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Stem Cell Therapy for Perianal Crohn's Disease
O V Knyazev1, N A Fadeeva1, A V Kagramanova1
1Moscow Clinical Research Center, Moscow, Russia.
Terapevticheskii Arkhiv
|February 1, 2019
Summary
Combination therapy with bone marrow mesenchymal stromal cells (MSC) and infliximab (IFX) shows superior healing rates for perianal fistulas in Crohn's disease compared to standard antibiotic/immunosuppressive treatments.
Area of Science:
- Gastroenterology and Hepatology
- Regenerative Medicine
- Immunology
Background:
- Perianal fistulas are a common and debilitating complication of Crohn's disease (CD).
- Current treatments, including antibiotics and immunosuppressors, often have limited efficacy and high recurrence rates.
- Novel therapeutic strategies are needed to improve fistula healing and reduce disease burden.
Purpose of the Study:
- To compare the effectiveness of combination therapy (local and systemic bone marrow mesenchymal stromal cells - MSCs) with infliximab (IFX) and antibiotic/immunosuppressive (AB/IS) therapy.
- To evaluate the impact of these therapies on the frequency and duration of simple perianal fistula healing in CD patients.
- To assess the recurrence rates associated with each treatment modality.
Main Methods:
- A comparative study involving three groups of CD patients with simple perianal fistulas.
- Group 1: Received systemic and local MSCs therapy.
- Group 2: Received anti-cytokine therapy with infliximab (IFX).
- Group 3: Received antibiotics (AB) and immunosuppressors (IS).
- Efficacy was measured using the Perianal Crohn's Disease Activity Index (PCDAI) and fistula healing rates over 24 months.
Main Results:
- After 12 weeks, fistula healing was observed in 66.6% of patients receiving MSCs, 60.0% receiving IFX, and 7.14% receiving AB/IS.
- At 24 months, fistula closure was maintained in 41.6% of the MSCs group and 40.0% of the IFX group, versus 0.0% in the AB/IS group.
- The MSCs and IFX groups demonstrated significantly higher and more sustained fistula healing rates compared to the AB/IS group.
Conclusions:
- Combined cellular (MSCs) and anti-cytokine (IFX) therapy significantly improves the frequency and duration of simple perianal fistula closure in Crohn's disease.
- These advanced therapies are more effective than conventional antibiotic/immunosuppressive treatments.
- Combination therapy also contributes to a reduced recurrence rate of perianal fistulas in CD patients.
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