Capillary Regeneration in Scleroderma: Stem Cell Therapy Reverses Phenotype?

作者：Jo Nadine Fleming, Richard A. Nash, D. O. McLeod, David Fiorentino, Howard M. Shulman, M. Kari Connolly, Jerry A. Molitor, Gretchen Henstorf, Robert Lafyatis, David K. Pritchard, Lawrence D. Adams, Daniel E. Fürst, Stephen M. Schwartz · 发表于：PLoS ONE · 年份：2008 · DOI：10.1371/journal.pone.0001452 · 被引用次数：185 · 研究领域：Systemic Sclerosis and Related Diseases、Lymphatic System and Diseases、Connective Tissue Growth Factor Research

BACKGROUND: Scleroderma is an autoimmune disease with a characteristic vascular pathology. The vasculopathy associated with scleroderma is one of the major contributors to the clinical manifestations of the disease. METHODOLOGY/PRINCIPAL FINDINGS: We used immunohistochemical and mRNA in situ hybridization techniques to characterize this vasculopathy and showed with morphometry that scleroderma has true capillary rarefaction. We compared skin biopsies from 23 scleroderma patients and 24 normal controls and 7 scleroderma patients who had undergone high dose immunosuppressive therapy followed by autologous hematopoietic cell transplant. Along with the loss of capillaries there was a dramatic change in endothelial phenotype in the residual vessels. The molecules defining this phenotype are: vascular endothelial cadherin, a supposedly universal endothelial marker required for tube formation (lost in the scleroderma tissue), antiangiogenic interferon alpha (overexpressed in the scleroderma dermis) and RGS5, a signaling molecule whose expression coincides with the end of branching morphogenesis during development and tumor angiogenesis (also overexpressed in scleroderma skin. Following high dose immunosuppressive therapy, patients experienced clinical improvement and 5 of the 7 patients with scleroderma had increased capillary counts. It was also observed in the same 5 patients, that the interferon alpha and vascular endothelial cadherin had returned to normal as other clinical sign...