Clinical efficacy and safety of stem cells in refractory Crohn's disease: A systematic review

Ye, Lei; Wu, Xiaowei; Yu, Na; Pan, Jing-Xin; Liao, Lianming; Wang, Fangyu

doi:10.1016/j.jocit.2016.01.001

Cited by 3 publications

(2 citation statements)

References 44 publications

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“…However, in clinical studies on humans with inflammatory gastrointestinal and immunological disorders, this medication has proved to be efficacious and safe. Most studies in human IBD use BM-MSCs, and ASCs have been increasingly employed for the local treatment of perianal fistulas that result as a complication of CD [93][94][95][96]. Table 4 summarizes published studies of intravenous MSC therapies in human IBD (CD and UC).…”

Section: Webb Andmentioning

confidence: 99%

A Comprehensive Exploration of Therapeutic Strategies in Inflammatory Bowel Diseases: Insights from Human and Animal Studies

Dias,

Franchi-Mendes

et al. 2024

Biomedicines

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Inflammatory bowel disease (IBD) is a collective term for a group of chronic inflammatory enteropathies which are characterized by intestinal inflammation and persistent or frequent gastrointestinal signs. This disease affects more than 3.5 million humans worldwide and presents some similarities between animal species, in particular, dogs and cats. Although the underlying mechanism that triggers the disease is not yet well understood, the evidence suggests a multifactorial etiology implicating genetic causes, environmental factors, microbiota imbalance, and mucosa immune defects, both in humans and in dogs and cats. Conventional immunomodulatory drug therapies, such as glucocorticoids or immunosuppressants, are related with numerous adverse effects that limit its long-term use, creating the need to develop new therapeutic strategies. Mesenchymal stromal cells (MSCs) emerge as a promising alternative that attenuates intestinal inflammation by modulating inflammatory cytokines in inflamed tissues, and also due to their pro-angiogenic, anti-apoptotic, anti-fibrotic, regenerative, anti-tumor, and anti-microbial potential. However, this therapeutic approach may have important limitations regarding the lack of studies, namely in veterinary medicine, lack of standardized protocols, and high economic cost. This review summarizes the main differences and similarities between human, canine, and feline IBD, as well as the potential treatment and future prospects of MSCs.

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Section: Webb Andmentioning

confidence: 99%

A Comprehensive Exploration of Therapeutic Strategies in Inflammatory Bowel Diseases: Insights from Human and Animal Studies

Dias,

Franchi-Mendes

et al. 2024

Biomedicines

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“…The incidence of serious adverse events caused by transplantation of MSCs is less than 1.75%. The most common possible adverse effects are pain at the injection site, fever and the formation of perianal abscesses (Lei Yea et al, 2016;Panes, 2016).…”

Section: Introductionmentioning

confidence: 99%

Stem Cell Therapy for Perianal Crohn’s Disease

Knyazev

Каграманова

et al. 2020

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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The goal of the study was to compare the effect of combination therapy (local and systemic administration) with bone marrow mesenchymal stromal cells (MSC), anticytokine therapy with infliximab (IFX), and antibiotic (AB)/immunosuppressive (IS) therapy on the frequency of healing of simple perianal fistulas in Crohn’s disease. Three patient groups were used in our study. The 1st group of patients (age 19 to 58 years, mean 29 years, n = 12) received MSCs culture systemically and locally. The 2nd group of patients with CD (age 20 to 68 years, mean age 36 years, n = 10) received anticytokine therapy with infliximab (IFX). The 3rd group of patients with CD (age 20 to 62 years, mean age 28 years, n = 14) received antibiotics (AB) and immunosuppressors (IS). Treatment effect was assessed by the index of perianal activity of Crohn’s disease (PCDAI) and the frequency of relapses. After 12 weeks, in the 1st group, healing of simple fistulas was noted in 8/12 patients (66.6%), in the 2nd group in 6/10 (60.0%) and in the 3rd group in 1/14 patients (7.1%). After six months, in the 1st group of patients healing of simple fistulas occurred in 8/12 (66.6%), in the 2nd group in 6/10 (60.0%) and in the 3rd group in 1/14 patients (7.1%). After 12 months, in the 1st group, healing of simple fistulas was observed in 7/12 (58.3%), in the 2nd group in 6/10 (60.0%) and in the 3rd group in 2/14 patients (14.3%). After 24 months, among the patients of the 1st group, fistula closure was observed in 5/12 patients (41.6%), in the 2nd group in 4/10 (40.0%) and in the 3rd group in 0/14 patients (0.0%). Combined cellular and anticytokine therapy of CD with perianal lesions significantly contributes to more frequent and prolonged closure of simple fistulas, as compared to antibiotics/immunosuppressors, and to a decrease in the frequency of recurrence of the disease.

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Efficacy and safety of stem cell therapy for fistula management: an overview of existing systematic reviews

Tripathi,

Mohan,

Alfaifi

et al. 2024

International Journal of Surgery

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Background: Fistulas, abnormal connections between two anatomical structures, significantly impact the quality of life and can result from a variety of causes, including congenital defects, inflammatory conditions, and surgical complications. Stem cell therapy has emerged as a promising alternative due to its potential for regenerative and immunomodulatory effects. This overview of systematic reviews aimed to assess the safety and efficacy of stem cell therapy in managing fistulas, drawing on the evidence available. Methods: This umbrella review was conducted following the Joanna Briggs Institute (JBI) methodology to assess the efficacy and safety of stem cell therapy for treating various types of fistulas. A comprehensive search was performed across multiple electronic databases including PubMed, Embase, Cochrane Register, and Web of Science up to May 5th, 2024. Systematic reviews focusing on stem cell therapy for fistulas were included, with data extracted on study design, stem cell types, administration methods, and outcomes. The quality of the reviews was assessed using the AMSTAR 2 tool, and meta-analyses were conducted using R software version 4.3. Results: Nineteen systematic reviews were included in our umbrella review. The stem cell therapy demonstrated by significant improvements in clinical remission rates, with a relative risk (RR) of 1.299 (95% CI: 1.192 to 1.420). Stem cell therapy enhanced fistula closure rates, both short-term (RR=1.481; 95% CI: 1.036 to 2.116) and long-term (RR=1.422; 95% CI: 1.091 to 1.854). The safety analysis revealed no significant increase in the risk of adverse events with stem cell therapy, showing a pooled RR of 0.972 (95% CI: 0.739 to 1.278) for general adverse events and 1.136 (95% CI: 0.821 to 1.572) for serious adverse events, both of which indicate a safety profile comparable to control treatments. Re-epithelialization rates also improved (RR=1.44; 95% CI: 1.322 to 1.572). Conclusion: Stem cell therapy shows promise as an effective and safe treatment for fistulas, particularly in inducing remission and promoting closure of complex fistulas. The findings advocate for further high-quality research to confirm these benefits and potentially incorporate stem cell therapy into standard clinical practice for fistula management. Future studies should focus on long-term outcomes and refining stem cell treatment protocols to optimize therapeutic efficacy.

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Clinical efficacy and safety of stem cells in refractory Crohn's disease: A systematic review

Cited by 3 publications

References 44 publications

A Comprehensive Exploration of Therapeutic Strategies in Inflammatory Bowel Diseases: Insights from Human and Animal Studies

A Comprehensive Exploration of Therapeutic Strategies in Inflammatory Bowel Diseases: Insights from Human and Animal Studies

Stem Cell Therapy for Perianal Crohn’s Disease

Efficacy and safety of stem cell therapy for fistula management: an overview of existing systematic reviews

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