DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20193112

Effectiveness of autologous lipoinjection into the hand to improve function in patients with scleroderma: pilot study

Juan Pablo Espinosa-Torres, Pedro Grajeda-López, María del Pilar Cruz-Domínguez, Luis Rodrigo Carazo-Quiroz, Edgar Ramírez-López, Maribel Belmontes-Castillo, Alan Isaac Valderrama-Treviño, Rodrigo Banegas-Ruíz, Víctor Manuel Ramos-Lojero, Baltazar Barrera-Mera

Abstract


Background: Scleroderma is a rare disease of the tissues that is characterized for being inflammatory and developing fibrosis in the skin. Typically, this disease affects middle-aged women.

Methods: A study was conducted in which 10 patients with scleroderma with involvement in the sclerotic stage were included. One of the hands was chosen randomly for treatment with fatty graft processed by Coleman technique and the other hand, physiological solution was placed. Patients were evaluated at 45 and 90 days after the procedure using the Cochin Hand Functional Scale (CHFS) questionnaire, modified Rodnan scale for the skin (mRSS), grip strength with dynamometer and measurement of fingertip to palm of hand in flexion.

Results: The average of CHFS before treatment was 42.30 and 25.70 at 90 days p=0.007. The average strength in the experimental hand before treatment was 11.67 and 14.58 at 90 days p=0.007, in the control hand p=0.873. The mean finger-palm tip distance before treatment was 44.80 and from 36.00 to 90 days p=0.019, in the control hand p=0.149. There is a significant difference in the degree of severity at 90 days of the mRSS of the back of the hands p=0.011 and phalanges p=0.000 between the patients with lipoinjection and physiological solution.

Conclusion: Significant improvement was observed in patients with scleroderma treated with autologous lipoinjection.


Keywords


Atologous transplant, Fibrosis, Lipoinjection, Scleroderma, Sclerotic stage, Thickened fingers

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References


Eckes B, Moinzadeh P, Sengle G, Hunzelmann N, Krieg T. Molecular and celular basis of scleroderma. J Mol Med (Berl). 2014;92(9):913-24.

Katsumoto TR, Whitfield ML, Connolly MK. The pathogenesis of systemic sclerosis. Annu Rev Pathol. 2011;6:509-37.

Mayes MD. Scleroderma epidemiology. Rheum Dis Clin North Am. 1996;22(4):751-64.

Cooper GS, Stroehla BC. The epidemiology of autoimmune diseases. Autoimmun Rev. 2003;2(3):119-25.

Mouthon L. Hand involvement in systemic sclerosis. Presse Med. 2013;42(12):1616-26.

Guillevin L, Hunsche E, Denton CP, Krieg T, Schwierin B, Rosenberg D, et al. Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry. Clin Exp Rheumatol. 2013;31(2 Suppl 76):71-80.

Rannou F, Poiraudeau S, Berezne A, Baubet T, Le-Guern V, Cabane J, et al. Assessing disability and quality of life in systemic sclerosis: construct validities of the Cochin Hand Function Scale, Health Assessment Questionnaire (HAQ), Systemic Sclerosis HAQ, and Medical Outcomes Study 36-Item Short Form Health Survey. Arthritis Rheum. 2007;57(1):94-102.

Nguyen C, Ranque B, Baubet T, Berezne A, Mestre-Stanislas C, Rannou F, et al. Clinical, functional and health-related quality of life correlates of clinically significant symptoms of anxiety and depression in patients with systemic sclerosis: a cross sectional survey. PLoS One. 2014;9(2):e90484.

Daumas A, Magalon J, Jouve E, Truillet R, Casanova D, Giraudo L, et al. Longterm follow-up after autologous adipose-derived stromal vascular fraction injection into fingers in systemic sclerosis patients. Curr Res Transl Med. 2017;65(1):40-3.

Gheisari M, Ahmadzadeh A, Nobari N, Iranmanesh B, Mozafari N. Autologous Fat Grafting in the Treatment of Facial Scleroderma. Dermatol Research and Practice. 2018;1-7.

Montero-Acebal MLM, Travesedo EE, Gomez-Bajo GJ, Autólogo IDT. Aplicaciones En Dermatología. 2015;30(3)159-68.

Magalon G, Daumas A, Sautereau A, Magalon JR, Sabatier F, Granel B. Regenerative Approach to Scleroderma with Fat Grafting. Clin Plastic Surg. 2015;353-64.

Griffin M, Ryan CM, Pathan O, Abraham D, Denton CP, Butler PEM, Characteristics of human adipose derived stem cells in scleroderma in comparison to sex and age matched normal controls: implications for regenerative medicine. Stem Cell Research & Therapy. 2017;8-23.

Daumas A, Eraud J, Hautier A, Sabatier F, Magalon G, Granel B. Interests and potentials of adipose tissue in scleroderma. La Revue de Medecine Interne. 2013 Dec;34(12):763-9.

Guillaume-Jugnot P, Daumas A, Magalon J, Sautereau N, Veran J, Magalon G, et al. State of the art. Autologous fat graft and adipose tissue-derived stromal vascular fraction injection for hand therapy in systemic sclerosis patients. Current research in translational medicine. 2016Jan1;64(1):35-42.