Published online Dec 26, 2017. doi: 10.4252/wjsc.v9.i12.235
Peer-review started: October 12, 2017
First decision: November 8, 2017
Revised: November 15, 2017
Accepted: December 3, 2017
Article in press: December 3, 2017
Published online: December 26, 2017
Clinical and laboratory results document psoriatic arthritis in a 56-year old patient. The symptoms did not resolve with standard treatments (nonsteroidal anti-inflammatory drugs, steroids and methotrexate). TNF-alpha inhibitors (certolizumab pegol and adalimumab) were added to the treatment regime, with some adverse effects. A trial of human umbilical cord stem cell therapy was then initiated. The stem cells were enriched and concentrated from whole cord blood, by removal of erythrocytes and centrifugation. The patient received several infusions of cord blood stem cells, through intravenous and intra-articular injections. These stem cell treatments correlated with remission of symptoms (joint pain and psoriatic plaques) and normalized serologic results for the inflammatory markers C-reactive protein and erythrocyte sedimentation rate. These improvements were noted within the first thirty days post-treatment, and were sustained for more than one year. The results of this trial suggest that cord blood stem cells may have important therapeutic value for patients with psoriatic arthritis, particularly for those who cannot tolerate standard treatments.
Core tip: Rheumatic diseases are common and often disabling. Standard drug treatments can control inflammation, but many patients do not find relief. Potent biologic drugs (tumor necrosis factor inhibitors) are not tolerated by some. This patient report describes treatment with umbilical cord blood stem cells (CBSC). Clinical observations and serology results document prolonged improvement of psoriatic arthritis. This type of report is important since it documents a dosage, time course, and a beneficial outcome, using an under-employed type of stem cell. These results can help guide clinicians in future trials using CBSC.