Allogeneic fibroblast cell therapy in the treatment of recessive dystrophic epidermolysis bullosa

Background

The non-healing wound is a characteristic clinical sign in recessive dystrophic epidermolysis bullosa (RDEB).

Methods

Six patients with recessive dystrophic epidermolysis bullosa were injected with suspension of allogeneic fibroblasts into erosion margins. Erosions (>1 month old) with surface area between 2 cm² and 28 cm² were selected for treatment. The patients were administered with 1 mL suspension of allogeneic fibroblasts with concentration 5 × 10⁶ cells/ml, 10 × 10⁶ cells/ml and 20 × 10⁶ cells/ml. Paired erosions were injected with vehicle solution alone. All erosions were assessed for healing rate and biopsied at baseline and at two weeks after treatment. Immunofluorescence antigen mapping (IFM) was performed to detect C7 expression.

Results

An increase of healing rate was detected 14 days after fibroblasts and vehicle alone injections, in some cases with complete erosion closure. The results of the IFM in patients treated with allogeneic fibroblasts and vehicle solution demonstrated the increase of collagen VII expression in dermo-epidermal junction, more intensive in patients injected with 20 × 10⁶ cells/ml.

Conclusions

Intradermal administration of allogeneic fibroblasts is a safe and effective method of treatment of non-healing wounds in recessive dystrophic epidermolysis bullosa.