For patients with rapidly progressive, early-stage diffuse cutaneous systemic sclerosis with internal organ involvement (lung fibrosis, cardiac dysfunction), HSCT at a specialised centre offers meaningful benefit and is considered by some specialists as a disease-modifying intervention, despite significant procedural risk. Placental MSC therapy may be a lower-risk option for early-stage or stable disease. Both remain investigational compared to conventional DMARDs and should be pursued only at academic centres with trial oversight.
Systemic sclerosis (scleroderma) is an autoimmune disease characterised by pathologic fibrosis of skin and internal organs (lungs, heart, kidneys), driven by activated fibroblasts that overproduce collagen and other extracellular matrix proteins. The underlying immunological dysfunction involves autoreactive T cells, B cells producing pathogenic antibodies (anti-topoisomerase, anti-centromere), and dysregulated cytokine signalling (TGF-β, IL-6). Placental MSCs are being explored as an anti-inflammatory and immunomodulatory intervention, delivering cytokines and cell-surface molecules that suppress autoreactive immune cells and potentially reprogram fibroblast behaviour. Unlike conventional disease-modifying antirheumatic drugs (DMARDs), cell therapy aims to reset immune tolerance rather than merely suppress inflammation. Note: autologous haematopoietic stem-cell transplantation (HSCT) is an established, though intensive, option for severe early-stage systemic sclerosis in selected candidates, with demonstrated benefit in some clinical series.
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Rivisto medicalmente dal team editoriale di StemCellAtlas con Dr Polina Krasenova (Haematologist · Clinical Haematology & Integrative Oncology · 15+ yrs cell therapy) della clinica partner Stem Plus (Sofia), rispetto alle linee guida ISSCR, FDA e EMA. Educational information, not medical advice; figures indicative.
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