Sequential intravenous allogeneic mesenchymal stromal cells as a potential treatment for thromboangiitis obliterans (Buerger's disease)

• Published in: Stem cell research & therapy 2018-05, Vol.9 (1), p.150-150, Article 150
• Main Authors: Martin-Rufino, Jorge D, Lozano, Francisco S, Redondo, Alba M, Villaron, Eva M, Rueda, Raquel, Fernandez-Samos, Rafael, Sanchez-Guijo, Fermin
• Format: Article
• Language: English
• Subjects: Allogeneic mesenchymal stromal cells; Amputation; Autografts; Blood platelets; Blood vessels; Bone marrow; Bone marrow transplantation; Cell transplantation; Disease; Foot diseases; Immune response; Immune system; Immunomodulation; Inflammation; Intravenous administration; Ischemia; Mesenchymal stem cells; Mesenchyme; Morbidity; Pain; Pathogenesis; Patients; Quality of life; Questionnaires; Short Report; Skin; Smoking cessation; Stem cells; Stromal cells; Therapeutic applications; Thromboangiitis obliterans; Ulcers; Vasculitis; Walking
• ISSN: 1757-6512; 1757-6512
• DOI: 10.1186/s13287-018-0901-6

Thromboangiitis obliterans (TAO), also known as Buerger's Disease, is an occlusive vasculitis linked with high morbidity and amputation risk. To date, TAO is deemed incurable due to the lack of a definitive treatment. The immune system and inflammation are proposed to play a central role in TAO pathogenesis. Due to their immunomodulatory effects, mesenchymal stromal cells (MSCs) are the subject of intense research for the treatment of a wide range of immune-mediated diseases. Thus far, local intramuscular injections of autologous or allogeneic MSCs have shown promising results in TAO. However, sequential intravenous allogeneic MSC administration has not yet been explored, which we hypothesized could exert a systemic anti-inflammatory effect in the vasculature and modulate the immune response. Here, we report the first case of a TAO patient at amputation risk treated with four sequential intravenous infusions of bone marrow-derived allogeneic MSCs from a healthy donor. Following administration, there was significant regression of foot skin ulcers and improvements in rest pain, Walking Impairment Questionnaire scores, and quality of life. Sixteen months after the infusion, the patient had not required any further amputations. This report highlights the potential of sequential allogeneic MSC infusions as an effective treatment for TAO, warranting further studies to compare this approach with the more conventionally used intramuscular MSC administration and other cell-based therapies.