Autologous bone marrow stem cell transplantation for the treatment of ulcerative colitis complicated with herpes zoster: a case report

doi:10.1007/s11684-016-0485-4

Front. Med.

2016, Vol. 10

Issue (4) : 522-526 https://doi.org/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

Download: PDF(169 KB) HTML
Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks

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 Author(s): Haixu Chen,Zheng Wang,Qiang Zeng

Just Accepted Date: 08 November 2016 Online First Date: 23 November 2016 Issue Date: 01 December 2016

Cite this article:

Hang Xiang,Xiaomei Zhang,Chao Yang, et al. Autologous bone marrow stem cell transplantation for the treatment of ulcerative colitis complicated with herpes zoster: a case report[J]. Front. Med., 2016, 10(4): 522-526.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-016-0485-4
https://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.

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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/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 https://doi.org/10.1053/j.gastro.2003.11.010 pmid: 14762782

[1]	Ching-Hon Pui. Precision medicine in acute lymphoblastic leukemia[J]. Front. Med., 2020, 14(6): 689-700.
[2]	Aining Xu,Lin Cheng. Chemical transdifferentiation: closer to regenerative medicine[J]. Front. Med., 2016, 10(2): 152-165.
[3]	Bao-Zhu Yuan,Junzhi Wang. The regulatory sciences for stem cell-based medicinal products[J]. Front. Med., 2014, 8(2): 190-200.
[4]	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.

Viewed

Full text

Abstract

Cited

Shared

Discussed