Autologous stem cell transplantation improves microcirculation in systemic sclerosis

Miniati, Irene; Guiducci, Serena; Conforti, Maria Letizia; Rogai, Veronica; Fiori, Ginevra; Cinelli, Marina; Saccardi, Riccardo; Guidi, Stefano; Bosi, Alberto; Tyndall, Alan; Matucci‐Cerinic, Marco

doi:10.1136/ard.2007.082495

Cited by 98 publications

(83 citation statements)

References 21 publications

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“…Besides the action of conditioning immunosuppressive therapy in ablating autoimmune response and strongly reducing fibroblast activation (1), it has been postulated that the ASCT effectiveness can be at least in part ascribed to the capacity of the repopulating stem cells to induce a neoangiogenesis in the sclerotic skin (13,23).…”

Section: Discussionmentioning

confidence: 99%

Autologous Fat Grafting in the Treatment of Fibrotic Perioral Changes in Patients with Systemic Sclerosis

et al. 2015

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Autologous fat tissue grafting (AFTG) has been successfully used in the treatment of different sclerotic conditions, including localized scleroderma. Patients with advanced systemic sclerosis (SSc)-related perioral thickening and mouth opening limitation are candidates for this therapeutic approach. AFTG of the lips was performed to improve mouth opening in patients with SSc. We enrolled in the study 20 female patients with diffuse SSc (median age 35 ± 15 years and 11 ± 10 years of disease duration). Two-milliliter fractions of autologous fat drawn from trochanteric or periumbilical areas were injected in eight different sites around the mouth. Baseline and after-treatment mouth opening changes were assessed by measuring interincisal distance and oral perimeter, while skin hardness was tested by digital durometer. Pre-and posttreatment modifications of microvascular architecture were assessed by counting capillaries in the inferior lip videocapillaroscopy (VC) images and by scoring the microvascular density (MVD) in anti-CD34/CD31 immunohistochemical (IH) stained perioral skin biopsy sections. Similarly, histological sections were examined to evaluate dermoepidermic junction (DEJ) modifications. Three months after treatment, both the interincisal distance and oral perimeter significantly increased (p < 0.001). At the same time, a significant skin neovascularization became evident, both considering the VC images (p < 0.001) and MVD scores in IH sections (p < 0.0001). Finally, some skin histological aspects also improved, as shown by the significant changes in DEJ flattening scores (p < 0.0001). The present study suggests that, in patients with SSc, AFTG can improve mouth opening and function, induce a neovascularization, and partially restore the skin structure.

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Section: Discussionmentioning

confidence: 99%

Autologous Fat Grafting in the Treatment of Fibrotic Perioral Changes in Patients with Systemic Sclerosis

et al. 2015

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“…A recent study showed that after hematopoietic stem cell transplantation, in beforehand avascular regions of the nailbed, a new formation of vessels, e.g. giant capillaries, could be observed (68).…”

Section: Clinical Implications -Supporting Repairmentioning

confidence: 99%

Mechanisms of vascular damage in systemic sclerosis

et al. 2009

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Although being classified as autoimmune connective tissue disease, dominant components of the pathophysiology of systemic sclerosis (SSc) consists of mechanisms of vascular damage, which can occur early in the course of the disease. Amongst them are abnormal vasoreactivity, hypoxia, insufficient neoangiogenesis and direct damage of vascular and perivascular cells. They result in a decreased capillary blood flow, and subsequently in clinically overt symptoms such as Raynaud's syndrome and fingertip ulcers. In addition, in active disease vascular pathology can affect various other organs, predominantly the lung, the kidney, the heart but also the gastrointestinal tract. Vascular pathology contributes also significantly to overall morbidity and mortality in SSc patients and reduces life expectancy by at least a decade. Fortunately, molecular biology has revealed a number of underlying pathways on the cellular and subcellular levels, including key factors of the aberrant function of (peri)vascular cells and autoimmune effector cells, the dysregulation of vasoconstrictive molecules and their receptors, the upregulation of intracellular signaling kinases and the altered balance of hypoxia-induced vascular growth factors. This increasing knowledge of vascular pathology in SSc has also resulted in novel therapeutic approaches ranging from endothelin antagonists to application of progenitor cells to counteract this aberrant vascular pathology and to support the repair of the dysfunctional vasculature.

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“…Severe nailfold capillaroscopy (NC) findings have been described but their association with disease activity and/or response to treatment have rarely been investigated [1][2][3][4][5][6][7] .…”

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confidence: 99%

Successful Immunosuppressive Treatment of Dermatomyositis: A Nailfold Capillaroscopy Survey

Riccieri

Vasile²,

Macri³

et al. 2010

J Rheumatol

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Autologous stem cell transplantation improves microcirculation in systemic sclerosis

Abstract: These results indicate that HSCT with a high dose CYC regimen may foster vascular remodelling, while CYC at lower doses and with a chronic regimen does not influence the microvasculature.

Cited by 98 publications

References 21 publications

Autologous Fat Grafting in the Treatment of Fibrotic Perioral Changes in Patients with Systemic Sclerosis

Autologous Fat Grafting in the Treatment of Fibrotic Perioral Changes in Patients with Systemic Sclerosis

Mechanisms of vascular damage in systemic sclerosis

Successful Immunosuppressive Treatment of Dermatomyositis: A Nailfold Capillaroscopy Survey

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