First-in-man intravenous implantation of stromal vascular fraction in psoriasis: a case study

Kristin Comella, Michelle Parlo, Rosemary Daly, Kellie Dominessy, Kristin Comella, Michelle Parlo, Rosemary Daly, Kellie Dominessy

Abstract

Background: Stromal vascular fraction (SVF) is a mixture of adipose-derived stem cells/mesenchymal stem cells, endothelial/progenitors, pericytes, fibroblasts, and other cells obtained from fat tissue. A small sample of fat or adipose tissue can be obtained under local anesthesia using a cannula. After an enzymatic digestion and centrifugation, the adipocytes (fat cells) are removed to obtain an SVF. Here, we describe the rationale and, to our knowledge, the first clinical implementation of SVF intravenously in a patient with severe psoriasis.

Methods: Adipose tissue (60 mL) was collected under local anesthesia via a mini-lipoaspirate procedure. The SVF was separated from the adipocytes via centrifugation after an enzymatic digestion. The cells were resuspended in normal saline and injected via bolus push intravenous. The subject was monitored over a period of 12 months for safety (adverse events), medication changes, and quality of life parameters.

Results: The patient did not report any safety concerns and did not experience any severe adverse events. The patient demonstrated a significant decrease in symptoms with a noticeable difference in skin quality appearance. Psoriasis area and severity index score went from 50.4 at baseline to 0.3 at 1 month follow-up.

Conclusion: Overall, the patient reported improved quality of life and willingness to continue treatments. This successful initial case study demonstrates that this may be a feasible treatment plan for patients suffering from psoriasis.

Keywords: adipose tissue; adipose-derived stromal/stem cells; autoimmune disease; cell therapy; mesenchymal stem cells; psoriasis; stem cells; stromal vascular fraction.

Conflict of interest statement

Disclosure KC is an officer of US Stem Cell, Inc. US Stem Cell is a publicly trading company providing physician-based stem cell therapies to human and animal patients as well as a developer of autologous cell therapies. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Picture of patient’s skin at baseline (A) and 3 months after IV delivery of SVF (B). Notes: Clear resolution of inflammed red skin at 3 months which was maintained during the 12-month follow-up period. Abbreviations: IV, intravenous; SVF, stromal vascular fraction.

