safety and efficacy of expanded allogeneic ad-mscs in patients with moderate to severe psoriasis

Conditions: Mesenchymal Stromal Cells; Psoriasis; Drug Toxicity; Drug Effect

Summary: the purpose of this study is to evaluate the safety and efficacy of adipose-derived mesenchymal stem cells (ad-mscs) with moderate to severe psoriasis. any adverse events related to ad-mscs infusion will be monitored. safety is assessed using incidence of adverse events(aes) and serious adverse events (saes). efficacy is assessed via the proportion of the improvement of pasi (psoriasis area and severity index), relapse rate in treatment period, changes in pasi score and bsa, as well as dlqi.

psoriasis is an immune-mediated, genetic disease manifesting in the skin or joints or both. numerous topical and systemic therapies are available for the treatment of psoriasis. treatment modalities are chosen on the basis of disease severity, relevant comorbidities, patient preference. for moderate to severe psoriasis, phototherapy, systemic therapy and biologic immune modifying agents are recommended, but all of them have some drawbacks or limitations. until now, no curative treatment is available. therefore, it is important to find new treatment for psoriasis. mesenchymal stem cells (mscs) are a kind of adult stem cells that can differentiate into bone, cartilage and adipose cells. adipos-derived mesenchymal stem cells(ad-mscs) were isolated from fat tissues and were reported to treat moderate to severe psoriasis vulgaris and psoriasis arthritis successfully by case reports. for the mechanism of the disease, involvement of the immune system in psoriasis is now widely accepted. mesenchymal stem cells (mscs) are found to have the function of immunomodulation, migration to skin lesions, limitation of autoimmunity. therefore, investigators supposed that the injection of ad-mscs could be beneficial for treatment of moderate to severe psoriasis.

Eligibility criteria:
inclusion criteria: 1．moderate to severe psoriasis vulgaris ( pasi \> 10 or bsa \>10% ) 2．18 to 65 years old 3．written/signed informed consent exclusion criteria: 1. guttate psoriasis, inverse psoriasis or exclusively associated with the face 2. acute progressive psoriasis, and erythroderma tendency 3. current (or within 1 year) pregnancy or lactation 4. current significant anxiety or depression with the self-rating anxiety scale (sas) \> 50 or the self-rating depression scale (sds) \> 53, or with other psychiatric disorders 5. with history of primary cardiovascular, respiratory, digestive, urinary, endocrinologic and hematologic diseases, which can't be controlled through ordinary treatments. those who with malignant diseases, infections, electrolyte imbalance, acid-base disturbance. patients with clinical test results listed below: abnormal serum calcium level ( ca2+ \> 2.9 mmol/l or \< 2 mmol/l);ast or alt 2 times more than normal upper limit; creatinine and cystatin c more than normal upper limit; hemoglobin elevates 20g/l more than normal upper limit,or hemoglobin reduction to anemia; platelet count less than 75.0\*10\^9/l; white blood cell less than 3.0\*10\^9/l; or any other abnormal laboratory test results, assessed by investigators, that are not suitable for this clinical study 6. patients with malignant tumors, or when they were enrolled with abnormal tumor markers or with other organ dysfunction 7. allergy to anything else ever before; 8. current registration in other clinical trials or participation within a month; 9. topical treatments (i.e. corticosteroids or retinoic acid or vitamin d analogs ) within 2 weeks; systemic therapy or phototherapy (ultraviolet radiation b,uvb) and psoralen combined with ultraviolet a (puva) within 4 weeks; biological therapy within 12 weeks; 10. medical conditions assessed by investigators, that are not suitable for this clinical study.