Stem Cell Therapies for Inflammatory Bowel Disease
- 68 Downloads
Purpose of Review
Stem cell therapies have demonstrated safety and efficacy in the treatment of perianal Crohn’s disease as compared to conventional therapy. Thus, an understanding of their place in the treatment algorithm for inflammatory bowel disease has become imperative as we move into an era of regenerative medicine.
There have now been over a dozen clinical trials highlighting stem cells as a useful therapeutic in Crohn’s disease. Due to the success in the local treatment for perianal Crohn’s disease, investigation is continuing in the space of targeted systemic delivery for the treatment of luminal disease.
As we increase the number of patients treated in clinical trials, it is imperative to define the optimal cell donor, optimize treatment dosing and retreatment protocols, and understand methods for safely targeting and treating intraluminal disease.
KeywordsMesenchymal stem cells Stem cells Luminal Crohn’s disease Perianal Crohn’s disease Regenerative medicine
Compliance with Ethical Standards
Conflict of Interest
Amy Lightner reports working as a consultant for Takeda.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 36.de la Portilla F, Alba F, Garcia-Olmo D, Herrerias JM, Gonzalez FX, Galindo A. Expanded allogeneic adipose-derived stem cells (eASCs) for the treatment of complex perianal fistula in Crohn’s disease: results from a multicenter phase I/IIa clinical trial. Int J Color Dis. 2013;28(3):313–23.CrossRefGoogle Scholar
- 37.• Panes J, Garcia-Olmo D, Van Assche G, et al. Expanded allogeneic adipose-derived mesenchymal stem cells (Cx601) for complex perianal fistulas in Crohn’s disease: a phase 3 randomised, double-blind controlled trial. Lancet. 2016;388(10051):1281–90 First phase III trial utilizing MSCs for the treament of perianal Crohn’s disease which showed that the treatment arm had improved healing compared to the control. CrossRefGoogle Scholar
- 44.Hare JM, Fishman JE, Gerstenblith G, DiFede Velazquez DL, Zambrano JP, Suncion VY, et al. Comparison of allogeneic vs autologous bone marrow-derived mesenchymal stem cells delivered by transendocardial injection in patients with ischemic cardiomyopathy: the POSEIDON randomized trial. JAMA. 2012;308(22):2369–79.CrossRefGoogle Scholar
- 50.•• Panes J, Garcia-Olmo D, Van Assche G, et al. Long-term efficacy and safety of stem cell therapy (cx601) for complex perianal fistulas in patients with Crohn’s disease. Gastroenterology. 2018;154(5):1334–1342 e1334 Reported one year outcomes of the first phase III trials utilizing MSCs for the treatment of perinal Crohn’s disease, demonstrating the lasting effects of using cellular therapy. CrossRefGoogle Scholar
- 53.•• Forbes GM, Sturm MJ, Leong RW, et al. A phase 2 study of allogeneic mesenchymal stromal cells for luminal Crohn’s disease refractory to biologic therapy. Clin Gastroenterol Hepatol. 2014;12(1):64–71 A phase II study which shows systemic delivery of MSCs may prove effective for the treatment of medically refractory Crohn’s luminal disease. THere were no adverse events related to the MSCs themselves. CrossRefGoogle Scholar