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BackgroundSjögren’s syndrome (SS) is a systemic autoimmune disease, with major symptoms including dry mouth and dry eyes, for which there is no effective treatment. Recent studies have demonstrated that mesenchymal stem cells (MSCs) are effective in the treatment of SS, but the efficacy of allogeneic MSCs is affected by variability among different cell donors, and they are easily cleared by the immune system of the recipient. Autologous MSCs are one of the ideal options for the treatment of SS; however, their function decreases with age. Regenerative fibroblast (rFib) is a type of new MSC obtained through chemical reprogramming technology from skin fibroblasts. In this study, we report the safety and efficacy of intravenous infusion of autologous rFib in a volunteer with SS.Case reportIn March 2021, the volunteer was diagnosed with SS due to positive anti-SSB antibodies, lymphocyte infiltration in the lip gland, dry eyes, and a large area of purpura in both lower limbs. From May 2021 to November 2022, she received allogeneic Umbilical cord mesenchymal stem cells (UCMSC) therapy (5.0 × 107 UCMSCs per time, totaling 10 infusions), but her condition did not improve. In May 2023, the rFib for the volunteer was prepared, meeting the quality standard of T/CSCB0003-2021 Human Mesenchymal Stem Cells. Between October 2023 and June 2024, the volunteer received a total of 12 intravenous transfusions of autologous rFib. After the treatments, the volunteer experienced no recurrence of purpura in both lower limbs. Symptoms of dry mouth, dry eyes, and fatigue were relieved. ESR, B lymphocytes, rheumatoid factor IgM, and IgA declined, while the proportion of NK cells increased, and most of the cytokines returned to normal levels. In vitro experiments showed that rFib could significantly inhibit the proliferation of T lymphocytes after PHA stimulation. No adverse effects were associated with the use of rFib in the volunteer during the clinical trial.SummaryThe results of this clinical trial indicate that intravenous injections of autologous rFib are both safe and effective for treating SS. Autologous rFib may be more suitable for treating autoimmune diseases than allogeneic MSCs.

Objective To identify risk factors associated with postoperative shoulder joint dysfunction in patients who underwent surgical intervention for acromioclavicular (AC) joint dislocation, with the aim of enhancing preoperative counselling, surgical planning, and postoperative management to optimize functional outcomes. Methods Patients who underwent surgery for AC joint dislocation between January 2018 and January 2023 at a hospital orthopaedic centre were enrolled into this retrospective study. Inclusion criteria were patients aged ≥18 years with a documented AC joint dislocation who underwent surgical treatment and had a minimum follow-up period >1 year. Patients with pre-existing shoulder conditions, prior shoulder surgeries, or incomplete medical records were excluded. Visual Analog Scale pain score ≥5 and Constant-Murley Score ≤70 was considered indicative of shoulder joint dysfunction. Statistical analyses included univariate and multivariate logistic regression to identify independent risk factors for postoperative shoulder joint dysfunction. Results Among 208 included patients, 56 (27%) exhibited shoulder joint dysfunction at the final follow-up. High-energy injury mechanisms, combined coracoclavicular ligament injuries, and lack of coronal plane congruity were identified as significant predictors of postoperative dysfunction. Specifically, high-energy injuries (odds ratio [OR] 5.493, 95% confidence interval [CI] 2.068, 14.590), combined coracoclavicular ligament injuries (OR 0.118, 95% CI 0.032, 0.432), and lack of coronal plane congruity (OR 2.540, 95% CI 1.197, 5.387) were associated with an increased risk of poor shoulder function postoperatively. Other factors, such as age, injury mechanism, and postoperative exercise compliance also contributed to the outcomes. Level of evidence: iv. Conclusions Injury mechanism, ligamentous injuries, and joint congruity are important in determining postoperative shoulder function. Accurate joint reduction and diligent postoperative rehabilitation are crucial for optimal recovery. These findings provide valuable insights for improving patient care and surgical outcomes in AC joint dislocation treatment. Further research is needed to validate these findings and explore additional factors that may influence postoperative shoulder function.