatment. There were no major adverse effects of this treatment. Autologous transplantation of bone-marrow-derived cells was shown to be a novel and useful approach to intractable ulcers in systemic sclerosis.
我们研究了自体骨髓细胞移植治疗系统性硬化症所致难治性溃疡的疗效和安全性。共纳入 8 例溃疡治疗抵抗的患者。采用多部位定位骨髓穿刺针从双侧髂嵴采集骨髓细胞，分离骨髓源性单个核细胞并注射到缺血肢体的骨骼肌中。使用视觉模拟评分（VAS）、硬皮病健康评估问卷（SHAQ）、改良 Rodnan 总皮肤评分（mTSS）和溃疡的大小和深度进行评估。在移植前后还进行了热成像、毛细血管镜、动脉内数字减影血管造影（IA-DSA）和激光多普勒血流仪检查。所有患者治疗后溃疡面积缩小，VAS 改善。我们的治疗还发现了表面温度升高、血流体积增加和甲床新毛细血管。该治疗无重大不良反应。自体骨髓细胞移植是治疗系统性硬化症难治性溃疡的一种新颖而有用的方法。
