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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2016, Vol. 10 Issue (4) : 522-526     DOI: 10.1007/s11684-016-0485-4
Autologous bone marrow stem cell transplantation for the treatment of ulcerative colitis complicated with herpes zoster: a case report
Hang Xiang1,Xiaomei Zhang1,Chao Yang2,Wenhuan Xu1,Xin Ge3,Rong Zhang2,Ya Qiu1,Wanjun Sun2,Fan Li1,Tianyuan Xiang4,Haixu Chen1(),Zheng Wang5(),Qiang Zeng1()
1. Institute of Health Management, Institute of Geriatrics, Beijing Key Laboratory of Normal Aging and Geriatrics, Department of Gerontal Gastroenterology, Chinese PLA General Hospital, Beijing100853, China
2. Department of Blood Transfusion, Department of Hematology, The General Hospital of the PLA Rocket Force, Beijing 100088, China
3. Galactophore Department of the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
4. Geriatrics Institute of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
5. Department of Biotherapy of PLA 455 Hospital, Shanghai 200052, China
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Ulcerative colitis (UC) is a chronic inflammatory bowel disease with continuous or recurrent symptoms. A 42-year-old male patient with intermittent diarrhea accompanied by bloody mucopurulent stools was admitted to our hospital. The diagnosis of UC was confirmed by a combination of laboratory examination, colonoscopy, and histological assay. The patient developed herpes zoster in the hospital, which challenged traditional treatments. Therefore, we performed an autologous bone marrow cells to modulate the immune system with his permission. Autologous bone marrow mononuclear cells were collected and injected locally into the bowel mucosa, and subsequently injected systemically through a peripheral vein. After the patient underwent auto bone marrow mononuclear cells transplantations twice, the patient’s symptoms were alleviated. Furthermore, he recovered from hematochezia, and his hypersensitive C reactive protein decreased. Colonoscopy results showed reduced lesions and decreased areas with bleeding and edema in the sigmoid colon and rectum. No recurrence occurred in the subsequent two years, but long-time monitoring is still necessary for the prophylaxis of colorectal cancer.

Keywords autograft      bone marrow stem cells      ulcerative colitis      cell therapy     
Corresponding Authors: Haixu Chen,Zheng Wang,Qiang Zeng   
Just Accepted Date: 08 November 2016   Online First Date: 23 November 2016    Issue Date: 01 December 2016
URL:     OR
Fig.1  Colonoscopy findings of the UC patient prior to treatment. Diffuse ulcerative lesions with mucopus and bloody coating in the colon were observed. The impaired mucus was edematous and granular, presenting a continuous and circumferential pattern.
Fig.2  Histopathological findings of the rectum. Histopathological examination of a resected specimen obtained from the patient revealed crypt abscesses and an abnormal morphology of the focal gland. Inflammatory cells infiltrated the lamina propria (H&E staining, 100×).
Fig.3  Bone marrow slide after stem cell mobilization. The slide shows the active proliferation of bone marrow monocytes (M/E= 4.38/1) and of granular leukocytes and erythrocytes, which accounted for 63.5% and 14.5%, respectively. The lymphocytes and megakaryocytes were within normal limits (H&E staining, 400×).
Fig.4  Colonoscopy findings after bone marrow stem cell transplantation. The ulcerative lesions were attenuated, with reduced mucopus and alleviated edematous.
