异基因骨髓间质干细胞移植治疗难治性红斑狼疮

目的探索异基因骨髓间质干细胞移植(MSCT)对难治性红斑狼疮(SLE)的疗效及安全性。方法取相关供体(母亲)的骨髓,体外扩增,输注细胞数(MSC)≥1×106/kg。选择难治性SLE患者进行MSCT,比较移植前后临床表现的改善及实验室指标如24 h尿蛋白定量、抗核抗体(ANA)、抗ds-DNA、血清补体C3、血清白蛋白、肾小球滤过率、血像的变化,评价MSCT的疗效。结果2例女性难治性SLE患者在行MSCT后,随访3月。例1患者血清肌酐(Cr)、尿蛋白和ANA滴度下降,血红蛋白、补体C3和肾小球滤过率上升;例2患者血清白蛋白、补体C3上升,尿蛋白下降,高血压得到改善。2例均无移植相关并发症。结论MSCT治疗难治性SLE安全有效,远期疗效有待进一步观察。

Study of Allogenic Mesenchymal Stem Cells Transplantation for Refractory Systemic Lupus Erythematosus

Objective To explore the clinical efficacy and safety of all-ogenic bone marrow mesenchymal stem cells transplantation(MSCT) for patients with refractory systemic lupus erythematosus(SLE).Methods The bone marrow of related donors was aspirated.The mesenchymal stem cells(MSCs) were expanded in vitro and infused intravenously into the two refractory SLE patients(1～2)×106/kg.The clinical manifestations and laboratory tests such as serum creatine,24-hour urine protein,anti-nuclear antibody(ANA),anti-dsDNA antibody,serum complement C3,serum albumin,glomerular filtration rate(GFR) and blood cells were compared before and after the MSCT.Results The two patients were followed up for three months after MSCT.The serum creatine,uria protein and ANA titer decreased,while hemoglobin,complement C3 and GFR increased in one patient;serum albumin and complement C3 increased,uria protein decreased and hypertension improved in another patient.Both patients have not developed transplantation related complications.Conclusion Treating refractory SLE with MSCT is effective and safe.However,further observation is required to evaluate long term efficacy.