Review

Advances in stem cell therapy for scleroderma

  • LIN Ruilian ,
  • MA Lili ,
  • CHEN Jia
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  • Department of Rheumatology, Shanghai Skin Disease Hospital of Tongji University, Shanghai 200443, China

Received date: 2024-10-27

  Online published: 2025-10-27

Abstract

Scleroderma is an autoimmune connective tissue disorder characterized by fibrosis of the skin and internal organs. Currently, there is no fully satisfactory treatment for this condition. In recent years, stem cells have emerged as a promising therapeutic strategy for a variety of diseases, owing to their capacities for self-renewal and multilineage differentiation. Substantial advances have been achieved in applying stem cell therapy to scleroderma. This review summarizes the mechanisms and clinical progress of stem cell-based treatments for scleroderma, with the aim of providing new insights for basic research and supporting evidence for future clinical applications.

Cite this article

LIN Ruilian , MA Lili , CHEN Jia . Advances in stem cell therapy for scleroderma[J]. Journal of Internal Medicine Concepts & Practice, 2025 , 20(04) : 340 -344 . DOI: 10.16138/j.1673-6087.2025.04.15

References

[1] Teske N, Fett N. Recent advances in treatment of systemic sclerosis and morphea[J]. Am J Clin Dermatol, 2024, 25(2):213-226.
[2] Jerjen R, Nikpour M, Krieg T, et al. Systemic sclerosis in adults. Part I: Clinical features and pathogenesis[J]. J Am Acad Dermatol, 2022, 87(5):937-954.
[3] Papara C, De Luca DA, Bieber K, et al. Morphea: the 2023 update[J]. Front Med, 2023, 10:1108623.
[4] Jessop H, Farge D, Saccardi R, et al. General information for patients and carers considering haematopoietic stem cell transplantation (HSCT) for severe autoimmune diseases (ADs)[J]. Bone Marrow Transplant, 2019, 54(7):933-942.
[5] Snowden JA, Saccardi R, Allez M, et al. Haematopoietic SCT in severe autoimmune diseases: updated Guidelines of the European Group for Blood and Marrow Transplant[J]. Bone Marrow Transplant, 2012, 47(6):770-790.
[6] Levin D, Hakim A, Shezen E, et al. Hematopoietic stem cell transplantation for systemic sclerosis: mechanisms of immune reconstitution and disease reset[J]. Cells, 2022, 11(19):3075.
[7] Kobayashi S, Nagafuchi Y, Shoda H, et al. The pathophysiological roles of regulatory T cells in the early phase of systemic sclerosis[J]. Front Immunol, 2022, 13:900638.
[8] Baraut J, Grigore EI, Jean-Louis F, et al. Peripheral blood regulatory T cells in patients with diffuse systemic sclerosis (SSc) before and after autologous hematopoietic SCT[J]. Bone Marrow Transplant, 2014, 49(3):349-354.
[9] Lima-Júnior JR, Arruda LCM, Gon?alves MS, et al. Autologous haematopoietic stem cell transplant restores the suppressive capacity of regulatory B cells in systemic sclerosis patients[J]. Rheumatology, 2021, 60(12):5538-5548.
[10] Adamska JZ, Zia A, Bloom MS, et al. Myeloablative autologous haematopoietic stem cell transplant resets the B cell repertoire to a more na?ve state in patients with systemic sclerosis[J]. Ann Rheum Dis, 2023, 82(3):357-364.
[11] Ayoglu B, Donato M, Furst DE, et al. Characterising the autoantibody repertoire in systemic sclerosis following myeloablative haematopoietic stem cell transplant[J]. Ann Rheum Dis, 2023, 82(5):670-680.
[12] Wareing N, Wang X, Keyes-Elstein L, et al. Myeloablation followed by hematopoietic stem cell transplant and long-term normalization of systemic sclerosis molecular signatures[J]. Arthritis Rheumatol, 2024, 76(8):1288-1293.
[13] Tyndall A, Black C, Finke J, et al. Treatment of systemic sclerosis with autologous haemopoietic stem cell transplantation[J]. Lancet, 1997, 349(9047):254.
[14] Burt RK, Shah SJ, Dill K, et al. Autologous non-myeloablative haemopoietic stem-cell transplantation compared with pulse cyclophosphamide once per month for systemic sclerosis (ASSIST)[J]. Lancet, 2011, 378(9790):498-506.
[15] van Laar JM, Farge D, Sont JK, et al. Autologous hematopoietic stem cell transplantation vs intravenous pulse cyclophosphamide in diffuse cutaneous systemic sclerosis[J]. JAMA, 2014, 311(24):2490-2498.
[16] Sullivan KM, Goldmuntz EA, Keyes-Elstein L, et al. Myeloablative autologous stem-cell transplantation for severe scleroderma[J]. N Engl J Med, 2018, 378(1):35-47.
[17] Higashitani K, Takase-Minegishi K, Yoshimi R, et al. Benefits and risks of haematopoietic stem cell transplantation for systemic sclerosis[J]. Mod Rheumatol, 2023, 33(2):330-337.
[18] van Bijnen S, de Vries-Bouwstra J, van Den Ende CH, et al. Predictive factors for treatment-related mortality and major adverse events after autologous haematopoietic stem cell transplantation for systemic sclerosis[J]. Ann Rheum Dis, 2020, 79(8):1084-1089.