Year Authors Ethnic Disease Case Transplantation Results
2013 Sagynbaeva et al. Russia UC 34 Allograft
Stem cells controlled the activity of UC and decreased the concentration of auto antibodies
2012 Kniazev et al. Russia UC 41 Allograft BMSC played a role in antiviral and antimicrobial activity
2010 Lazebnik et al. Russia UC 50 Allograft Cell transplantation increased the duration of remission, reduced the risk of recurrence
2008 Mitsuyama et al. Japan UC 20 Allograft Both colonies and CD34(+) cells increased after transplantation
2001 Martí et al. Spain UC?with breast cancer 50 Autograft
(Bone marrow mobilization)
UC relapsed after 25 months follow-up.?Mesalazine and oral azathioprine kept asymptomatic for 36 months after relapse
Tab.1  Clinical trials of BMSC transplantation for the treatment of UC
1 Algeri M, Conforti A, Pitisci A, Starc N, Tomao L, Bernardo ME, Locatelli F. Mesenchymal stromal cells and chronic inflammatory bowel disease. Immunol Lett 2015;168(2):191–200
doi: 10.1016/j.imlet.2015.06.018 pmid: 26170204
2 Sartor RB. Current concepts of the etiology and pathogenesis of ulcerative colitis and Crohn’s disease. Gastroenterol Clin North Am 1995; 24(3): 475–507
pmid: 8809232
3 Deng X, Szabo S, Chen L, Paunovic B, Khomenko T, Tolstanova G, Tarnawski AS, Jones MK, Sandor Z. New cell therapy using bone marrow-derived stem cells/endothelial progenitor cells to accelerate neovascularization in healing of experimental ulcerative colitis. Curr Pharm Des 2011; 17(16): 1643–1651
doi: 10.2174/138161211796197007 pmid: 21548863
4 He XW, He XS, Lian L, Wu XJ, Lan P. Systemic infusion of bone marrow-derived mesenchymal stem cells for treatment of experimental colitis in mice. Dig Dis Sci 2012; 57(12): 3136–3144
doi: 10.1007/s10620-012-2290-5 pmid: 22752635
5 Hayashi Y, Tsuji S, Tsujii M, Nishida T, Ishii S, Iijima H, Nakamura T, Eguchi H, Miyoshi E, Hayashi N, Kawano S. Topical implantation of mesenchymal stem cells has beneficial effects on healing of experimental colitis in rats. J Pharmacol Exp Ther 2008; 326(2): 523–531
doi: 10.1124/jpet.108.137083 pmid: 18448866
6 Milanetti F, Abinun M, Voltarelli JC, Burt RK. Autologous hematopoietic stem cell transplantation for childhood autoimmune disease. Pediatr Clin North Am 2010; 57(1): 239–271
doi: 10.1016/j.pcl.2009.12.003 pmid: 20307720
7 Snarski E, Torosian T, Paluszewska M, Urbanowska E, Milczarczyk A, Jedynasty K, Franek E, Jedrzejczak WW. Alleviation of exogenous insulin requirement in type 1 diabetes mellitus after immunoablation and transplantation of autologous hematopoietic stem cells. Pol Arch Med Wewn 2009; 119(6): 422–426
pmid: 19694226
8 Snarski E, Milczarczyk A, Torosian T, Paluszewska M, Urbanowska E, Król M, Boguradzki P, Jedynasty K, Franek E, Wiktor-Jedrzejczak W. Independence of exogenous insulin following immunoablation and stem cell reconstitution in newly diagnosed diabetes type I. Bone Marrow Transplant 2011; 46(4): 562–566
doi: 10.1038/bmt.2010.147 pmid: 20581881
9 Doğan SM, Kılınç S, Kebapçı E, Tuğmen C, Gürkan A, Baran M, Kurtulmuş Y, Olmez M, Karaca C. Mesenchymal stem cell therapy in patients with small bowel transplantation: single center experience. World J Gastroenterol 2014; 20(25): 8215–8220
doi: 10.3748/wjg.v20.i25.8215 pmid: 25009395
10 Zhang J, Ren X, Shi W, Wang S, Chen H, Zhang B, Wang Z, Zhou Y, Chen L, Zhang R, Lv Y, Zhou J, Nan X, He L, Yue W, Li Y, Pei X. Small molecule Me6TREN mobilizes hematopoietic stem/progenitor cells by activating MMP-9 expression and disrupting SDF-1/CXCR4 axis. Blood 2014; 123(3): 428–441
doi: 10.1182/blood-2013-04-498535 pmid: 24196072
11 Wei Y, Nie Y, Lai J, Wan YJ, Li Y. Comparison of the population capacity of hematopoietic and mesenchymal stem cells in experimental colitis rat model. Transplantation 2009; 88(1): 42–48
doi: 10.1097/TP.0b013e3181a9f0a7 pmid: 19584679
12 Kniazev OV, Ruchkina IN, Parfenov AI, Konopliannikov AG, Sagynbaeva VE. Complete elimination of cytomegalovirus without antiviral therapy after systemic transplantation of mesenchymal bone marrow stromal cells in a patient with ulcerative colitis. Eksp Klin Gastroenterol 2012; (3):118–123 (in Russian)
