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Treatment of Pulmonary Sarcoidosis Using Allogenic Bone Marrow-Derived Mesenchymal Stem Cell Therapy is Safe: A Case Report

Mesenchymal stem cells have a proven potent immunomodulatoryeffectboth in vitro and in vivo.We reportacase of a67-year-oldmale patient, first diagnosed with sarcoidosis in 2005, that responded well clinically and biologically to ImmunoARTTM(developed by Educell Ltd.) allogenic, HLA-incompatible, and non-related bone marrow- derived MSCs in a dose of 106/kg. The patientpresented to St. Catherine Specialty Hospital in 2021withan exacerbation of respiratory symptoms.After a clinicaland radiological examinationwith laboratory workup, radiological findings were consistent with pulmonary sarcoidosis, while laboratory work revealedincreased leucocytes at 14.2g/L, CRP at 51.2 mg/L, and lymphocytes at 4.25 g/L. The patient was then administered intravenous application of MSCs on three occasions in the out-patient clinic. MSC doses were prepared from a young, healthy donor who agreedto donate bone marrow for allogeneic treatment and who was negative for viral markers (HBs Ag, HBc Ab, HCV Ab, HIV 1-2 Ab, TPHA, HBV NAT, HCV NAT, HIV NAT) according to EU legislation. Cells were prepared in a controlled and verified laboratory for “Hospital exemption” cell preparation in the cleanroom facility in safety cabinet class A and expressed CD105, CD 73, and CD 90 but lacked the expression of CD45 and CD34.Before the treatment, standard print and detailed verbal information were provided to patients undergoing treatment. Immediately after the informed consent form (ICF) was signed by the patient. ThroughoutMSC therapy, the patient showed an improvementclinicallyand biologicallywith a decrease in inflammatory parameters.Laboratory valueswere assessedon days 2, 5, and7.On day 7, leucocyteswere11.2 g/L, CRP 5.1 mg/L, and lymphocytes 4.0 g/L. In thefollow-up period, the patient felt subjectively better, without any side effects of the MSC therapy. Unfortunately, the patient dropped out from follow-up, therefore, the prolonged effects of this therapy were not able to be assessed. Therefore, systemic MSC therapy presents an opportunity to treatsarcoidosis that needs to be further researched.

Mesenchymal stem cells, allogenic, sarcoidosis, bone marrow.

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