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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
CASE REPORT |
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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Abstract  

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:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-016-0485-4     OR     http://academic.hep.com.cn/fmd/EN/Y2016/V10/I4/522
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
(Leukocytapheresis)
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
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