title: Mesenchymal stem cell therapy unable to rescue the vision from advanced Behcet's disease retinal vasculitis: report of three patients.
abstract: OBJECTIVE
  Retinal vasculitis (RV) is the most aggressive lesion of ocular manifestations of Behcet's disease, seen in 32.1% of patients. Although visual acuity (VA) improves with early and aggressive treatment, in the long run it is seen in only 48% of patients. Mesenchymal stem cell (MSC) transplantation (MSCT) can theoretically reverse the RV process.
  
  
  METHODS
  Three patients with advanced RV and very low VA were selected. Eyes selected for MSCT were legally blind (no useful vision) with severe retinal damage due to vasculitis, resistant to combinations of monthly pulse-cyclophosphamide (1000 mg) + azathioprine 2-3 mg/kg/day + prednisolone 0.5 mg/kg/day. After patient signed written consent, 30 mL of bone marrow were taken and cultured for MSC growth. After having enough MSCs in culture (4-5 weeks) and taking into consideration all safety measures, cells were injected in one eye of each patient (approximately 1.8 million MSCs). VA was measured. Disease Activity Index (DAI) was calculated for anterior uveitis (AU), posterior uveitis (PU) and RV.
  
  
  RESULTS
  Visual acuity was light perception (LP) for two patients and finger count (FC) for the third. Follow-up at 1, 6 and 12 months were respectively LP/LP/FC at 0.5 m, no-light perception (NLP)/LP/LP, NLP/LP/NLP.
  
  
  CONCLUSIONS
  Results showed a total failure of the procedure, essentially due to the late and advanced state of vasculitis. However, the autoimmune/inflammatory reaction was greatly controlled by the procedure.
  
  
  CONCLUSIONS
  Earlier cases have to be selected for further trials.
authors.affiliation: Rheumatology Research Center, Shariati Hospital, Tehran University for Medical Sciences, Tehran, Iran. fddh@davatchi.net
authors.forename: Fereydoun
authors.initials: F
authors.lastname: Davatchi
authors.forename: Behrooz
authors.initials: B
authors.lastname: Nikbin
authors.forename: Hormoz
authors.initials: H
authors.lastname: Shams
authors.forename: Bahar
authors.initials: B
authors.lastname: Sadeghi Abdollahi
authors.forename: Mandana
authors.initials: M
authors.lastname: Mohyeddin
authors.forename: Farhad
authors.initials: F
authors.lastname: Shahram
mesh_terms: D000328:Adult; D001528:Behcet Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002478:Cells, Cultured; D005260:Female; D006801:Humans; D056965:Injections, Intraocular; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D008875:Middle Aged; D020127:Recovery of Function; D031300:Retinal Vasculitis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012720:Severity of Illness Index; D013997:Time Factors; D017211:Treatment Failure; D014606:Uveitis, Anterior / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D015866:Uveitis, Posterior / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014792:Visual Acuity