title: CTLA4 overexpressing adipose tissue-derived mesenchymal stem cell therapy in a dog with steroid-refractory pemphigus foliaceus.
abstract: BACKGROUND
  Canine pemphigus foliaceus is an autoimmune antibody-mediated skin disease characterized by acantholysis. The objective of this case report is to present the successful management of steroid refractory pemphigus foliaceus with cytotoxic T-lymphocyte antigen 4 (CTLA4)-overexpressing adipose tissue mesenchymal stem cells (ATMSCs).
  
  
  METHODS
  A 10-year-old, 12.3-kg, castrated male Shih Tzu presented with severe pruritus and anorexia. The diagnosis of pemphigus foliaceus was made based on its history, physical examination, and histopathology results of a skin biopsy. Treatment with prednisolone and combination therapy of other immunosuppressive drugs had failed; therefore, immunosuppressive gene, CTLA4 overexpressing ATMSCs (CTLA4-ATMSCs) and/or naive ATMSCs administration was performed with the consent of the owner. ATMSCs were administered 21 times over a period of 20 months with intervals of 2 to 8 week. Prednisolone was gradually tapered concurrently and no relapse of the clinical signs was observed. After the termination of CTLA4-ATMSCs and/or naive ATMSCs treatment, the skin lesions had improved and could be managed with a low dose of prednisolone for 12 months.
  
  
  CONCLUSIONS
  CTLA4-ATMSCs or naive ATMSCs transplantation may be beneficial as adjunctive therapy to initiate and maintain the remission of skin lesions caused by pemphigus foliaceus in veterinary medicine.
authors.affiliation: Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul, 151-742, Republic of Korea. prettydoggy@snu.ac.kr.
authors.forename: Sei-Myoung
authors.initials: SM
authors.lastname: Han
authors.affiliation: Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul, 151-742, Republic of Korea. vetis@snu.ac.kr.
authors.forename: Hyun-Tae
authors.initials: HT
authors.lastname: Kim
authors.affiliation: Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul, 151-742, Republic of Korea. Nearbuddha@hanmail.net.
authors.forename: Kun-Woo
authors.initials: KW
authors.lastname: Kim
authors.affiliation: Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul, 151-742, Republic of Korea. 02liebe@hanmail.net.
authors.forename: Kee-Ok
authors.initials: KO
authors.lastname: Jeon
authors.affiliation: Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, 305-764, Republic of Korea. kwseo@cnu.ac.kr.
authors.forename: Kyoung-Won
authors.initials: KW
authors.lastname: Seo
authors.affiliation: Laboratory Animal Research Center, Samsung Biomedical Research Institute/ School of Medicine, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Republic of Korea. vet.cew@gmail.com.
authors.forename: Eun Wha
authors.initials: EW
authors.lastname: Choi
authors.affiliation: Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul, 151-742, Republic of Korea. hyyoun@snu.ac.kr.
authors.forename: Hwa-Young
authors.initials: HY
authors.lastname: Youn
mesh_terms: D000273:Adipose Tissue / Q000166:cytology*; D000818:Animals; D060908:CTLA-4 Antigen / Q000276:immunology*; D004283:Dog Diseases / Q000473:pathology / Q000628:therapy*; D004285:Dogs; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000662:veterinary*; D010392:Pemphigus / Q000473:pathology / Q000628:therapy / Q000662:veterinary*; D012867:Skin / Q000473:pathology
chemical_list: D060908:CTLA-4 Antigen; D007166:Immunosuppressive Agents