First patients affected by eczema Treated with stem cells

Chronic or recurring eczema is an inflammatory skin disease characterized by the presence of redness and scabs on dry skin, leading to itching.

Eczema, a common chronic disease in children

Chronic or recurring eczema is an inflammatory skin disease characterized by the presence of redness and scabs on dry skin, leading to itching. It is caused by malfunctioning of the skin’s immune system due to both genetic and environmental factors. It typically occurs during childhood and, in developed countries, can affect up to 20% of children and 3% of adults.

Current treatments consist of topical steroids – such as corticosteroid cream – and systemic immunosuppressants. However, on the one hand, the effectiveness of creams is limited and their application in the medium term is accompanied by side effects. While, on the other hand, immunosuppressants represent a risk of toxicity and side effects.

Interesting immunomodulatory properties

Stem cell-based therapies (SCT) have demonstrated their potential effectiveness against incurable diseases through several preliminary studies. Mesenchymal stem cells in particular, and in view of their immunomodulatory properties, have already been used in the treatment of some immune disorders. In this context, their effect on the treatment of eczema has recently been evaluated.

An early pre-clinical study, conducted by the Seoul National University (South Korea), has established the mechanisms through which mesenchymal cells extracted from human umbilical cord blood interact with the skin’s immune system to alleviate the inflammatory reaction when injected subcutaneously.

A major first for patients affected by eczema

This year, the same group, in collaboration with Seoul St. Mary’s Hospital, proved that these results could be reproduced successfully within the framework of a clinical trial.

The study involved 34 patients:

  • 7 patients for phase I (assessment of tolerance and treatment safety)
  • 27 patients for phase IIa (assessment of effectiveness according to the treatment dose administered)

2 doses: low and high were tested during phase IIa and were randomly administered. Following treatment, consisting of a single, subcutaneous, monodose injection, patients were examined every 2 weeks up to 12 weeks. The severity of their condition was assessed using a standard score system. Two parameters were measured: SCORAD (Scoring Atopic Dermatitis) and EASI (Eczema Area and Severity Index).

Symptomatic improvement and reduced biomarker levels

The subcutaneous injection of human umbilical cord blood mesenchymal stem cells allowed for the symptomatic improvement of the disease. It was possible to quantify and confirm this improvement through the measurement of the 2 parameters (SCORAD and EASI).

More specifically, in 55% of patients receiving the high dose, an EASI score reduction of 50% was observed. It is interesting to note that the effectiveness of the treatment depends on the dose administered, with the higher dose achieving the best results.

Alongside these results, it is important to highlight that the treatment brought about a reduction of biomarkers pertaining to the severity level of the allergic reaction (total IgE serum and number of blood eosinophils).

From a safety point of view, no serious side effects were observed and a good treatment tolerance could be recorded.

Proof of concept

The authors of this study consider these results to be promising and revealing for potential therapies based on stem cells from umbilical cord blood to treat a widespread disease.

They plan to conduct a new study, on a larger scale and with a control group that will receive a placebo, in order to reinforce the results obtained and develop a new treatment that is available to the general public.

REFERENCES
Kim HS, Yun JW, Shin TH et al. (2015) Human umbilical cord blood mesenchymal stem cell- derived PGE2 and TGF-beta1 alleviate atopic dermatitis by reducing mast cell degranulation. STEM CELLS 33:1254–1266. Kim HS, Lee J H, Roh KH et al. (2016) Clinical Trial of Human Umbilical Cord Blood-derived Stem Cells for the Treatment of Moderate-to-Severe Atopic Dermatitis: Phase I/IIa Studies. STEM CELLS