Häggström, Mikael (2014). "Medical gallery of Mikael Häggström 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.008. ISSN 2002-4436. Public Domain. or By Mikael Häggström, used with permission. - All used images are in public domain.
Systemic lupus erythematosus (SLE) is a chronic multiorgan autoimmune disease in which the immune system attacks the body leading to damage to the kidneys, blood vessels, joints, lungs and brain. Lupus nephritis (LN) is a serious complication observed at advanced stage of lupus which led to protein in the urine, high blood pressure, and kidney failure. The complication occurs when anti-dsDNA antibodies bind to the antigens deposited in the kidneys. High levels of anti-dsDNA signify ongoing inflammation and damage to the kidneys. Glucocorticosteroids and other immunosuppression regimens are the current standard of care for SLE patients. However, an estimated 20% to 40% of SLE patients do not respond well to these treatments. There are clinical trials using mesenchymal stem cells to suppress inflammation in lupus patients. Trials using Bone Marrow Mesenchymal Stem Cell (BMMSC) have shown promising results.
Studies have shown Cord Lining Mesenchymal Stem Cell (CLMSC) secretes a host of anti-inflammatory cytokines like IL-10, HLA-G and HLA-E. CellResearch Corporation and Singapore General Hospital have successfully completed a preclinical study investigating the immunomodulatory effects of CLMSC versus BMMSC in the treatment of SLE in Faslpr lupus-prone mice. Dr Fan Xiubo is the principal investigator of the study. She is a Senior Research Fellow in the Department of Clinical Translational Research in Singapore General Hospital and Assistant Professor in SingHealth-Duke-NUS Medicine Academic Clinical Programme of Duke-NUS Medical School.
At the end of the study, the results demonstrated the robust immunosuppressive capacity of CLMSC therapy by significantly improving the rate of survival and kidney functions as well as reducing the disease activity (reduction in anti-dsDNA levels, proteinuria, renal complement C3 deposition. To elucidate the healing pathways, RNA sequencing were performed on samples taken from the study and the data obtained was feed and analysed by the Ingenuity Pathway Analysis software. The analysed results clearly demonstrated CLMSC mediate their immunosuppression actions via concerted action of proinflammatory cytokine-induced chemokines and production of nitric oxide.
Figure 1. RNA sequencing confirms CL-MSCs mediate immunosuppression via the concerted action of proinflammatory cytokine-induced chemokines and production of nitric oxide