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Open Access Highly Accessed Editorial

Safety and feasibility of umbilical cord mesenchymal stem cells in treatment-refractory systemic lupus erythematosus nephritis: time for a double-blind placebo-controlled trial to determine efficacy

Thasia G Woodworth and Daniel E Furst*

Author Affiliations

Division of Rheumatology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

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Arthritis Research & Therapy 2014, 16:113  doi:10.1186/ar4677


See related research by Wang et al., http://arthritis-research.com/content/16/2/R79

Published: 30 July 2014

Abstract

As translational clinical researchers familiar with the risk-benefit of hematopoietic stem cell transplantation in autoimmune diseases, we are intrigued by the recent report of umbilical cord mesenchymal stem cell (UC-MSC) transplantation in treatment-refractory systemic lupus erythematosus nephritis by Wang and colleagues. They report the results of an open-label single-arm multicenter phase I/II study. This stimulated us to examine whether collective data from this group provide sufficient evidence for the feasibility, safety, dose rationale, and potential efficacy of UC-MSCs to conduct a randomized controlled trial in such patients. Results, though confounded by variable baseline prednisone and immuno-suppressive treatment, appear to indicate near-term response rates of approximately 50%, which are comparable to those seen with hematopoietic stem cell transplantation but with less morbidity and mortality.