Stem Cell Therapy in Inflammatory Bowel Disease: A Review of Achievements and Challenges

Abstract

Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a group of chronic inflammatory diseases of the gastrointestinal tract. Repeated inflammation can lead to complications, such as intestinal fistula, obstruction, perforation, and bleeding. Unfortunately, achieving durable remission and mucosal healing (MH) with current treatments is difficult. Stem cells (SCs) have the potential to modulate immunity, suppress inflammation, and have anti-apoptotic and pro-angiogenic effects, making them an ideal therapeutic strategy to target chronic inflammation and intestinal damage in IBD. In recent years, hematopoietic stem cells (HSCs) and adult mesenchymal stem cells (MSCs) have shown efficacy in treating IBD. In addition, numerous clinical trials have evaluated the efficiency of MSCs in treating the disease. This review summarizes the current research progress on the safety and efficacy of SC-based therapy for IBD in both preclinical models and clinical trials. We discuss potential mechanisms of SC therapy, including tissue repair, paracrine effects, and the promotion of angiogenesis, immune regulation, and anti-inflammatory effects. We also summarize current SC engineering strategies aimed at enhancing the immunosuppressive and regenerative capabilities of SCs for treating intestinal diseases. Additionally, we highlight current limitations and future perspectives of SC-related therapy for IBD.

Advancements in hydrogel-based drug delivery systems for the treatment of inflammatory bowel disease: a review

“…The role of stem cells in treating intestinal diseases is emerging, 107 as they have the ability to inhibit inflammation and promote regenerative processes; this represents a new direction in the clinical management of IBD. 108 However, stem cells alone cannot survive and function well in the harsh environment of the inflamed gut.…”

Mesenchymal Stromal Cells: New Generation Treatment of Inflammatory Bowel Disease

“… 198 , 199 MSCs secrete vascular endothelial growth factor, platelet-derived growth factor, TGF-β, and angiopoietin-1 to promote the regeneration of blood vessels. 200 , 201 Intestinal epithelial tissue regeneration requires the formation of new blood vessels to provide oxygen and nutrients, 202 and it is hypothesized that the induction of angiogenesis by MSCs is another major mechanism of action of MSCs in promoting tissue regeneration.…”

Enhancement of the therapeutic efficacy of mesenchymal stem cell-derived exosomes in osteoarthritis

“…In particular, MSC-secreted EVs can show comparable biological effects out of parental cells and exhibit more stability and safety, thus researchers have exploited a lot of efforts for clinical application [ 162 , 163 ]. According to the registered projects of the clinical trials database, they are about studies on MSC-EVs, with more than 3000 subjects expected to receive MSC-EVs for a variety of diseases, including acute respiratory distress syndrome [ 164 , 165 ]. These clinical trials have given new potential for the treatment of patients in the corresponding fields, especially exosome-based therapy for OA.…”