Ann: MSB Licensee Files For Skin Disease Marketing Approval, page-25

This is great news for sufferers of EB. I think this is a very small market but the implications for our cells imo are tremendous.

I'm wondering if this could also have implications for our cells' position in clinical practice for aGvHD.

If I recall right, SI once mentioned a two-step process. First inflammation then repair. I wished at the time he'd elaborated a bit more but he was addressing a lay audience. I wondered at the time whether our cells had the capacity not just to put out inflammation but for structural repair. I wondered if they could restore the epithelial barrier, which is increasingly attracting interest as a key therapeutic goal. I've long suspected that loss of mucosal integrity is the main driver of chronic disease.

The gut is the key organ where GvHD starts. Team leader of a research group in GvHD Hendrik Poeck of the Technical University of Munich says: "If the epithelium could be protected or quickly restored, the risk of an immune response would be much lower."

This imo is another indication that MSCs should be used first line. Why would we continue to use steroids first line anyway if they're considered an inadequate therapy?

I think a strong case could be made for reimbursement for MSCs first line. We could see an overall reduction in chronic GvHD, which is increasing in paediatrics (Arai et al, 2015), also reduction in cost of intensive care due to infection, reduction in risking graft v cancer through avoiding too broad immune suppressants.