Diagnosis and Treatment > Investigation > Cytokines
You are looking at 1 - 2 of 2 items
Search for other papers by Silvia M Becerra-Bayona in
Google Scholar
PubMed
Search for other papers by Víctor Alfonso Solarte-David in
Google Scholar
PubMed
Banco Multitejidos y Centro de Terapias Avanzadas, Fundación Oftalmológica de Santander, Clínica Carlos Ardila Lulle – FOSCAL, Floridablanca, Colombia
Search for other papers by Claudia L Sossa in
Google Scholar
PubMed
Search for other papers by Ligia C Mateus in
Google Scholar
PubMed
Search for other papers by Martha Villamil in
Google Scholar
PubMed
Search for other papers by Jorge Pereira in
Google Scholar
PubMed
Search for other papers by Martha L Arango-Rodríguez in
Google Scholar
PubMed
Summary
Diabetic foot ulcer morbidity and mortality are dramatically increasing worldwide, reinforcing the urgency to propose more effective interventions to treat such a devastating condition. Previously, using a diabetic mouse model, we demonstrated that administration of bone marrow mesenchymal stem cells derivatives is more effective than the use of bone marrow mesenchymal stem cells alone. Here, we used the aforementioned treatments on three patients with grade 2 diabetic foot ulcers and assessed their beneficial effects, relative to the conventional approach. In the present study, two doses of cell derivatives, one dose of mesenchymal stem cells or one dose of vehicle (saline solution with 5% of human albumin), were intradermally injected around wounds. Wound healing process and changes on re-epithelialization were macroscopically evaluated until complete closure of the ulcers. All ulcers were simultaneously treated with conventional treatment (PolyMen® dressing). Patients treated with either cell derivatives or mesenchymal stem cells achieved higher percentages of wound closure in shorter times, relative to the patient treated with the conventional treatment. The cell derivative and mesenchymal stem cells approaches resulted in complete wound closure and enhanced skin regeneration at some point between days 35 and 42, although no differences between these two treatments were observed. Moreover, wounds treated with the conventional treatment healed after 161 days. Intradermal administration of cell derivatives improved wound healing to a similar extent as mesenchymal stem cells. Thus, our results suggest that mesenchymal stem cell derivatives may serve as a novel and potential therapeutic approach to treat diabetic foot ulcers.
Learning points:
-
In diabetic mouse models, the administration of mesenchymal stem cells derivatives have been demonstrated to be more effective than the use of marrow mesenchymal stem cells alone.
-
Mesenchymal stem cells have been explored as an attractive therapeutic option to treat non-healing ulcers.
-
Mesenchymal stem cells derivatives accelerate the re-epithelialization on diabetic foot ulcers.
Department of Diabetes and Endocrinology, Wakayama Red Cross Hospital, Wakayama, Japan
Search for other papers by Hiroto Minamino in
Google Scholar
PubMed
Search for other papers by Hidefumi Inaba in
Google Scholar
PubMed
Search for other papers by Hiroyuki Ariyasu in
Google Scholar
PubMed
Search for other papers by Hiroto Furuta in
Google Scholar
PubMed
Search for other papers by Masahiro Nishi in
Google Scholar
PubMed
Search for other papers by Takashi Yoshimasu in
Google Scholar
PubMed
Search for other papers by Akinori Nishikawa in
Google Scholar
PubMed
Search for other papers by Masanori Nakanishi in
Google Scholar
PubMed
Search for other papers by Shigeki Tsuchihashi in
Google Scholar
PubMed
Search for other papers by Fumiyoshi Kojima in
Google Scholar
PubMed
Search for other papers by Shin-ichi Murata in
Google Scholar
PubMed
Search for other papers by Gen Inoue in
Google Scholar
PubMed
Search for other papers by Takashi Akamizu in
Google Scholar
PubMed
Summary
A 73-year-old man with Hashimoto's thyroiditis (HT) suffered from purpura on the lower legs. He was diagnosed with IgG4-related disease (IgG4-RD) with serum IgG4 elevation and dacryo-sialadenitis confirmed histologically. Serum Th2 and Treg cytokines, interleukin 7 (IL7), IL8 and Th2 chemokine levels were elevated, while skewed Th1 balance was seen in fluorescence-activated cell sorting (FACS). Therefore, preferential Th1 balance in HT appeared to be followed by IgG4-RD characterized with Th2 and Treg polarization. The commencement of steroid therapy dramatically exacerbated clinical manifestations including IgG4-RD-associated HT. The measurement of cytokine and chemokine levels as well as FACS analysis in the development of IgG4-RD seemed to be beneficial. In conclusion, an innovative association of HT, IgG4-RD and vasculitis was observed. This report also offers novel diagnostic and therapeutic approaches for IgG4-RD.
Learning points
-
Recently, a subtype of HT has been considered to be a thyroid manifestation of IgG4-RD, although the etiology of IgG4-RD is not established yet.
-
Immunologically a close association between HT and vasculitis was reported.
-
Leukocytoclastic vasculitis is a rare skin presentation of IgG4-RD.
-
In the current case, during the course of HT, IgG4-RD and leukocytoclastic vasculitis occurred; thus, innate immunity and acquired immunity seem to be involved in the development of IgG4-RD.
-
The measurement of cytokine and chemokines appeared to be beneficial in the development of IgG4-RD.
-
Remarkably, effectiveness of steroid therapy for HT suggested presence of IgG4-RD-associated HT. Therefore, this report highlights the pathogenesis of IgG4-RD and proposes novel therapeutic mechanisms. Clinicians should pay attention to the development of IgG4-RD and vasculitis during long course of HT.