Abstract
BACKGROUND: Atopic dermatitis (AD) is a chronic skin condition affecting patients' well-being, but conventional treatments have limitations. Mesenchymal stem cells (MSCs) present a promising option for AD therapy, though large-scale clinical studies are scarce. This study aimed to assess the efficacy and safety of autologous adipose tissue-derived MSC (AtMSC) in moderate to severe AD refractory to conventional treatments. METHODS: This multicenter, randomized, single-blind, placebo-controlled, phase 2 trial included 114 participants. Participants received two intravenous injections of AtMSCs or placebo at 4-week intervals. Clinical assessments, comprising Eczema Area and Severity Index (EASI), Scoring Atopic Dermatitis (SCORAD), and Investigator's Global Assessment (IGA), were performed every 4 weeks for 16 weeks total. Biomarker analyses were conducted using ELISA. RESULTS: Statistically significant differences between the treatment and placebo groups in EASI total score were observed at 8, 12, and 16 weeks (P = .0.017, 0.015, < 0.001). At week 16, 23.7% [14/59] of participants in the treatment group achieved a 75% or greater reduction in EASI total score (EASI-75), compared to 7.3% [4/55] in the placebo group, with a statistically significant difference (P = .016). In addition, SCORAD, disease severity, and IGA score were also improved in the treatment group compared to the placebo group. Furthermore, the change in TARC levels from baseline to week 16 was significantly different between the treatment and placebo groups. CONCLUSIONS: AtMSC therapy improved moderate to severe AD, offering a promising treatment option with potential applications in chronic inflammatory diseases. Further investigation, including double-blind phase 3 trials, is needed to confirm these findings and explore additional biomarkers. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT04137562; October 21, 2019; https://clinicaltrials.gov/study/NCT04137562 .