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Mesenchymal Stem Cell–Based Therapy as a New Approach for the Treatment of Systemic Sclerosis

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Abstract

Systemic sclerosis (SSc) is an intractable autoimmune disease with unmet medical needs. Conventional immunosuppressive therapies have modest efficacy and obvious side effects. Targeted therapies with small molecules and antibodies remain under investigation in small pilot studies. The major breakthrough was the development of autologous haematopoietic stem cell transplantation (AHSCT) to treat refractory SSc with rapidly progressive internal organ involvement. However, AHSCT is contraindicated in patients with advanced visceral involvement. Mesenchymal stem cells (MSCs) which are characterized by immunosuppressive, antifibrotic and proangiogenic capabilities may be a promising alternative option for the treatment of SSc. Multiple preclinical and clinical studies on the use of MSCs to treat SSc are underway. However, there are several unresolved limitations and safety concerns of MSC transplantation, such as immune rejections and risks of tumour formation, respectively. Since the major therapeutic potential of MSCs has been ascribed to their paracrine signalling, the use of MSC-derived extracellular vesicles (EVs)/secretomes/exosomes as a “cell-free” therapy might be an alternative option to circumvent the limitations of MSC-based therapies. In the present review, we overview the current knowledge regarding the therapeutic efficacy of MSCs in SSc, focusing on progresses reported in preclinical and clinical studies using MSCs, as well as challenges and future directions of MSC transplantation as a treatment option for patients with SSc.

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This work was supported by a grant from the National Natural Science Foundation of China (No. 81402442).

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Authors and Affiliations

  1. Department of Oncology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China

    Xiufen Zhuang

  2. Department of Oncology, Suqian First Hospital, Suqian, Jiangsu, China

    Xiao Hu

  3. Department of Immunology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China

    Shuren Zhang

  4. Shuwen Biotech Company Ltd, Hangzhou, Zhejiang, China

    Xingmin Li & Xiaoying Yuan

  5. Department of Medical Microbiology and Immunology, School of Preclinical Medicine, Wannan Medical College, Wuhu, China

    Yanhong Wu

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Zhuang, X., Hu, X., Zhang, S. et al. Mesenchymal Stem Cell–Based Therapy as a New Approach for the Treatment of Systemic Sclerosis. Clinic Rev Allerg Immunol 64, 284–320 (2023). https://doi.org/10.1007/s12016-021-08892-z

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  • DOI: https://doi.org/10.1007/s12016-021-08892-z

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