[Contribution of mesenchymal stromal cell transplantation in systemic scleroderma]

Contribution of mesenchymal stromal cell transplantation in systemic scleroderma Systemic scleroderma is a rare chronic autoimmune disease with the highest mortality rate among rheumatologic diseases. Its pathophysiology is based on three mechanisms: endothelial damage with initial vasculopathy, activation of the immune response, progressive fibrosis of the skin and various organs. Cellular therapy allows to envision new perspectives: autologous hematopoietic stem cell transplantation has been widely validated to treat severe forms of the disease, but its use is restricted to the most severely affected patients and contraindicated in advanced forms of the disease. The use of mesenchymal stromal cells, and their immunomodulatory, pro-angiogenic and anti-fibrotic properties, as well characterized in vitro and in vivo, broadens the field of possibilities. The use of mesenchymal stromal cells in targeted indications (treatment of graft versus host disease, crohn's disease fistulas, etc.) Has received market authorization and is currently being studied in systemic scleroderma with very promising results.