Long-Term Follow-Up of Crohn Disease Fistulas After Local Injections of Bone Marrow–Derived Mesenchymal Stem Cells

Ciccocioppo, Rachele; Gallia, A.; Sgarella, Adele; Kružliak, Peter; Gobbi, Paolo G.; Corazza, Gino Roberto

doi:10.1016/j.mayocp.2015.03.023

Cited by 94 publications

(50 citation statements)

References 52 publications

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“…In 2015 Ciccocioppo et al reported the outcomes of 10 patients prospectively recorded over a period of 7 years. The probability of fistula relapse-free survival was 88% at 1 year, 50% at 2 years, and 37% with no adverse effects; supporting the effectiveness and long-term safety of this procedure [57]. More recently, a randomized phase III controlled trial has shown good effectiveness in patients who have failed conventional or biologic treatments [58].…”

Section: Treatment Of Cpcdmentioning

confidence: 97%

Management of complex perianal Crohn’s disease

Aguilera

Ferre‐Aracil

Paredes

et al. 2016

aog

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Patients with Crohn’s disease often develop perianal disease, successfully managed in most cases. However, its most aggressive form, complex perianal disease, is associated with high morbidity and a significant impairment in patients’ quality of life. The aim of this review is to provide an updated approach to this condition, reviewing aspects of its epidemiology, diagnosis and therapeutic alternatives. Emerging treatment options are also discussed. A multidisciplinary assessment of these patients with a coordinated medical and surgical approach is crucial.

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Section: Treatment Of Cpcdmentioning

confidence: 97%

Management of complex perianal Crohn’s disease

Aguilera

Ferre‐Aracil

Paredes

et al. 2016

aog

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“…Clinical trials involving patients with perianal fistulising CD have been conducted using bone marrow-derived MSC [15][16][17] and adipose-derived stem cells (ASC) [18][19][20][21][22][23] . Whether making a distinction between stem cells originating from these 2 tissue sites is semantic, or alternatively, clinically relevant, is unclear.…”

Section: Perianal Fistulising CDmentioning

confidence: 99%

“…At 1 year follow-up, complete fistula closure was seen in 7 of the 10 patients. Eight patients were then followed for 5 years, and only one was free of biological therapy or subsequent surgery [16] .…”

Section: Perianal Fistulising CDmentioning

confidence: 99%

Mesenchymal Stromal Cell Therapy in Crohn's Disease

Forbes

2017

Dig Dis

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Background: Mesenchymal stromal cells (MSC) are multipotent adult stem cells with immunomodulatory properties. They uniquely express HLA class I antigen at a low level, and do not express HLA class II. Hence, for allogeneic administration, donor to recipient matching is not required; yet a prolonged chimeric state does not occur. Contrary to haematopoietic stem cell transplantation, cytotoxic drug therapy is not required to harvest, or administer, cells. Key Messages: MSC are obtained from marrow, adipose tissue or placenta. In our centre, MSC are isolated from a 10 ml donor marrow aspirate, by virtue of their adherence to plastic. They are expanded in culture, cryopreserved, and subjected to strict quality controls before release for intravenous administration. These activities occur in a dedicated, nationally accredited, laboratory. Initial observations of allogeneic MSC efficacy were in graft-versus-host disease. Both autologous and allogeneic MSC have since been evaluated in biologic refractory luminal and fistulising Crohn's disease (CD). Data from early-phase studies have suggested efficacy for luminal disease when allogeneic MSC were given intravenously and also suggested efficacy for fistulising disease when either allogeneic or autologous MSC were administered into fistulas. MSC treatment is not reported to have caused serious adverse events. Although in vitro criteria for defining MSC exist, a major challenge lies in how to define MSC for clinical use. MSC function in vivo is likely to be dependent upon donor immunological characteristics, and widely varying manufacturing processes between laboratories. MSC dose, frequency of administration, stage of disease, and presence of concomitant immunosuppression also require to be defined. Conclusions: MSC therapy may have future utility in CD, but considerable work is first required to determine appropriate phenotypic and functional characteristics of administered cells.

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“…Furthermore, preclinical and clinical studies have focused on MSC-based therapy in Crohn disease, a major inflammatory bowel disease characterized by pathological immune responses to different antigens (Forte et al, 2015). Clinical studies demonstrated that, when administered locally by injection, MSCs represent a harmless therapy that can sustain the therapeutic response in patients with Crohn disease (Ciccocioppo et al, 2015).…”

Section: Adult Stem Cellsmentioning

confidence: 99%

Current status of stem cell therapy: opportunities and limitations

Rusu¹,

Necula²,

Neagu³

et al. 2016

Turk J Biol

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Over recent years stem cells have stood out as a promising tool for regenerative medicine, providing alternative therapeutic solutions for a large number of diseases. Many clinical trials using stem cells or induced pluripotent stem cells are focused on the repair and regeneration of various tissues and organs in degenerative diseases, whose current treatment only succeeds in slowing down the progression of the disease. Although the preliminary results are interesting, further studies are required in order to evaluate the safety and benefits of stem cell therapy, considering the teratoma development and ethical considerations in embryonic stem cell cases or reprogramming-induced somatic mutations and epigenetic defects. This review summarizes several current clinical and nonclinical data on the use of embryonic stem cells, mesenchymal stem cells, and induced pluripotent stem cells in various diseases.

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Long-Term Follow-Up of Crohn Disease Fistulas After Local Injections of Bone Marrow–Derived Mesenchymal Stem Cells

Cited by 94 publications

References 52 publications

Management of complex perianal Crohn’s disease

Management of complex perianal Crohn’s disease

Mesenchymal Stromal Cell Therapy in Crohn's Disease

Current status of stem cell therapy: opportunities and limitations

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