What is Systemic Sclerosis?
Systemic sclerosis (SSc) is an autoimmune disease marked by immunological deregulation, vasculopathy, and fibrosis of the skin and internal organs.
Fibroblasts are the primary cells implicated with fibrosis: a process that involves increased production of extracellular matrix components (ECMs), such as collagen, and modifies connective tissue structure.
Using Stem Cell Therapy as Treatment
Autologous hematopoietic stem cell transplantation (AHSCT) is an intensive immunosuppressive therapy that has been investigated as treatment for severe and progressive SSc patients.
The therapy can lead to eradication of autoreactive immune cells and enables the reconstitution of a more tolerant immune system that contributes to clinical improvement.
Recently, a group of researhers investigated if AHSCT modified the expression of molecules associated with fibrosis and connective tissue homeostasis in the skin and serum of patients with systemic sclerosis.
Study Development and Results
For the study a total of 39 participants were included with SSc. They were treated at the Ribeirão Preto Medical School (University of São Paulo, Brazil). The participants were transplanted and evaluated before the procedure and 12 months after.
Those taking immunossupressive medications stoped them before beginning the treatment and evaluations.
After AHSCT, SSc patients showed clinical improvement in skin involvement, assessed by modified Rodnan’s skin score (mRSS). Their collagen density and skin thickness decreased after the procedure and had a decrease expression of NF-κB p65.
The therapy with AHSCT for SSc were found to modify the inflammatory components of the disease, and clinical response to AHSCT is associated with reduced autoreactivity, increased regulation, and modulation of the inflammatory environment.
They also found the transplantation of AHSCT was influential on mechanisms related to fibrosis, a key component normally increased in the disease.
Their histological analyses showed that skin thickness and collagen density decreased in the 12 months that followed transplantation.
Zanin-Silva, D.C., Santana-Gonçalves, M., Kawashima-Vasconcelos, M.Y. et al. Autologous hematopoietic stem cell transplantation promotes connective tissue remodeling in systemic sclerosis patients. Arthritis Res Ther 24, 95 (2022). https://doi.org/10.1186/s13075-022-02779-w