Therapeutic effects of systemic transplantation of cultured autologous mesenchymal stem cells derived from bone marrow in patients with resistant pulmonary tuberculosis

Systemic transplantation of mesenchymal stem cells (MSC) is known to promote reparative process in a number of tissue damage as well as lung tissue one. It provided the basis for our study which was aimed to the effect of systemic transplantation of autologous MSC (intravenous transfusion) in complex therapy of patients with resistant pulmonary tuberculosis. Started three years ago, 27 tuberculous patients are being under our observation now; 15 patients were classified as having multidrug resistance, 12 cases - as being X-drug resistant. Bacterioexcretion and substantial pulmonary cavitation were observed in every patient, most of them (n=17) having chronic tuberculosis of 13 months to 5 years duration, the rest 10 patients diagnosed 6 to 12 months before including them to the study. All these patients had previously been undertreated or unsuccessfully treated, with one patient having one lung removed. Undergone systemic transplantation of 150-200 million of cultured MSCs derived from autlogous bone marrow the patients continued conservative therapy started before. 16 patients have been under observation for 1.5 -2 years and longer after transplantation, the rest 11 patients observed not less than 6 months. MSC- introduction gave positive clinical effects in all 27 cases: somatic status improvement, dyspnoea reduction, relieving of weakness and indisposition, putting on weight (24 cases). 3-4 months after transplantation bacterioexcretion was noticed to stop in 20 patients, in 11 patients long-termed cavities healed later. At present 9 of 16 patients who had MSC transplantation 1.5-2 years ago can be stated to have stable remission of tuberculosis, 6 patients of this group demonstrate significant positive bacteriological and morphological dynamics. Only in one of 16 cases MSC transplantation resulted in short clinical improvement. Thus, MSC transplantation as a part of antitubercular therapy can be perspective in enhancing treatment of patients with drug-resistant tuberculosis.