Autologous mesenchymal stem cells foster revascularization of ischemic limbs in systemic sclerosis: a case report.

Abstract:

BACKGROUND:Mesenchymal stem cells can differentiate into endothelial cells and participate in angiogenesis in adults. In experimental models of acute myocardial infarction, mesenchymal stem cells led to the recovery of cardiac function through the formation of a new vascular network. OBJECTIVE:To describe treatment with intravenous infusions of expanded autologous mesenchymal stem cells in 1 patient with critical limb ischemia due to systemic sclerosis. DESIGN:Case report. SETTING:The rheumatology unit at the University of Florence, Florence, Italy. PATIENT:A woman, aged 34 years, with systemic sclerosis who developed acute gangrene of the upper and lower limbs. INTERVENTION:3 intravenous pulses of expanded autologous mesenchymal stem cells. MEASUREMENTS:Angiography, skin histopathology, and immunohistochemistry. RESULTS:Areas of necrotic skin were reduced after the first mesenchymal stem-cell infusion. After the third infusion, angiography showed revascularization of the patient's extremities. Skin section analysis revealed cell clusters with tubelike structures, and angiogenic factors were strongly expressed. LIMITATION:Causality cannot be established by a single case. CONCLUSION:In patients with systemic sclerosis who have severe peripheral ischemia, intravenous infusion of expanded autologous mesenchymal stem cells may foster the recovery of the vascular network, restore blood flow, and reduce skin necrosis. PRIMARY FUNDING SOURCE:Fondazione Cassa di Risparmio di Pistoia e Pescia (partial funding).

journal_name

Ann Intern Med

authors

Guiducci S,Porta F,Saccardi R,Guidi S,Ibba-Manneschi L,Manetti M,Mazzanti B,Dal Pozzo S,Milia AF,Bellando-Randone S,Miniati I,Fiori G,Fontana R,Amanzi L,Braschi F,Bosi A,Matucci-Cerinic M

doi

10.7326/0003-4819-153-10-201011160-00007

subject

Has Abstract

pub_date

2010-11-16 00:00:00

pages

650-4

issue

10

eissn

0003-4819

issn

1539-3704

pii

153/10/650

journal_volume

153

pub_type

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