Jeong H. Yun, MD, MPH
Potential Conflicts of Interest: None disclosed.
Yun JH. Autologous Mesenchymal Stem Cells Foster Revascularization of Ischemic Limbs in Systemic Sclerosis. Ann Intern Med. 2011;155:65. doi: 10.7326/0003-4819-155-1-201107050-00013
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Published: Ann Intern Med. 2011;155(1):65.
TO THE EDITOR:
The case report by Guiducci and colleagues (1) presents the therapeutic potential of autologous mesenchymal stem cells (MSCs) for patients with systemic sclerosis. The authors suggest that factors expressed from MSCs and the ability of MSCs to differentiate into endothelial and vascular smooth muscle cells account for the observed revascularization. The potential immunosuppressive effect of MSCs also may have contributed to the positive outcome.
It is well-documented that MSCs suppress inflammation through soluble factors and direct physical contact, affecting the innate as well as the adaptive immune system (2). Researchers report that patients with systemic sclerosis may retain this feature (3). Investigators know less about whether MSCs have intact function in terms of endothelial differentiation and promoting angiogenesis in systemic sclerosis. Because reports show defects of endothelial progenitors in patients with systemic sclerosis (4), it would be interesting to test the immunomodulatory function, as well as the endothelial-differentiating capacity, of the MSCs derived from this patient to obtain further insight into the mechanism of treatment with MSCs.
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