[19] Franks JM, Martyanov V, Wang Y, et al. Machine learning predicts stem cell transplant response in severe scleroderma[J]. Ann Rheum Dis, 2020, 79(12):1608-1615.
[20] Ayano M, Tsukamoto H, Mitoma H, et al. CD34-selected versus unmanipulated autologous haematopoietic stem cell transplantation in the treatment of severe systemic sclerosis[J]. Arthritis Res Ther, 2019, 21(1):30.
[21] Bruera S, Sidanmat H, Molony DA, et al. Stem cell transplantation for systemic sclerosis[J]. Cochrane Database Syst Rev, 2022, 7(7):CD011819.
[22] Moll M, Holzer U, Zimmer C, et al. Autologous stem cell transplantation in two children with disabling pansclerotic morphea[J]. Pediatr Rheumatol Online J, 2011, 9 Suppl 1:P77.
[23] Nair V, Sharma A, Sharma S, et al. Successful autologous hematopoietic stem cell transplantation for a patient with rapidly progressive localized scleroderma[J]. Int J Rheum Dis, 2015, 18(3):366-371.
[24] Huang Y, Wu Q, Tam PKH. Immunomodulatory mechanisms of mesenchymal stem cells and their potential clinical applications[J]. Int J Mol Sci, 2022, 23(17):10023.
[25] Viswanathan S, Shi Y, Galipeau J, et al. Mesenchymal stem versus stromal cells[J]. Cytotherapy, 2019, 21(10):1019-1024.
[26] Guiducci S, Manetti M, Romano E, et al. Bone marrow-derived mesenchymal stem cells from early diffuse systemic sclerosis exhibit a paracrine machinery and stimulate angiogenesis in vitro[J]. Ann Rheum Dis, 2011, 70(11):2011-2021.
[27] Griffin M, Ryan CM, Pathan O, et al. Characteristics of human adipose derived stem cells in scleroderma in comparison to sex and age matched normal controls[J]. Stem Cell Res Ther, 2017, 8(1):23.
[28] Müller L, Tunger A, Wobus M, et al. Immunomodulatory properties of mesenchymal stromal cells[J]. Front Cell Dev Biol, 2021, 9:637725.
[29] Dudek DW, Walczuk E, Wajda A, et al. Mesenchymal stem cells in systemic sclerosis therapy[J]. Reumatologia, 2020, 58(5):324-330.
[30] Sensebé L, Bourin P, Tarte K. Good manufacturing practices production of mesenchymal stem/stromal cells[J]. Hum Gene Ther, 2011, 22(1):19-26.
[31] Christopeit M, Schendel M, F?ll J, et al. Marked improvement of severe progressive systemic sclerosis after transplantation of mesenchymal stem cells from an allogeneic haploidentical-related donor mediated by ligation of CD137L[J]. Leukemia, 2008, 22(5):1062-1064.
[32] Keyszer G, Christopeit M, Fick S, et al. Treatment of severe progressive systemic sclerosis with transplantation of mesenchymal stromal cells from allogeneic related donors: Report of five cases[J]. Arthritis Rheum, 2011, 63(8):2540-2542.
[33] Guiducci S, Porta F, Saccardi R, et al. Autologous mesenchymal stem cells foster revascularization of ischemic limbs in systemic sclerosis[J]. Ann Intern Med, 2010, 153(10):650-654.
[34] Farge D, Loisel S, Resche-Rigon M, et al. Safety and preliminary efficacy of allogeneic bone marrow-derived multipotent mesenchymal stromal cells for systemic sclerosis[J]. Lancet Rheumatol, 2022, 4(2):e91-e104.
[35] Scuderi N, Ceccarelli S, Onesti MG, et al. Human adipose-derived stromal cells for cell-based therapies in the treatment of systemic sclerosis[J]. Cell Transplant, 2013, 22(5):779-795.
[36] Ménard C, Dulong J, Roulois D, et al. Integrated transcriptomic, phenotypic, and functional study reveals tissue-specific immune properties of mesenchymal stromal cells[J]. Stem Cells, 2020, 38(1):146-159.
[37] Granel B, Daumas A, Jouve E, et al. Safety, tolerability and potential efficacy of injection of autologous adipose-derived stromal vascular fraction in the fingers of patients with systemic sclerosis[J]. Ann Rheum Dis, 2015, 74(12):2175-2182.
[38] Daumas A, Magalon J, Jouve E, et al. Adipose tissue-derived stromal vascular fraction for treating hands of patients with systemic sclerosis[J]. Rheumatology, 2022, 61(5):1936-1947.
[39] Liu J, Wang J, Zhang Q, et al. Clinical, histologic, and transcriptomic evaluation of sequential fat grafting for morphea[J]. JAMA Dermatol, 2024, 160(4):425-433.
[40] Barrett AN, Fong CY, Subramanian A, et al. Human Wharton’s jelly mesenchymal stem cells show unique gene expression compared with bone marrow mesenchymal stem cells using single-cell RNA-sequencing[J]. Stem Cells Dev, 2019, 28(3):196-211.
[41] Zhang H, Liang J, Tang X, et al. Sustained benefit from combined plasmapheresis and allogeneic mesenchymal stem cells transplantation therapy in systemic sclerosis[J]. Arthritis Res Ther, 2017, 19(1):165.
[42] Liang J, Zhang H, Kong W, et al. Safety analysis in patients with autoimmune disease receiving allogeneic mesenchymal stem cell infusion[J]. Stem Cell Res Ther, 2018, 9(1):312.
[43] Wang L, Li T, Ma X, et al. Exosomes from human adipose-derived mesenchymal stem cells attenuate localized scleroderma fibrosis by the Let-7a-5p/TGF-βR1/Smad axis[J]. J Dermatol Sci, 2023, 112(1):31-38.
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