none13nomixedSpinella, Amelia; Pignatti, Marco; Citriniti, Giorgia; Lumetti, Federica; Cocchiara, Emanuele; Palermo, Adalgisa; Sighinolfi, Gianluca; Pacchioni, Lucrezia; Zaccaria, Giovanna; Lusetti, Irene Laura; Santis, Giorgio De; Salvarani, Carlo; Giuggioli, DiliaSpinella, Amelia; Pignatti, Marco; Citriniti, Giorgia; Lumetti, Federica; Cocchiara, Emanuele; Palermo, Adalgisa; Sighinolfi, Gianluca; Pacchioni, Lucrezia; Zaccaria, Giovanna; Lusetti, Irene Laura; Santis, Giorgio De; Salvarani, Carlo; Giuggioli, Dili

Adalgisa Palermo

Amelia Spinella

Carlo Salvarani

Dilia Giuggioli

Emanuele Cocchiara

Federica Lumetti

Gianluca Sighinolfi

Giorgia Citriniti

Giorgio De Santis

Giovanna Zaccaria

Irene Laura Lusetti

Lucrezia Pacchioni

Marco Pignatti

English

Archivio istituzionale della ricerca - Università di Modena e Reggio Emilia

and SSc pts with interstitial lung disease (ILD) and high systolic pulmo-nary artery pressure (PAP). A linear negative correlation between thehigh hybrid M1/M2 cell percentage and diffusing capacity of the lungs forcarbon monoxide (DLCO)% and the forced vital capacity (FVC)/DLCOratio higher than 1.5 was observed. No significant correlations werereported with SSc duration, other treatments, NVC patterns, renal arteryresistive index, heart and kidney involvements, digital ulcers, telangiecta-sias, calcinosis.Conclusion: The study identified a circulating cell population expressingboth M1 and M2 surface markers, which is increased together with circu-lating M2 cells in SSc pts, in particular affected by ILD and high PAP,suggesting their possible involvement in the pathogenesis of those dis-ease complications. Further evaluations are in progress.REFERENCES:[1] Cutolo M, et al. Nat Rev Rheumatol. 2015;11:569-71. 2. Stifano G, et al.Curr Rheumatol Rep. 2016;18:2.Disclosure of Interests: None declaredDOI: 10.1136/annrheumdis-2019-eular.6748THU0349 AUTOLOGOUS FAT GRAFTING IN THE TREATMENT OFPATIENTS WITH SYSTEMIC SCLEROSIS: CURRENTEXPERIENCE AND FUTURE PROSPECTSAmelia Spinella1, Marco Pignatti2, Giorgia Citriniti1, Federica Lumetti1,Emanuele Cocchiara1, Adalgisa Palermo1, Gianluca Sighinolfi1,Lucrezia Pacchioni3, Giovanna Zaccaria3, Irene Laura Lusetti3, Giorgio De Santis3,Carlo Salvarani1, Dilia Giuggioli1. 1Scleroderma Unit, Chair of Rheumatology,University of Modena and Reggio Emilia, Modena, Italy; 2Department ofExperimental Diagnostic and Specialty Medicine, S.Orsola-Malpighi UniversityHospital, Modena, Italy; 3Department of Medical and Surgical Sciences, Universityof Modena and Reggio Emilia, Modena, ItalyBackground: Systemic Sclerosis (SSc) is a connective tissue disease,characterized by endothelial dysfunction and fibrosis, potentially affectinginternal organs and reducing life expectancy. Digital ulcers (DUs), as wellas hand and face skin thickening, are the hallmarks of the disease.These alterations lead to pain, functional impairment, aesthetic damages,and psychological distress. Autologous fat grafting (AFG) is a surgicaltechnique used also to promote tissue regeneration. In the last decade,AFG has been successfully developed to treat clinical conditions charac-terized by skin atrophy or fibrosis. AFG composition of multipotent cells,carrying angiogenic, and immunogenic properties, may be able to restorethe damaged tissues.Objectives: Evaluate our experience with AFG to treat and prevent dam-age and disability due to DUs and SSc skin complications.Methods: We analyzed 25 SSc patients, extrapolated from a larger seriesof 45 subjects, complaining about mouth and/or hand impairment, due toskin involvement, and, in some cases, long-lasting DUs (M/F 6/19, meanage 55.69±9.25-SD-years, mean disease duration 184.68±121.09-SD-months, L/D cutaneous subsets 21/4). Surgical procedures consisted inthe injection of centrifuged and purified autologous fat, harvested fromhips or abdomen. 2ml of fat were grafted in each of the 8 sites aroundthe mouth, while 0.5 or 1 ml around the neurovascular bundle at thebase of each finger. The study included: preoperative data collection; 2or 3 surgical sessions at a distance of 6 months one from the other;data collection at 3 months after each surgical session; data collection at3 and 6 months of follow up-FU after the last surgical procedure. Datacollection consisted of clinic-serological SSc features and clinimetric meas-ures about hand and mouth, if present DUs were assessed as well. Fur-thermore, patients were asked to fill in questionnaires in order to expresstheir level of satisfaction with hand and mouth functionality.Results: Overall 63 surgical procedures were performed. After 1 to 3 pro-cedures, patients reported an improvement of perioral skin tension(p=0.0238) and a reduced dry mouth feeling (p=0.0269). Similarly,patients stated an improvement of hands tension (p=0.0037). Furthermore,we