Use of Mesenchymal Stem Cells in Crohn's Disease and Perianal Fistulas: A Narrative Review

Abstract

: Crohn's disease (CD) which usually leads to anal fistulas among patients is the most important inflammatory bowel disease that causes morbidity in many people around the world. This review article proposes using MSCs as a hopeful therapeutic strategy for CD and anal fistula treatment in both preclinical and clinical conditions. Finally, Darvadstrocel - a cell based medication to treat complex anal fistulas in adults- as the only European Medicines Agency (EMA)-approved product for the treatment of anal fistulas in CD is addressed. Although several common therapies such as surgery and anti-tumor necrosis factor-alpha (TNF-α) drugs as well as a combination of these methods is used to improve this disease, however, due to the low effectiveness of these treatments, the use of new strategies with higher efficiency is still recommended. Cell therapy is among the new emerging therapeutic strategies that have attracted great attention from clinicians due to its unique capabilities. One of the most widely used cell sources administrated in cell therapy is mesenchymal stem cell (MSC). This review article will discuss preclinical and clinical studies about MSCs as a potent and promising therapeutic option in the treatment of CD and anal fistula.

Regulation of Extracellular Vesicle-Mediated Immune Responses against Antigen-Specific Presentation

“…To date, clinical trials have been conducted using MSCs as novel therapeutic agents to treat various diseases, including acute diseases, such as ischaemic stroke and myocardial infarction. MSCs are also intended anti-inflammatory therapy for diseases caused by uncontrolled inflammatory reactions, such as acute graft-versus-host disease (GvHD) and Crohn’s disease [ 329 , 330 , 331 , 332 ].…”

hUC-MSCs therapy for Crohn’s disease: efficacy in TNBS-induced colitis in rats and pilot clinical study

“…Some studies on local injection of MSCs for treatment of anal fistula in CD have shown it is safe and effective, and a phase 3 clinical trial is under way. 10 , 11 , 12 Sophie Vieujean et also used local injection to treat CD patients with stenosis 13 and showed allogenic bone-marrow derived MSCs tropic injection in CD stricture was well tolerated and may offer a benefit. However, whether MSCs can alleviate or cure intestinal ulcers in CD has not been well studied.…”

Up-to-date meta-analysis of long-term evaluations of mesenchymal stem cell therapy for complex perianal fistula

“…In recent years, local injection of mesenchymal stem cells (MSCs) has shown notable promising results in the treatment of PFs[ 11 ]. MSCs are a heterogeneous subset of stromal stem cells.…”