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

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

References

[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

[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

[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

[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

[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

[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

[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

[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

[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

[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

[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

[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)

[13] Collins P, Rhodes J. Ulcerative colitis: diagnosis and management. BMJ 2006; 333(7563): 340–343

[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

[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

[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

[17] Trounson A, McDonald C. Stem cell therapies in clinical trials: progress and challenges. Cell Stem Cell 2015;17(1):11–22

[18] Gladstone DE, Fuchs E. Hematopoietic stem cell transplantation for chronic lymphocytic leukemia. Curr Opin Oncol 2012; 24(2): 176–181

[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

[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

[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

[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

[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

[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

[25] Travis S. Advances in therapeutic approaches to ulcerative colitis and Crohn’s disease. Curr Gastroenterol Rep 2005; 7(6): 475–484

[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

[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

RIGHTS & PERMISSIONS

Higher Education Press and Springer-Verlag Berlin Heidelberg