Stromal cell therapy in cats with feline chronic gingivostomatitis: current perspectives and future direction

Abstract

Feline chronic gingivostomatitis (FCGS) is a painful, immune-mediated, oral mucosal inflammatory disease in cats. The etiology of FCGS remains unclear, with evidence pointing potentially toward a viral cause. Full-mouth tooth extraction is the current standard of care, and cats that are non-responsive to extraction therapy may need lifelong medical management and, in some cases, euthanasia. Adipose-derived mesenchymal stromal cells (adMSCs) have been demonstrated to have advantages in the treatment and potentially the cure of non-responsive FCGS in cats. Therefore, adMSCs have attracted a series of ongoing clinical trials in the past decade. AdMSC therapy immediately after full-mouth tooth extraction was not explored, and we postulate that it may benefit the overall success rate of FCGS therapy. Here, we aim to summarize the current knowledge and impact of adMSCs for the therapeutic management of FCGS and to suggest a novel modified approach to further increase the efficacy of FCGS treatment in cats.

Feline chronic gingivostomatitis current concepts in clinical management

“…The efficacy of both autologous and allogeneic, fresh, adipose-derived MSCs administered intravenously has been studied in cats with refractory FCGS, 29 , 45 , 46 and is reported in a recently published paper from the authors’ group at the University of California, Davis (see ‘Companion paper on FCGS’ highlight circle). 79 The immunomodulatory action of MSCs has shown promise for treating cats with refractory FCGS, with up to 57% and 71% of FCGS patients exhibiting clinical improvement or remission after allogeneic and autologous treatments, respectively. 29 , 46 No response was seen when treating with MSCs before extraction therapy in a pilot study.…”

Distinctive characteristics of extracellular vesicles from feline adipose and placenta stromal cells unveil potential for regenerative medicine in cats

“…[9][10][11][12][13] This may be explained by their multilineage differentiation potential, high expansion potential, and immunomodulatory effects. 14 MSCs, in general, have been shown to play a significant role in the modulation of immune system activity on different levels. Moreover, MSCs are a rich source of a wide range of growth factors, including transforming growth factor-β (TGF-β), IL-10, and prostaglandin E 2 , which contribute to their immunomodulatory effects.…”

“…Moreover, MSCs are a rich source of a wide range of growth factors, including transforming growth factor-β (TGF-β), IL-10, and prostaglandin E 2 , which contribute to their immunomodulatory effects. 14 Finally, through cell-cell contact, they interact with the immune cells' compartment and may activate or inhibit their proliferation, which corresponds with oxidative stress development in the injured side. 15 Taken together, MSCs may act as a source of anti-inflammatory or immunomodulatory cytokines or chemokines that, in turn, can suppress the activity of proinflammatory immune cells, such as macrophages and T cells.…”