Reuters report today on drug-resistant tuberculosis. http://www.reuters.com/article/2014/03/23/us-tuberculosis-kids-idUSBREA2M0P520140323
It reminds me of a report 5 years ago from Russia by Erokhin et al. They gave intravenous expanded autologous mesenchymal cells to patients with drug-resistant tuberculosis and saw improvement.1
A new publication just came our of Sweden–a phase I safety trial of the same cell population in patients with multi-drug resistant and extremely drug resistant tuberculosis concluded: “MSCs as an adjunct therapy are safe and can now be explored further for the treatment of patients with MDR or XDR tuberculosis in combination with standard drug regimens. Adjunct treatment with MSCs needs to be evaluated in controlled phase 2 trials to assess effects on immune responses and clinical and microbiological outcomes.2
It would be interesting in someone did a trial expanded allogenic umbilical cord-derived mesenchymal stem cells (huMSCs) vs. autologous bone marrow. huMSCs have been shown to be more effective than autologous and allogenic cells in a number of conditions.
1. Probl Tuberk Bolezn Legk. 2008;(10):3-6.
[Systemic transplantation of autologous mesenchymal stem cells of the bone marrow in the treatment of patients with multidrug-resistant pulmonary tuberculosis].
The study undertaken 3 years ago examined the effect of systemic transplantation of autologous mesenchymal stem cells (MSC) in the complex therapy of 27 patients with pulmonary tuberculosis, including 15 patients with multidrug-resistant pulmonary tuberculosis and 12 with extensive drug resistance of Mycobacterium tuberculosis. All the patients were bacteria-discharging persons with disseminated destructive processes in lung tissue, most (n=17) of them had chronic fibrocavernous tuberculosis. In all the patients, previous long specific antituberculous treatment was ineffective or inadequately effective. After systemic MSC transplantation, 16 patients were followed up for 1.5-2 years or more and the remaining 11 patients for at least 6 months. After MSC administration, a positive clinical effect was observed in all 27 cases; bacterial discharge stopped in 20 patients after 3-4 months; resolution of sustained lung tissue cavities further occurred in 11 patients. At present, a persistent remission of a tuberculous process may be stated in 9 of the 16 patients in whom MSCs were transplanted 1.5-2 years, significant positive bacteriological and morphological changes are observed in 6 patients. Thus, inclusion of transplantation of the autologous MSCs propagated in the culture into a course of antituberculous therapy may be a promising procedure for enhancing the efficiency of therapy in patients with resistant forms of pulmonary tuberculosis.
2.Lancet Respir Med. 2014 Feb;2(2):108-22.
Autologous mesenchymal stromal cell infusion as adjunct treatment in patients with multidrug and extensively drug-resistant tuberculosis: an open-label phase 1 safety trial.
Skrahin A1, Ahmed RK2, Ferrara G3, Rane L4, Poiret T5, Isaikina Y6, Skrahina A7, Zumla A8, Maeurer MJ9.