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Published on: October 1, 2012
Mesenchymal stromal cells of bone marrow and azathioprine in Crohn's disease therapy
O V Knyazev1, A V Kagramanova1, N A Fadeeva1
1S.A. Loginov Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia.
Aim:
To evaluate the effectiveness of MSCs therapy in patients with CD receiving azathioprine (AZA).
Materials And Methods:
The study included 34 patients with inflammatory (luminal) form of CD. The 1st group of patients (n=15) received an- ti-inflammatory therapy using MSCs culture in combination with AZA. The 2nd group (n=19) received MSCs without AZA. The severity of the attack was assessed in points in accordance with the of Crohn's disease activity index (CDAI). Immunoglobulins (IgA, IgG, IgM), interleukins (IL) 1β, 4, 10, tumor necrosis factor-α (TNF-α), interferon-γ (INF-γ), transforming growth factor-1β (TGF-1β), C-reactive protein (CRP), platelets and erythrocyte sedimentation rate (ESR) at 2, 6 and 12 months from the beginning of MSCs therapy.
Results:
The initial mean CDAI in the 1st group was 337.6±17.1 points, in the 2nd group - 332.7±11.0 points (p=0.3). In both groups of pa- tients there was a significant decrease in CDAI after 2 months. From the beginning of therapy MSCs: in the 1st group to 118.9±12.4 points, in the 2nd - 120.3±14.1 points (p=0.7), after 6 months - 110.3±11.1 and 114.3±11.8 points (p=0.8), respectively. After 12 months CDAI in the 1st group was 99.9±10.8 points, in the 2nd group it was 100.6±12.1 points (p=0.8). The level of IgA, IgG, IgM was significantly lower in the group of patients with a longer history of the disease and long-term ASA. After the introduction of MSC in both groups of patients with BC, there was a tendency for the growth of pro- and anti-inflammatory cytokines, with a significantly lower level of pro-inflammatory cytokines - INF-γ, TNF-α, IL-1β - in the 1st group, indicating potentiation of the immunosuppressive effect of MSCs and AZA, which provides a more pro- nounced anti-inflammatory effect.
Conclusion:
Transplantation of MSCs promotes an increase in the serum of patients with CD initially reduced concentration of IG, cytokines and restoring their balance as the onset of clinical remission. The combination with AZA has a more pronounced anti-inflammatory effect.
Insights
Mesenchymal stem cell (MSC) therapy effectively treats Crohn's disease (CD). Combining MSCs with azathioprine (AZA) enhances the anti-inflammatory effect, improving patient outcomes in CD management.
Area of Science:
- Immunology
- Gastroenterology
- Regenerative Medicine
Background:
- Crohn's disease (CD) is a chronic inflammatory condition requiring effective therapeutic strategies.
- Mesenchymal stem cells (MSCs) show potential for treating inflammatory diseases.
- Azathioprine (AZA) is a common immunosuppressive drug used in CD management.
Purpose of the Study:
- To assess the efficacy of MSCs therapy in patients with CD.
- To compare the effects of MSCs therapy alone versus in combination with AZA.
- To evaluate the impact on disease activity and inflammatory markers.
Main Methods:
- A study involving 34 patients with luminal CD.
- Group 1: MSCs therapy combined with AZA.
- Group 2: MSCs therapy alone.
- Assessment of Crohn's Disease Activity Index (CDAI), immunoglobulins, and cytokines at baseline and 2, 6, 12 months.
Main Results:
- Both groups showed significant CDAI reduction within 2 months.
- CDAI decreased to approximately 100 points in both groups after 12 months.
- The combination of MSCs and AZA demonstrated a more pronounced reduction in pro-inflammatory cytokines (INF-γ, TNF-α, IL-1β).
Conclusions:
- MSC transplantation helps restore immunoglobulin and cytokine balance in CD patients, leading to clinical remission.
- Combining MSCs therapy with AZA offers a more potent anti-inflammatory effect.
- MSC therapy represents a promising approach for managing Crohn's disease.
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