Stem cell treatment for patients with autoimmune disease by systemic infusion of culture-expanded autologous adipose tissue derived mesenchymal stem cells

Abstract

Prolonged life expectancy, life style and environmental changes have caused a changing disease pattern in developed countries towards an increase of degenerative and autoimmune diseases. Stem cells have become a promising tool for their treatment by promoting tissue repair and protection from immune-attack associated damage. Patient-derived autologous stem cells present a safe option for this treatment since these will not induce immune rejection and thus multiple treatments are possible without any risk for allogenic sensitization, which may arise from allogenic stem cell transplantations. Here we report the outcome of treatments with culture expanded human adipose-derived mesenchymal stem cells (hAdMSCs) of 10 patients with autoimmune associated tissue damage and exhausted therapeutic options, including autoimmune hearing loss, multiple sclerosis, polymyotitis, atopic dermatitis and rheumatoid arthritis. For treatment, we developed a standardized culture-expansion protocol for hAdMSCs from minimal amounts of fat tissue, providing sufficient number of cells for repetitive injections. High expansion efficiencies were routinely achieved from autoimmune patients and from elderly donors without measurable loss in safety profile, genetic stability, vitality and differentiation potency, migration and homing characteristics. Although the conclusions that can be drawn from the compassionate use treatments in terms of therapeutic efficacy are only preliminary, the data provide convincing evidence for safety and therapeutic properties of systemically administered AdMSC in human patients with no other treatment options. The authors believe that ex-vivo-expanded autologous AdMSCs provide a promising alternative for treating autoimmune diseases. Further clinical studies are needed that take into account the results obtained from case studies as those presented here.

Mesenchymal stromal cells for treatment of arthritis

“…The third patient received 4 times iv injection of 200 Â 10 6 AdMSC in intervals of one month. All 3 patients improved and no adverse events were observed [100].…”

“…A fourth small study describes 3 RA patients who received adipose tissue derived MSC (AdMSC) [100]. Five grams of fat tissue were collected by liposuction, transferred immediately to the GMP facility and Stromal Cell Research Center of RNL BIO and culture-expanded for 3 passages using the standard protocol to obtain AdMSC.…”

Mesenchymal stromal cells and rheumatic disorders

“…A controlled prospective trial was recommended by the authors. A single case report of a 35-year-old female showed significantly improved strength after 4 IVI injections of autologous expanded adipose derived MSC at three months follow-up [35].…”

“…Clinical benefit was seen in all cases without significant toxicity. All patients received multiple injections of MSC, in two cases IVI and a third, intra-articular [35].…”

Clinical Aspects of Regenerative Medicine

“…In RA patients, the studies performed to evaluate the efficacy and biologic activity of MSC have shown some benefit, In the first study, intra-articular injections of cells to patients with RA improved the symptoms dramatically [58]. In another study [59], of four subjects with refractory rheumatoid arthritis transplanted with MSC, three experienced a reduction in ESR, DAS-28 (28-joint disease activity score) and pain VAS score at 1 and 6 months after transplantation.…”