observed a complete healing of DUs in 8/9 patients (p=0.0297).These positive clinical changes were mirrored by a subjective ameliora-tion. In particular, pain decreased, evaluated by short-form McGill PainQuestionnaire (SF-MPQ), scrutinizing sensory (p=0.3340) and affective(p=0.2234) descriptors. The perception of disability improved too, showingan amelioration trend in Health Assessment Questionnaire-HAQ(p=0.4301) and Mouth Handicap in Systemic Sclerosis scale-MHISS-(p=0.9775).Conclusion: Our results confirm the potential efficacy of AFG to treatSSc skin complications and DUs. We reported an almost completehealing of DUs and a promising improvement of skin thickness and hard-ness both at hands and mouth, with good safety profiles. These clinicalresults were reflected by the subjective improvement of patients’ well-being. Population enlargement and extended FU is ongoing to identifymore responsive SSc subsets. Long term results with soft tissue biopsieswill give us further data to finally evaluate the efficacy of this approachthat aims to improve the care and quality of life of our SSc patients.Disclosure of Interests: None declaredDOI: 10.1136/annrheumdis-2019-eular.5623THU0350 ANTI-INFLAMMATORY AND ANTI-FIBROTIC EFFECTSOF INTRAVENOUS ADIPOSE-DERIVED STEM CELLTRANSPLANTATION IN A MOUSE MODEL OFBLEOMYCIN-INDUCED SCLERODERMATakayasu Suzuka1, Takuya Kotani1, Shogo Matsuda1, II Masaaki1,Tohru Takeuchi1, Shigeki Arawaka1, Koji Nagai1, Yumiko Wada1. 1Osaka MedicalCollege, Takatsuki Osaka, JapanBackground: Systemic sclerosis (SSc) is a systemic autoimmune diseasecharacterized by microvascular damages and fibrosis. The main lesions ofSSc are peripheral circulation insufficiency, sclerodermia, and interstitialpneumonia. Skin lesions are related to patient‘s ADL and QOL, howeverthere is no effective treatment for normalizing the disease state. Adipose-derived stem cells (AdSCs) have recently been considered a useful treat-ment tool for autoimmune disease because of their anti-inflammatory andimmunosuppressive effects (ref).Objectives: We investigated the therapeutic effect of intravenous mouseAdSCs (mAdSCs) transplantation in a SSc mouse model.Methods: SSc was induced by bleomycin (BLM) in Balb/c mice, and themice were assigned in the following groups: 1. Control (BLM-SSc), 2.mAdSCs (1.0×104 cells), 3. mAdSCs (1.0×105 cells). After the administra-tion of BLM, mAdSCs were injected via a tail vein on day 7. The micewere sacrificed at 14 days after mAdSCs injection, and the skins wereharvested for histological analysis.Results: In mAdSCs (1.0×105 cells) group, thickening of skin, hydroxypro-line content, infiltration of inflammatory cells, gene expression of inflam-matory cytokines, and fibrotic factors were significantly reduced comparedwith control group (Figure). But in mAdSCs (1.0×104 cells) group, therewere no reduction of them. mAdSCs did not accumulate in skin. The lev-els of MMP-2, MMP-9, and COL1A1 mRNA expression at 21 days afterBLM administration were significantly lower in mAdSCs (1.0×105 cells)group compared with those in control group.Abstract THU0350 – Figure 1Conclusion: Intravenous mAdSCs inhibited both skin inflammation and fib-rosis of BLM-SSc mice in a dose-dependent manner.REFERENCES:[1] Cell Transplant 2015.24: 2297-2305.[2] Journal of Autoimmunity, 2016. 70: 31-39.Acknowledgement: This study was supported by Grants-in-Aid for ScientificResearch-KAKENHI- of Japan (Young Scientists B; 17K15761, 17K16216).456 Thursday, 13 June 2019 Scientific Abstracts on September 27, 2021 by guest. Protected by copyright.http://ard.bmj.com/Ann Rheum Dis: first published as 10.1136/annrheumdis-2019-eular.5623 on 27 June 2019. Downloaded from 

Thu0349 autologous fat grafting in the treatment of patients with systemic sclerosis: current experience and future prospects

Spinella, Amelia

Pignatti, Marco

Citriniti, Giorgia

Lumetti, Federica

Cocchiara, Emanuele

Palermo, Adalgisa

Sighinolfi, Gianluca

Pacchioni, Lucrezia

Zaccaria, Giovanna

Lusetti, Irene Laura

Santis, Giorgio De

Salvarani, Carlo

Giuggioli, Dilia

Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna

THU0349 AUTOLOGOUS FAT GRAFTING IN THE TREATMENT OF PATIENTS WITH SYSTEMIC SCLEROSIS: CURRENT EXPERIENCE AND FUTURE PROSPECTS

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THU0349 AUTOLOGOUS FAT GRAFTING IN THE TREATMENT OF PATIENTS WITH SYSTEMIC SCLEROSIS: CURRENT EXPERIENCE AND FUTURE PROSPECTS

https://iris.unimore.it/bitstream/11380/1253660/1/EULAR%202019%20FAT%20GRAFTING%20.pdf

Thu0349 autologous fat grafting in the treatment of patients with systemic sclerosis: current experience and future prospects

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Archivio istituzionale della ricerca - Università di Modena e Reggio Emilia

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