Human placental mesenchymal stromal cell‐derived exosome‐enriched extracellular vesicles for chronic cutaneous graft‐versus‐host disease: A case report

• Published in: Journal of cellular and molecular medicine 2022-01, Vol.26 (2), p.588-592
• Main Authors: Norooznezhad, Amir Hossein, Yarani, Reza, Payandeh, Mehrdad, Hoseinkhani, Zohreh, Kiani, Sarah, Taghizadeh, Elham, Thakor, Avnesh S., Mansouri, Kamran
• Format: Article
• Language: English
• Subjects: Adipose tissue; Alkaline phosphatase; Alopecia; Aspartate transaminase; Bilirubin; Bone marrow; C-reactive protein; Case reports; Creatinine; cutaneous GVHD; Cytomegalovirus; exosome; Exosomes; Extracellular Vesicles; Female; Graft versus host disease; Graft vs Host Disease - etiology; Hematocrit; Hemoglobin; Hepatitis B; Hepatitis C; HIV; Human immunodeficiency virus; human mesenchymal stromal cell; Humans; Hyperpigmentation; Immunomodulation; Immunoregulation; Inflammatory diseases; L-Lactate dehydrogenase; Laboratories; Lactic acid; Leukocytes (eosinophilic); Leukocytes (neutrophilic); Lymphocytes; Medical tests; Mesenchymal Stem Cell Transplantation; Mesenchymal Stem Cells; Mesenchyme; Phosphatase; Placenta; Pregnancy; Proteins; Short Communication; Short Communications; Stem cells; Transmission electron microscopy; Transplantation; Transplants & implants; Viral infections
• ISSN: 1582-1838; 1582-4934
• DOI: 10.1111/jcmm.17114

According to the studies, the cutaneous cGVHD is associated with an inflammatory state in which anti-inflammatory agents are the most important treatment option. 5 Human mesenchymal stromal cells (hMSC) have been used to treat many inflammatory diseases/disorders in the clinic. Depending on the origin and microenvironment of exosomes, they could play different roles, of which immune modulation is one of the most important ones. 10 Comparing to other sources such as bone marrow or adipose tissue, the placenta is a richer source of stem cells. Since in pregnancy, there is a ‘tolerated allograft’ in which the placenta is the immunoregulatory organ in this process, this tissue might be a better source in the allogeneic stem cell source. At his clinic visit, reticulated pink to violet papules and plaques admixed with post-inflammatory hyperpigmentation were noted on his face and other areas. [...]vitiligo/amelanic patches with scarring alopecia were detected on his scalp. Upper and lower pictures represent before and after the treatment (four treatments of extracellular vesicles therapy) TABLE 1 Laboratory variables before and 4 weeks after the last session of intervention Variable Before treatment After the fourth intervention White blood cells/mm3 6830 7800 Neutrophils/mm3 2049 3666 Lymphocytes/mm3 3346 3588 Monocytes/mm3 1229 390 Eosinophils/mm3 204 2 Haemoglobin gr/dl 17.7 17.3 Haematocrit (%) 51.1 48.3 Platelet ×103/mm3 225 228 C-reactive protein 1+ Negative Erythrocyte sedimentation rate (mm/h) 23 10 Creatinine mg/dl 0.8 0.9 Aspartate transaminase IU/L 59 57 Alkaline transaminase IU/L 50 59 Alkaline phosphatase U/L 333 365 Total bilirubin 0.8 0.8 Direct bilirubin 0.4 0.4 Lactate dehydrogenase U/ml 482 461 The exosomes-enriched EVs were isolated from placental-derived human mesenchymal stromal cells as has been described, and the patient received four treatments at a weekly interval (June 2021; 5 years and 2 months after the transplantation).