American Journal of Obstetrics and Gynecology
AbstractsDonor chimerism across full allogenic barriers achieved by in utero transplantation of fetal mesenchymal stem cells in a case of osteogenesis imperfecta
Section snippets
Objective
Mesenchymal stem cells (MSCs) retain multilineage potential in vivo and in vitro, and upon induction these cells can form cartilage, adipose, bone, and muscle. MSCs have immunomodulatory effects and suppress T-cell responses. Recently, it was shown that transplantation of MSCs in children with osteogenesis imperfecta (OI) led to an acceleration of growth, increased mineral content, and a decreased incidence of fractures.
Study design
A female fetus with OI with multiple fractures was transplanted in the 29th week of gestation in utero with ex vivo expanded human fetal MSCs (0.5×106 cells) of male origin.
Results
The pregnancy was uneventful and the mother was delivered in the 36th week with CS. The neonatal course was uncomplicated and she was discharged at 3 weeks' postnatal age. The girl's first year has been remarkably uneventful, and she has never been hospitalized during this period. At 8 months of age a bone biopsy revealed that 5 of 100 osteoblasts are of male origin.
Conclusion
This case shows that expanded allogenic MSCs of fetal liver origin can migrate from the intravascular space to bone, after intrauterine transplantation to an immunocompetent recipient, and demonstrate site-specific differentiation and long-term persistence. The girl did well in regard to body mineral content, fracture incidence, and bone histology. The possibility to transplant miss-matched MSCs to immunocompetent recipients may have wide implications for pre- and postnatal transplantation for