Clinical Efficacy and Safety of Mesenchymal Stem Cells for Systemic Lupus Erythematosus

Abstract

Systemic lupus erythematosus (SLE) is a polymorphic, multisystemic autoimmune disease that causes multiorgan damage in which cellular communication occurs through the involvement of autoantibodies directed against autoantigen production. Mesenchymal stem cells (MSCs), which have strong protective and immunomodulatory abilities, are obtained not only from bone marrow but also from medical waste such as adipose tissue and umbilical cord tissue and have been recognized as a promising tool for the treatment of various autoimmune diseases and inflammatory disorders. This meta-analysis is aimed at assessing whether MSCs can become a new treatment for SLE with good efficacy and safety. Based on predetermined criteria, a bibliographical search was performed from January 1, 2000, to July 31, 2019, by searching the following databases: ISI Web of Science, Embase, PubMed, the Cochrane Library, and the Chinese Biomedical Literature Database (CBM). Eligible studies and data were identified. Statistical analysis was conducted to assess the efficacy (proteinuria, systemic lupus erythematosus disease activity index (SLEDAI), Scr, BUN, albumin, C3, and C4) and safety (rate of adverse events) of MSCs for SLE using Cochrane Review Manager Version 5.3. Ten studies fulfilled the inclusion criteria and were eligible for this meta-analysis, which comprised 8 prospective or retrospective case series and four randomized controlled trails (RCTs) studies. In the RCT, the results indicated that the MSC group had lower proteinuria than the control group at 3 months and 6 months and the MSC group displayed a lower SLEDAI than the control group at 2 months and 6 months. Furthermore, the MSC group showed a lower rate of adverse events than the control group (OR=0.26, 95% CI: 0.07, 0.89, P=0.03). In the case series trials, the results indicated that the MSC group had lower proteinuria at 1 month, 2 months, 3 months, 4 months, 6 months, and 12 months. In conclusion, MSCs might be a promising therapeutic agent for patients with SLE.

Mesenchymal stem cell treatment for refractory pediatric rheumatic diseases: A single center case series

“…Studies have shown that providers do not tightly adhere to recommended dosing of GVHD with an average dose of 1.4 × 10 6 MSCs/kg and three total doses administered (range is 1-10 doses administered) [16]. With such varying doses in MSC treatments, adverse events might be expected in the comparatively higher-dosed infusion; but overall, studies have not shown signi cant adverse events, which is consistent with our observations [15][16]. There has been…”

“…Furthermore, no standard dosing has been published for pediatric rheumatic disease. There have been a few studies investigating the clinical e cacy and safety of MSC treatment in adult SLE with intravenous doses ranging from 1 × 10 6 MSCs/kg/dose to 2 × 10 8 MSCs/kg/dose [15]. In this case series, the patients' dosing ranged from 1.2 × 10 6 MSCs/kg/dose to 6.5 × 10 6 MSCs/kg/dose.…”

Nephroprotective Effect of Mesenchymal Stem Cell-Based Therapy of Kidney Disease Induced by Toxicants

“…Our previous meta-analysis also found that MSCs reduce Scr levels, BUN levels, and proteinuria, as well as alleviate renal damage in animal models of AKI [ 43 ]. Lower proteinuria was also found in patients with SLE after MSC therapy [ 44 ].…”

Potential of Immune-Related Therapy in COVID-19

“…Mesenchymal stem cells (MSCs) are characterized by strong anti-inflammatory and immune-regulatory activities, improving the microenvironment of the body and promoting the endogenous repair of the host. The safety and efficacy of MSC therapy have been demonstrated in many clinical trials, especially in immune-mediated inflammatory diseases, such as graft-versus-host disease ( Hashmi et al, 2016 ) and systemic lupus erythematosus ( Zhou et al, 2020 ). Given the strong immune-regulatory capacity of MSCs, the team recruited seven patients with COVID-19 for MSC transplantation to explore the potential of MSCs to treat patients with COVID-19 by observing the changes in immune and inflammatory system functions and the occurrence of side effects within 14 days after transplantation ( Leng et al, 2020 ).…”