pmid: 22830236
13 Collins P, Rhodes J. Ulcerative colitis: diagnosis and management. BMJ 2006; 333(7563): 340–343
doi: 10.1136/bmj.333.7563.340 pmid: 16902215
14 Xiang H, Chen H, Li F, Liu J, Su Y, Hao L, Wang F, Wang Z, Zeng Q. Predictive factors for prolonged remission after autologous hematopoietic stem cell transplantation in young patients with type 1 diabetes mellitus. Cytotherapy 2015; 17(11): 1638–1645
doi: 10.1016/j.jcyt.2015.07.006 pmid: 26318272
15 Carbonnel F, Gargouri D, Lémann M, Beaugerie L, Cattan S, Cosnes J, Gendre JP. Predictive factors of outcome of intensive intravenous treatment for attacks of ulcerative colitis. Aliment Pharmacol Ther 2000; 14(3): 273–279
doi: 10.1046/j.1365-2036.2000.00705.x pmid: 10735919
16 Fiorino G, Cesarini M, Danese S. Biological therapy for ulcerative colitis: what is after anti-TNF. Curr Drug Targets 2011; 12(10): 1433–1439
doi: 10.2174/138945011796818225 pmid: 21466492
17 Trounson A, McDonald C. Stem cell therapies in clinical trials: progress and challenges. Cell Stem Cell 2015;17(1):11–22
doi: 10.1016/j.stem.2015.06.007 pmid: 26140604
18 Gladstone DE, Fuchs E. Hematopoietic stem cell transplantation for chronic lymphocytic leukemia. Curr Opin Oncol 2012; 24(2): 176–181
doi: 10.1097/CCO.0b013e32834f8011 pmid: 22234253
19 D’Addio F, Valderrama Vasquez A, Ben Nasr M, Franek E, Zhu D, Li L, Ning G, Snarski E, Fiorina P. Autologous nonmyeloablative hematopoietic stem cell transplantation in new-onset type 1 diabetes: a multicenter analysis. Diabetes 2014; 63(9): 3041–3046
doi: 10.2337/db14-0295 pmid: 24947362
20 Lysaght T, Kerridge I, Sipp D, Porter G, Capps BJ. Oversight for clinical uses of autologous adult stem cells: lessons from international regulations. Cell Stem Cell 2013; 13(6): 647–651
doi: 10.1016/j.stem.2013.11.013 pmid: 24315438
21 Yang C, Dai W, Chen H, Wu B. Application of human bone marrow-derived mesenchymal stem cells in the treatment of radiation-induced gastrointestinal syndrome. Sci China Life Sci 2014; 57(12): 1177–1182
doi: 10.1007/s11427-014-4721-3 pmid: 25205377
22 Yang C, Chen HX, Zhou Y, Liu MX, Wang Y, Wang JX, Ren SP, Han Y, Wu BY. Manganese superoxide dismutase gene therapy protects against irradiation-induced intestinal injury. Curr Gene Ther 2013; 13(5): 305–314
doi: 10.2174/15665232113136660027 pmid: 24060314
23 Xiang H, Yang C, Xiang T, Wang Z, Ge X, Li F, Su Y, Chen H, Huang X, Zeng Q. Residual b-cell function predicts clinical response after autologous hematopoietic stem cell transplantation. Stem Cells Transl Med 2016; 5(5): 651–657
doi: 10.5966/sctm.2015-0144 pmid: 27025691
24 Mitsuyama K, Andoh A, Masuda J, Yamasaki H, Kuwaki K, Takedatsu H, Seki R, Nishida H, Tsuruta O, Sata M. Mobilization of bone marrow cells by leukocytapheresis in patients with ulcerative colitis. Ther Apher Dial 2008; 12(4): 271–277
doi: 10.1111/j.1744-9987.2008.00587.x pmid: 18789113
25 Travis S. Advances in therapeutic approaches to ulcerative colitis and Crohn’s disease. Curr Gastroenterol Rep 2005; 7(6): 475–484
doi: 10.1007/s11894-005-0079-9 pmid: 16313878
26 Ekbom A, Helmick C, Zack M, Adami HO. Ulcerative colitis and colorectal cancer: a population-based study. N Engl J Med 1990; 323(18): 1228–1233
doi: 10.1056/NEJM199011013231802 pmid: 2215606
27 Rutter M, Saunders B, Wilkinson K, Rumbles S, Schofield G, Kamm M, Williams C, Price A, Talbot I, Forbes A. Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis. Gastroenterology 2004; 126(2): 451–459
doi: 10.1053/j.gastro.2003.11.010 pmid: 14762782
[1] Aining Xu,Lin Cheng. Chemical transdifferentiation: closer to regenerative medicine[J]. Front. Med., 2016, 10(2): 152-165.
[2] Bao-Zhu Yuan,Junzhi Wang. The regulatory sciences for stem cell-based medicinal products[J]. Front. Med., 2014, 8(2): 190-200.
[3] Rui ZHU MD, Heng FAN MD, Lin SHEN MD, Jianguo LIU BD, Jia ZHAO MM, . Expression of STAT6 and NF-κB p65 in the colon mucosa of patients with ulcerative colitis[J]. Front. Med., 2009, 3(4): 475-479.
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