A Clinical Efficacy Study In The Treatment Of Lupus Nephritis By Umbilical Cord Mesenchymal Stem Cells

Objective To investigate the efficacy and safety of umbilical cord mesenchymal stem cells used in the treatment of lupus nephritis.Methods Retrospectively collect patients diagnosed with lupus nephritis in our hospital Select 32 cases of lupus nephritis patients accepted umbilical cord mesenchymal stem cells theratment as the treatment group, another 35 patients are selected from the database as the control group who are similar with the treatment group in gender, age, body mass index, pathological type distribution, course of disease,pathogenetic condition.Two groups were treated based on lupus nephritis treatment guidelines of 2011 KDIGO. Treatment group plus 1 courses of umbilical cord mesenchymal stem cell therapy on the basis of the control group treatment. Finally,a total of 60 people completed 16 weeks observation. A retrospective comparative analysis of two groups changes in the detection indexes before treatment(0 weeks) and at 2, 4, 6,8, 12 and 16 weeks after treatment, autoantibodies positive rate and clinical efficacy evaluation at the end of the observation,adverse reactions occurred throughout the observation process. in addition to the end of the observation the people who achieve complete remission or partial remission are followed up 1 year.Result(1)In terms of disease activity,At the same time point,lupus activity scores according to SLE-DAI and complement C3 have no significant difference between two groups before treatment(0 week)(P>0.05),but from 2 weeks to 16 weeks after treatment,there were significant difference(P<0.05).(2)In the kidneys urinary protein leakage,At the same time point,blood albumin, urine protein(24h) of two groups have no significant difference before treatment(0week) and 2week,4 week,6 week after treatment(P>0.05), but by 8 week,12 week,16 week after treatment,there were significant difference(P<0.05).(3)In the renal function,At the same time point,serum creatinine of two groups has no significant difference before and after the treatment(P>0.05).(4)In the hematopoietic system,At the same time point,two groups of hemoglobin,white blood cells, platelets have no significant difference before and after treatment(P>0.05).(5)In terms of autoantibodies,positive rate of ANA, ds-DNA of two groups have no significant difference before treatment(week 0)(P>0.05), but there were significant difference at 16 weeks after treatment(P=0.038<0.05,P=0.015<0.05).(6)Clinical efficacy evaluation,At the 16 weeks after treatment,two groups of complete remission rate(CR) and partial remission rate(PR)were no significant difference(P =0.390>0.05, P = 0.176>0.05), Two groups of total remission rate were significant difference(P = 0.032<0.05).(7)Recurrence,Two groups of patients with complete remission or partial remission were followed up for 1 years. There were significant difference in the recurrence rate between the two groups(P=0.047<0.05).(8)Adverse reactions,In the course of UC-MSCs infusion, there were no obvious adverse reactions. In the observation of 16 weeks, two groups of patients with infection and gastrointestinal complications were the most common.Although fewer complications were in the stem cell group, there were no significant difference between the two groups(P>0.05).Conclusion UC-MSCs treatment has positive effects in alleviation of lupus activity in a timely manner, improvement of lupus nephritis condition and prevent of lupus recurrence.no significantly side effects or adverse reaction have been observed, but long-term effects awaits to multi center, large sample and long-term follow-up of clinical trials.