References

    1. Menter A, Gottlieb A, Feldman SR, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008;58(5):826–850.
    1. Helmick CG, Lee-Han H, Hirsch SC, Baird TL, Bartlett CL. Prevalence of psoriasis among adults in the U.S: 2003–2006 and 2009–2010 national health and nutrition examination surveys. Am J Prevent Med. 2014;47(1):37–45.
    1. Rachakonda TD, Schupp CW, Armstrong AW. Psoriasis prevalence among adults in the United States. J Am Acad Dermatol. 2014;70(3):512–516.
    1. Hematti P, Keating A. Mesenchymal stromal cells in regenerative medicine: a perspective. Mesenchymal Stromal Cells. 2012:3–16.
    1. Przybyt E, Harmsen MC. Mesenchymal stem cells: promising for myocardial regeneration? Curr Stem Cell Res Ther. 2013;8(4):270–277.
    1. Owczarczyk-Saczonek A, Krajewska-Włodarczyk M, Kruszewska A, Placek W, Maksymowicz W, Wojtkiewicz J. Stem cells as potential candidates for psoriasis cell-replacement therapy. Int J Mol Sci. 2017;18(10)
    1. Bronckaers A, Hilkens P, Martens W, et al. Mesenchymal stem/stromal cells as a pharmacological and therapeutic approach to accelerate angiogenesis. Pharmacol Ther. 2014;143(2):181–196.
    1. Caplan AI, Correa D. The MSC: an injury drugstore. Cell Stem Cell. 2011;9(1):11–15.
    1. Lee YS, Sah SK, Lee JH, Seo KW, Kang KS, Kim TY. Human umbilical cord blood-derived mesenchymal stem cells ameliorate psoriasis-like skin inflammation in mice. Biochem Biophys Rep. 2016;9:281–288.
    1. Minteer D, Marra KG, Rubin JP. Adipose-derived mesenchymal stem cells: biology and potential applications. Adv Biochem Eng Biotechnol. 2012;129:59–71.
    1. Gimble JM, Katz AJ, Bunnell BA. Adipose-derived stem cells for regenerative medicine. Circ Res. 2007;100(9):1249–1260.
    1. Rehman J, Traktuev D, Li J, et al. The secretion of angiogenic and anti-apoptotic factors by human adipose stromal cells. Circulation. 2004;109(10):1291–1298.
    1. Traktuev DO, Merfeld-Clauss S, Li J, et al. A population of multipotent CD34-positive adipose stromal cells share pericyte and mesenchymal surface markers, reside in a periendothelial location, and stabilize endothelial networks. Circ Res. 2008;102(1):77–85.
    1. Michalek J, Moster R, Lukac L, et al. WITHDRAWN: Autologous adipose tissue-derived stromal vascular fraction cells application in patients with osteoarthritis. Cell Transplant. 2015 Jan;:20. Epub.
    1. Bansal H, Comella K, Leon J, et al. Intra-articular injection in the knee of adipose derived stromal cells (stromal vascular fraction) and platelet rich plasma for osteoarthritis. J Transl Med. 2017;15(1):141.
    1. Siennicka K, Zolocinska A, Stepien K, et al. Adipose-derived cells (stromal vascular fraction) transplanted for orthopedical or neurological purposes: are they safe enough? Stem Cells Int. 2016;2016:5762916.
    1. Comella K, Silbert R, Parlo M. Effects of the intradiscal implantation of stromal vascular fraction plus platelet rich plasma in patients with degenerative disc disease. J Transl Med. 2017;15:12.
    1. Daumas A, Magalon J, Jouve E, et al. Granel. Long-term follow-up after autologous adipose-derived stromal vascular fraction injection into fingers in systemic sclerosis patients. Curr Res Transl Med. 2017;65(1):40–43.
    1. Usuelli FG, Grassi M, Maccario C, Viganoâ M, Lanfranchi L, Montrasio US. Intratendinous adipose-derived Stromal Vascular Fraction (SVF) injection provides a safe, efficacious treatment for achilles tendinopathy: results of a randomized controlled clinical trial at a 6-month followup. Knee Surg Sports Traumatol Arthrosc. 2017 Mar;:1. Epub.
    1. Comella K, Parcero J, Bansal H, et al. Effects of the intramyocardial implantation of stromal vascular fraction in patients with chronic ischemic cardiomyopathy. J Transl Med. 2016;14(1):158.
    1. Comella K, Perez J, Ichim T, Lopez J, Limon J, Moreno RC. Autologous stromal vascular fraction in the intravenous treatment of end-stage chronic obstructive pulmonary disease: A Phase I trial of Safety and Tolerability. J Clin Med Res. 2017;9(8):701–708.
    1. Parcero JJ, Perez JA, Patel AN, et al. Autologous adipose-derived stromal stem cell implantation to resolve critical limb ischemia: case report. Cureus. 2014;6(5):e182.
    1. Comella K, Bell W. First in man intraglandular implantation of stromal vascular fraction and adipose derived stem cells plus platelet rich plasma in irradiation induced gland damage: A Case Study. Int Med Case Rep J. 2017;10:295–299.
    1. Riordan N, Ichim T, Min W, Wang H, Solano F, Lara F. Non-expanded adipose stromal vascular fraction cell therapy for multiple sclerosis. J Transl Med. 2009;7:29.
    1. Comella K, Parlo M, Daly R, et al. Safety analysis of autologous stem cell therapy in a variety of degenerative diseases and injuries using the stromal vascular fraction. J Clin Med Res. 2017;9(11):935–942.
    1. Lander EB, Berman MH, See JR. Safety of stromal vascular fraction cells applications in chronic pain. Tech Reg Anesth Pain Management. 2015;19(1–2):10–13.
    1. Panfilov IA, de Jong R, Takashima S, Duckers HJ. Clinical study using adipose-derived mesenchymal-like stem cells in acute myocardial infarction and heart failure. Methods Mol Biol. 2013;1036:207–212.
    1. Jang Y, Koh YG, Choi YJ, et al. Characterization of adipose tissue-derived stromal vascular fraction for clinical application to cartilage regeneration. In Vitro Cell Dev Biol Anim. 2015;51(2):142–150.
    1. Aust L, Devlin B, Foster S, et al. Yield of human adipose-derived adult stem cells from liposuction aspirates. Cytotherapy. 2004;6(1):7–14.
    1. Najarian DJ, Gottlieb AB. Connections between psoriasis and Crohn’s disease. J Am Acad Dermatol. 2003;48:805–821.
    1. Armstrong AW, Gelfand JM, Boehncke WH, et al. Cardiovascular comorbidities of psoriasis and psoriatic arthritis: a report from the GRAPPA 2012 annual meeting. J Rheumatol. 2013;40:1434–1437.
    1. Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370:263–271.
    1. Kurd SK, Troxel AB, Crits-Christoph P, Gelfand JM. The risk of depression, anxiety, and suicidality in patients with psoriasis: a population-based cohort study. Arch Dermatol. 2010;146:891–895.
    1. Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009;61:451–485.
    1. Hou R, Li J, Niu X, et al. Stem cells in psoriasis. J Dermatol Sci. 2017;86(3):181–186.
    1. Shin TH, Kim HS, Choi SW, Kang KS. Mesenchymal stem cell therapy for inflammatory skin diseases: clinical potential and mode of action. Int J Mol Sci. 2017;18(2)
    1. Kim KH, Blasco-Morente G, Cuende N, Arias-Santiago S. Mesenchymal stromal cells: properties and role in management of cutaneous diseases. J Eur Acad Dermatol Venereol. 2017;31(3):414–423.

Source: PubMed

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