title: Mesenchymal stem cell transplantation reverses multiorgan dysfunction in systemic lupus erythematosus mice and humans.
abstract: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that, despite the advances in immunosuppressive medical therapies, remains potentially fatal in some patients, especially in treatment-refractory patients. Here, we reported that impairment of bone marrow mesenchymal stem cells (BMMSCs) and their associated osteoblastic niche deficiency contribute in part to the pathogenesis of SLE-like disease in MRL/lpr mice. Interestingly, allogenic BMMSC transplantation (MSCT) is capable of reconstructing the bone marrow osteoblastic niche and more effectively reverses multiorgan dysfunction when compared with medical immunosuppression with cyclophosphamide (CTX). At the cellular level, MSCT, not CTX treatment, was capable to induce osteoblastic niche reconstruction, possibly contributing to the recovery of regulatory T-cells and reestablishment of the immune homeostasis. On the basis of the promising clinical outcomes in SLE mice, we treated four CTX/glucocorticoid treatment-refractory SLE patients using allogenic MSCT and showed a stable 12-18 months disease remission in all treated patients. The patients benefited an amelioration of disease activity, improvement in serologic markers and renal function. These early evidences suggest that allogenic MSCT may be a feasible and safe salvage therapy in refractory SLE patients.
authors.affiliation: Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Lingyun
authors.initials: L
authors.lastname: Sun
authors.forename: Kentaro
authors.initials: K
authors.lastname: Akiyama
authors.forename: Huayong
authors.initials: H
authors.lastname: Zhang
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Yamaza
authors.forename: Yayi
authors.initials: Y
authors.lastname: Hou
authors.forename: Shengnan
authors.initials: S
authors.lastname: Zhao
authors.forename: Ting
authors.initials: T
authors.lastname: Xu
authors.forename: Anh
authors.initials: A
authors.lastname: Le
authors.forename: Songtao
authors.initials: S
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000818:Animals; D001323:Autoantibodies / Q000097:blood; D015153:Blotting, Western; D016026:Bone Marrow Transplantation; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000628:therapy*; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D051379:Mice; D019463:Mice, Inbred MRL lpr; D010865:Pilot Projects; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055153:Stem Cell Niche; D055815:Young Adult
chemical_list: D001323:Autoantibodies