Biodistribution of Liver-Derived Mesenchymal Stem Cells After Peripheral Injection in a Hemophilia A Patient
Etienne M Sokal1, Catherine Anne Lombard, Véronique Roelants
11 Université Catholique de Louvain, Cliniques Universitaires St Luc, Service de Gastroentérologie & Hépatologie Pédiatrique, Brussels, Belgium.2 Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Brussels, Belgium.3 Centre de Thérapie Cellulaire et Tissulaire, Cliniques Universitaires St Luc, Brussels, Belgium.4 Service de Médecine Nucléaire, Cliniques Universitaires St Luc, Brussels, Belgium.5 Division of Medicine, Institute for Liver and Digestive Health, Royal Free Hospital, University College of London, London, United Kingdom.6 Department of Cardiovascular Sciences, Center for Molecular and Vascular Biology, KU Leuven, Belgium.7 Service d'Hématologie, Cliniques Universitaires St Luc, Brussels, Belgium.
Background:
With the exception of liver transplantation, there is no cure for hemophilia, which is currently managed by preemptive replacement therapy. Liver-derived stem cells are in clinical development for inborn and acquired liver diseases and could represent a curative treatment for hemophilia A. The liver is a major factor VIII (FVIII) synthesis site, and mesenchymal stem cells have been shown to control joint bleeding in animal models of hemophilia. Adult-derived human liver stem cells (ADHLSCs) have mesenchymal characteristics and have been shown able to engraft in and repopulate both animal and human livers. Thus, the objectives were to evaluate the potency of ADHLSCs to control bleeding in a hemophilia A patient and assess the biodistribution of the cells after intravenous injection.
Methods:
A patient suffering from hemophilia A was injected with repeated doses of ADHLSCs via a peripheral vein (35 million In-oxine-labeled cells, followed by 125 million cells the next day, and 3 infusions of 250 million cells every 2 weeks thereafter; total infusion period, 50 days).
Results:
After cell therapy, we found a temporary (15 weeks) decrease in the patient's FVIII requirements and severe bleeding complications, despite a lack of increase in circulating FVIII. The cells were safely administered to the patient via a peripheral vein. Biodistribution analysis revealed an initial temporary entrapment of the cells in the lungs, followed by homing to the liver and to a joint afflicted with hemarthrosis.
Conclusion:
These results suggest the potential use of ADHLSCs in the treatment of hemophilia A.
