Treatment of Buerger’s disease (Thromboangiitis obliterans) with autologous adipose tissue-derived mesenchymal stem cell: Report of three cases

Abstract

Buerger’s disease or Thromboangiitis obliterans is an orphan vascular disease that most commonly affects nerves, small or medium-sized vessels in the upper and lower extremities, and is characterized by a non-atherosclerotic, segmental, inflammatory disorder. The etiology and the pathogenesis of the disease have not been fully elucidated. Although various interventions have been adopted recently, there is still no effective treatment for the prevention of the progression of the disease. This report presents three clinical cases that show the efficacies of autologous adipose tissue-derived mesenchymal stem cell (AdMSC) treatment in Buerger’s disease. Three male patients diagnosed with Buerger’s disease were between 46 and 55 years and had a smoking history. AdMSCs (5X10 6 cells/kg body weight) were injected intramuscularly into at least 38 points of the ischemic legion of the lower limb at one time. The patients were checked for safety and efficacy at one, three, and six months after AdMSC injection. No severe adverse events and no adverse drug events were observed in physical examination, vital signs, and laboratory tests for all three patients. Ulcers in the affected legs of the patients were healed completely after the treatment. Visual Analogue Scale scores and all the criteria (activities, emotional, pain, social, symptoms and total) of the King s College Hospital s Vascular Quality of Life Questionnaire (VascuQOL) of all the patients were improved from baseline to six months follow-up. Digital Infrared Thermal Imaging showed the gradual alleviation of lesions in the leg. Angiogenesis in the affected limbs was identified by CT-Angiography after AdMSC injection. The present cases show the improvement in patients with Buerger’s disease with the observation of angiogenesis after intramuscular injection of autologous AdMSCs. This suggests that autologous AdMSC can be an effective alternative treatment for Buerger’s disease.