CTLA4 overexpressing adipose tissue-derived mesenchymal stem cell therapy in a dog with steroid-refractory pemphigus foliaceus.

Sei-Myoung Han,Kyoung-Won Seo,Hwa-Young Youn,Kee-Ok Jeon,Kun-Woo Kim,Hyun-Tae Kim,Eun Wha Choi

doi:10.1186/s12917-015-0371-3

Abstract

BackgroundCanine pemphigus foliaceus is an autoimmune antibody-mediated skin disease characterized by acantholysis. The objective of this case report is to present the successful management of steroid refractory pemphigus foliaceus with cytotoxic T-lymphocyte antigen 4 (CTLA4)-overexpressing adipose tissue mesenchymal stem cells (ATMSCs).Case presentationA 10-year-old, 12.3-kg, castrated male Shih Tzu presented with severe pruritus and anorexia. The diagnosis of pemphigus foliaceus was made based on its history, physical examination, and histopathology results of a skin biopsy. Treatment with prednisolone and combination therapy of other immunosuppressive drugs had failed; therefore, immunosuppressive gene, CTLA4 overexpressing ATMSCs (CTLA4-ATMSCs) and/or naive ATMSCs administration was performed with the consent of the owner. ATMSCs were administered 21 times over a period of 20 months with intervals of 2 to 8 week. Prednisolone was gradually tapered concurrently and no relapse of the clinical signs was observed. After the termination of CTLA4-ATMSCs and/or naive ATMSCs treatment, the skin lesions had improved and could be managed with a low dose of prednisolone for 12 months.ConclusionCTLA4-ATMSCs or naive ATMSCs transplantation may be beneficial as adjunctive therapy to initiate and maintain the remission of skin lesions caused by pemphigus foliaceus in veterinary medicine.

Highlights

Canine pemphigus foliaceus is an autoimmune antibody-mediated skin disease characterized by acantholysis
cytotoxic T-lymphocyte antigen 4 (CTLA4)-adipose tissue mesenchymal stem cells (ATMSCs) or naive ATMSCs transplantation may be beneficial as adjunctive therapy to initiate and maintain the remission of skin lesions caused by pemphigus foliaceus in veterinary medicine
This case report describes the successful management of steroid refractory pemphigus foliaceus with CTLA4ATMSCs and/or naive ATMSCs

Summary

Conclusion

CTLA4-ATMSCs or naive ATMSCs transplantation could be beneficial as adjunctive therapy in both the remission and management of lesions by canine pemphigus foliaceus in veterinary medicine. Competing interests The authors declare that they have no competing interests. Authors’ contributions SMH drafted and edited the manuscript. HTK, KWK and KOJ participated in patient management and data collection used in figures. KWS edited and revised the manuscript EWC carried out gene engineering of cells and helped with editing and revision of the manuscript. HYY supervised all management procedure and revised the manuscript. All authors read and approved the final manuscript

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