Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China.
Clin Rheumatol. 2012 May;31(5):841-6. doi: 10.1007/s10067-012-1943-2.
Umbilical cord-derived mesenchymal stem cell transplantation (UC-MSCT) has been proved to be effective in the treatment of systemic lupus erythematosus (SLE), based on animal experiments and clinical trials. Diffuse alveolar hemorrhage (DAH) is a rare complication of SLE with a high mortality usually over 50%. This study aimed to assess the efficacy of UC-MSCT in the treatment of SLE-associated DAH. Four SLE patients complicated with DAH, who underwent UC-MSCT, were included. Clinical changes before and after transplantation were assessed by measurements of hemoglobin, platelet level, oxygen saturation, and serological factors. High-resolution CT (HRCT) scans of the chest were performed to evaluate pulmonary manifestation. All the four patients showed dramatic improvements of their clinical manifestations. Hemoglobin was elevated after UC-MSCT and was sustained at a normal level 6 months after UC-MSCT in the four patients. Platelet level was upregulated in two patients who had thrombocytopenia at baseline. Oxygen saturation appeared to be normal at 1 month after UC-MSCT, and this result was confirmed by the HRCT scan of the chest. Serum albumin elevated to 3.5 g/dl 6 months after transplantation. Our findings suggest that UC-MSCT results in amelioration of oxygen saturation as well as hematological and serologic changes, which revealed that UC-MSCT could be applied as a salvage strategy for DAH patients.
脐带间充质干细胞移植（UC-MSCT）已被证明在治疗系统性红斑狼疮（SLE）方面是有效的，这基于动物实验和临床试验。弥漫性肺泡出血（DAH）是 SLE 的一种罕见并发症，死亡率通常超过 50%。本研究旨在评估 UC-MSCT 治疗 SLE 相关 DAH 的疗效。纳入了 4 例接受 UC-MSCT 的合并 DAH 的 SLE 患者。通过测量血红蛋白、血小板水平、氧饱和度和血清学因素来评估移植前后的临床变化。对胸部进行高分辨率 CT（HRCT）扫描以评估肺部表现。所有 4 例患者的临床表现均明显改善。UC-MSCT 后血红蛋白升高，在 UC-MSCT 后 6 个月维持在正常水平。基线时有血小板减少的 2 例患者的血小板水平上调。UC-MSCT 后 1 个月氧饱和度似乎正常，胸部 HRCT 扫描证实了这一结果。血清白蛋白在移植后 6 个月升高至 3.5 g/dl。我们的研究结果表明，UC-MSCT 可改善氧饱和度以及血液学和血清学变化，这表明 UC-MSCT 可作为 DAH 患者的挽救策略。
