Serena Guiducci, MD; Francesco Porta, MD; Riccardo Saccardi, MD; Stefano Guidi, MD; Lidia Ibba-Manneschi, MD; Mirko Manetti, PhD; Benedetta Mazzanti, BSc; Simone Dal Pozzo, BSc; Anna Franca Milia, PhD; Silvia Bellando-Randone, MD; Irene Miniati, MD; Ginevra Fiori, MD; Rossana Fontana, MD; Laura Amanzi, HP; Francesca Braschi, HP; Alberto Bosi, MD; Marco Matucci-Cerinic, MD, PhD
Mesenchymal stem cells can differentiate into endothelial cells and participate in angiogenesis in adults. In experimental models of acute myocardial infarction, mesenchymal stem cells led to the recovery of cardiac function through the formation of a new vascular network.
To describe treatment with intravenous infusions of expanded autologous mesenchymal stem cells in 1 patient with critical limb ischemia due to systemic sclerosis.
The rheumatology unit at the University of Florence, Florence, Italy.
A woman, aged 34 years, with systemic sclerosis who developed acute gangrene of the upper and lower limbs.
3 intravenous pulses of expanded autologous mesenchymal stem cells.
Angiography, skin histopathology, and immunohistochemistry.
Areas of necrotic skin were reduced after the first mesenchymal stem-cell infusion. After the third infusion, angiography showed revascularization of the patient's extremities. Skin section analysis revealed cell clusters with tubelike structures, and angiogenic factors were strongly expressed.
Causality cannot be established by a single case.
In patients with systemic sclerosis who have severe peripheral ischemia, intravenous infusion of expanded autologous mesenchymal stem cells may foster the recovery of the vascular network, restore blood flow, and reduce skin necrosis.
Fondazione Cassa di Risparmio di Pistoia e Pescia (partial funding).
Guiducci S, Porta F, Saccardi R, Guidi S, Ibba-Manneschi L, Manetti M, et al. Autologous Mesenchymal Stem Cells Foster Revascularization of Ischemic Limbs in Systemic Sclerosis: A Case Report. Ann Intern Med. 2010;153:650–654. doi: 10.7326/0003-4819-153-10-201011160-00007
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Published: Ann Intern Med. 2010;153(10):650-654.
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