Han Sei-Myoung, Kim Hyun-Tae, Kim Kun-Woo, Jeon Kee-Ok, Seo Kyoung-Won, Choi Eun Wha, Youn Hwa-Young
Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul, 151-742, Republic of Korea.
Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, 305-764, Republic of Korea.
BMC Vet Res. 2015 Mar 6;11:49. doi: 10.1186/s12917-015-0371-3.
Canine pemphigus foliaceus is an autoimmune antibody-mediated skin disease characterized by acantholysis. The objective of this case report is to present the successful management of steroid refractory pemphigus foliaceus with cytotoxic T-lymphocyte antigen 4 (CTLA4)-overexpressing adipose tissue mesenchymal stem cells (ATMSCs).
A 10-year-old, 12.3-kg, castrated male Shih Tzu presented with severe pruritus and anorexia. The diagnosis of pemphigus foliaceus was made based on its history, physical examination, and histopathology results of a skin biopsy. Treatment with prednisolone and combination therapy of other immunosuppressive drugs had failed; therefore, immunosuppressive gene, CTLA4 overexpressing ATMSCs (CTLA4-ATMSCs) and/or naive ATMSCs administration was performed with the consent of the owner. ATMSCs were administered 21 times over a period of 20 months with intervals of 2 to 8 week. Prednisolone was gradually tapered concurrently and no relapse of the clinical signs was observed. After the termination of CTLA4-ATMSCs and/or naive ATMSCs treatment, the skin lesions had improved and could be managed with a low dose of prednisolone for 12 months.
CTLA4-ATMSCs or naive ATMSCs transplantation may be beneficial as adjunctive therapy to initiate and maintain the remission of skin lesions caused by pemphigus foliaceus in veterinary medicine.
犬落叶型天疱疮是一种自身免疫性抗体介导的以棘层松解为特征的皮肤病。本病例报告的目的是介绍用细胞毒性T淋巴细胞抗原4（CTLA4）过表达的脂肪组织间充质干细胞（ATMSC）成功治疗类固醇难治性落叶型天疱疮。
一只10岁、体重12.3千克的去势雄性西施犬出现严重瘙痒和厌食。根据病史、体格检查及皮肤活检的组织病理学结果诊断为落叶型天疱疮。泼尼松龙治疗及其他免疫抑制药物联合治疗均失败；因此，在主人同意下进行了免疫抑制基因CTLA4过表达的ATMSC（CTLA4-ATMSC）和/或未处理的ATMSC给药。在20个月内间隔2至8周给予ATMSC 21次。同时泼尼松龙逐渐减量，未观察到临床症状复发。在CTLA4-ATMSC和/或未处理的ATMSC治疗结束后，皮肤病变有所改善，低剂量泼尼松龙治疗12个月即可控制。
在兽医学中，CTLA4-ATMSC或未处理的ATMSC移植作为辅助治疗可能有助于启动和维持落叶型天疱疮引起的皮肤病变的缓解。
