Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Dec 26, 2017; 9(12): 235-240
Published online Dec 26, 2017. doi: 10.4252/wjsc.v9.i12.235
Umbilical cord blood stem cell treatment for a patient with psoriatic arthritis
Margaret Coutts, Rowena Soriano, Rajendran Naidoo, Habib Torfi
Margaret Coutts, Rowena Soriano, Rajendran Naidoo, Habib Torfi, Invitrx Therapeutics, Irvine, CA 92618, United States
Author contributions: Torfi H contributed to the conception and design of the study; Soriano R and Torfi H acquired the data; Coutts M and Naidoo R analyzed the data and wrote the paper.
Supported by Invitrx Therapeutics.
Informed consent statement: The patient involved in this case report gave written informed consent authorizing use and disclosure of their protected health information.
Conflict-of-interest statement: Authors are paid employees of Invitrx Therapeutics. Torfi H is the founder and chief executive officer.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Margaret Coutts, PhD, Research Scientist, Invitrx Therapeutics, 27 Mauchly Suite 200, Irvine, CA 92618, United States. margaret@invitrx.com
Telephone: +1-949-8563142 Fax: +1-888-3897949
Received: October 11, 2017
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
Processing time: 75 Days and 22.4 Hours
ARTICLE HIGHLIGHTS
Case characteristics

A 56-year-old male patient presented with joint stiffness and pain, skin lesions and fatigue.

Clinical diagnosis

Swelling, pain and reduced range of motion in the metacarpal and proximal phalangeal joints; joint symptoms progressed to include wrist and shoulder joints. Stiffness and pain were more pronounced on waking. Two years of arthritic symptoms preceded red, scaly skin lesions.

Differential diagnosis

Rheumatoid arthritis, osteoarthritis, rheumatic fever, systemic lupus erythematosus, gout, secondary syphilis.

Laboratory diagnosis

Values for C-reactive protein (CRP) and red blood cell sedimentation rate (ESR) became normal after cord blood stem cell (CBSC) treatment.

Pathological diagnosis

Anatomical pathology indicating psoriatic arthritis (PsA) resolved after treatment with CBSC.

Treatment

Nonsteroidal anti-inflammatory drugs (NSAIDs), prednisone (steroid), methotrexate, TNF blockers (certolizumab and adalimumab), and umbilical cord blood stem cells.

Related reports

Mesenchymal stem cells (from bone marrow or fat) have been used to treat rheumatoid arthritis.

Term explanation

Human umbilical cord blood was obtained from CorCell Cord Blood. Erythrocytes were removed using an ammonium chloride lysis buffer, used according to manufacturer’s directions (eBioScience). Flow analysis of similar preparations revealed about 3% of the population had the MSC marker, CD90+. Live, nucleated cells were concentrated by centrifugation, enumerated, and resuspended in cryopreservative (CryoGold Serum-Free Freezing Media, purchased from Stemgent, Inc.) The resulting samples were aliquoted into 1.8 mL cryogenic vials and gradually chilled to -160 ˚C. Immediately before use, cells were thawed and assessed for viability. Post thaw viability was 80%, as determined by an automated cell counter (Bio-Rad TC-20). Figure 3 shows one of the preparations administered to the patient.

Experiences and lessons

This patient had persistent PsA symptoms, and did not find relief with standard therapies. Remission of symptoms correlated with injections of umbilical cord blood stem cells. Serological tests for inflammation (ESR and CRP) were normal for over a year after the initial CBSC injections.