Fat Cell Transplants Boost Hand Function in SSc

In a small pilot trial, systemic sclerosis patients whose own abdominal fat cells were injected into their hands enjoyed better than a 50% improvement in hand disability. Injected cells seemed to increase growth of blood vessels.

Granel B, Daumas A, Jouve E, et al., Safety, tolerability and potential efficacy of injection of autologous adipose-derived stromal vascular fraction in the fingers of patients with systemic sclerosis: an open-label phase I trial. Ann Rheum Dis (2014) doi:10.1136/annrheumdis-2014-205681 [Online Aug 11, open access]

Transplanted into their fingers, their own fat cells produce improvements in hand disability, pain, swelling and Raynaud’s phenomenon in as little as two months among patients with scleroderma, according to preliminary results from a small clinical trial in France.

In the open-label, single-arm trial, autologous adipose-derived stromal/stem cells (ADSC) were aspirated from the abdomen, purified, and injected into the fingers of 12 women with systemic sclerosis (SSc), with no serious adverse consequences.

ADSC cells taken from the stromal vascular fraction of adipose tissue appear to have the ability to grow into other cell types, to have anti-fibrotic and antiinflammatory effects, and to increase the growth and function of small blood vessels in the hands, these researchers say.

In the trial, the patient’s ADSC fat cells were injected under the skin of each finger in contact with neurovascular pedicles. Four minor adverse events (pain and minor paresthesia) resolved spontaneously.

At six months, patients hadmore than 50% decrease in hand disability (assessed by the Cochin Hand Function Scale, CHFS), an almost 68% decrease in the Raynaud’s condition scores (RCS), and a perceived improvement in quality of life as reported in the Scleroderma Health Assessment Questionnaire (SHAQ).

They also had a 38% improvement in hand pain in Visual Analogue Scores , increased grip strength, reduced finger swelling, and fewer digital ulcers.

Most of these women, whose ages ranged from 34 to 68, had limited cutaneous SSc with a median disease duration of almost 10 years and a history of Raynaud’s for an average of 14 years.

This is the first treatment to improve hand manifestations of SSc, but the researchers stress that their results need confirmation in a randomized placebo-controlled trial among a larger patient population.