scholarly journals Current Overview on the Use of Mesenchymal Stem Cells for Perianal Fistula Treatment in Patients with Crohn’s Disease

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1133
Author(s):  
Marcin Włodarczyk ◽  
Katarzyna Czerwińska ◽  
Jakub Włodarczyk ◽  
Jakub Fichna ◽  
Adam Dziki ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Treatment Options ◽  
Perianal Fistula ◽  
Current Treatment ◽  
Culture Conditions ◽  
Optimal Dosage ◽  
Number Of Patients

Perianal fistula in patients with Crohn’s disease is an extremely challenging condition. The disease tends to reoccur, and with current treatment options, a large number of patients are left with active ailment and experience major morbidity. In recent years, hopeful results regarding local use of mesenchymal stem cells (MSCs) in perianal Crohn’s disease have been published. Although to this day there are no clear guidelines determining optimal dosage, injections frequency and culture conditions, their efficiency has proven to be much higher than conventionally used methods. According to studies, they can effectively induce as well as maintain fistula closure. This approach also avoids common side effects related to conventional surgical treatment.

Stem Cell Therapy For The Treatment Of Crohn's Disease; Current Obstacles And Future Hopes. (Mini-Review)

2021 ◽  
Vol 16 ◽  
Author(s):  
Sarah El-Nakeep
Keyword(s):  
Stem Cells ◽  
Clinical Trials ◽  
Mesenchymal Stem Cells ◽  
Stem Cell ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Cell Therapy ◽  
Stem Cell Therapy ◽  
Perianal Fistula ◽  
The United States

Background: Crohn's disease (CD) is an autoimmune disease of the gastrointestinal tract, characterized by relapsing and remitting courses. The disease is debilitating in nature with three prominent phenotypic clinical presentations; fistulizing, stenosing, and inflammatory. Stem cells offer a new hope for CD patients with modifying the immune response and progression of the healing process. Aim: This mini-review discusses the role of stem cells in treating CD, their effectiveness as a new therapy and their current limitations faced. Methods: The author conducted a literature review on recent randomized controlled trials and cohort studies concerned with the topic in question using the following keywords (Crohn's Disease, perianal fistula, Stem cell therapy, mesenchymal stem cells, remission). Results: Clinical trials show that the stem cells are more effective in the CD associated complex perianal fistula than the CD enteritis. Till the time being, there are no standardized guidelines regarding; dose of stem cells used, number of doses administered, route of administration, type of stem cells used. Only one group of researchers proposed a standardized procedure for injecting mesenchymal stem cells in complex perianal fistula, according to their own experience in clinical trials. Moreover, mesenchymal stem cells and their related types (placental, adipose tissue, umbilical tissue, etc.) are the most safe and effective in clinical trials. Currently; the commercially available mesenchymal stem cells preparation (Darvadstrocel (Cx601)) is the only one approved by The United States Food and Drug Administration (FDA) for clinical use in refractory CD associated complex perianal fistula. Conclusions: Stem cell therapy (SCT) shows promise in; inducing remission in refractory Crohn's colitis, and perianal fistula, but further research is required before SCT could be applied to clinical practice guidelines

scholarly journals DOP059 Combined anticytokine and local mesenchymal stem cells therapy promotes longer healing of simple fistulas in patients with Crohn’s disease

2018 ◽  
Vol 12 (supplement_1) ◽  
pp. S071-S072
Author(s):  
N Belyakov ◽  
O Knyazev ◽  
N Fadeeva ◽  
N Orlova ◽  
A Konoplyannikov ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Stem Cells Therapy

scholarly journals Adipose-Derived Stem Cells in Crohn's Rectovaginal Fistula

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
D. García-Olmo ◽  
D. Herreros ◽  
P. De-La-Quintana ◽  
H. Guadalajara ◽  
J. Trébol ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Stem Cells ◽  
Clinical Trials ◽  
Mesenchymal Stem Cells ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Adipose Derived Stem Cells ◽  
Vaginal Fistula ◽  
History Of ◽  
First Time

Therapeutic options for recto-vaginal fistula in the setting of Crohn's disease are limited and many data are available in the literature. The manuscript describes the history of a patient who has been the pioneer of our Clinical Trials in treating this disease in fistulizing Crohn's disease environment. We believe it is the first time that a patient with this disease has been treated by adipose-derived stem cells in allogeneic form. The conclusion of our study with Mary is that the use of mesenchymal stem cells derived from adipose tissue is secure, either in autologous or allogeneic form. Furthermore, we have proved that if we use multi-dose and multiple applications on a patient, it does not produce any adverse effect, which confirms us the safety of using these cells in patients at least in the fistulizing Crohn's disease environment.

Safety of Allogeneic Adipose Tissue-Derived Mesenchymal Stem Cells for the Treatment of Complex Perianal Fistulas Not Associated With Crohn’s Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Víctor Manuel Maciel Gutiérrez ◽  
Sergio Giovanni Gutiérrez Guillen ◽  
Manuel Willebaldo Centeno Flores ◽  
Jesús Alonso Valenzuela Pérez ◽  
Francisco Manuel Abarca Rendón ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Adipose Tissue ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Perianal Fistulas

scholarly journals P345 Lack of anti-TNF drugs levels in fistula tissue: A reason for non-response in Crohn’s perianal fistula?

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S330-S331
Author(s):  
S Adegbola ◽  
M Sarafian ◽  
K Sahnan ◽  
A Pechlivanis ◽  
R Phillips ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Limit Of Detection ◽  
Significant Proportion ◽  
Perianal Fistula ◽  
Serum Levels ◽  
Positive Control ◽  
Response To Therapy ◽  
Perianal Fistulas ◽  
Number Of Patients

Abstract Background Anti-TNF therapy is recommended as a treatment for patients with Crohn ́s perianal fistulas. However, a significant proportion of patients have a sub-optimal response to anti-TNF therapy. Higher serum levels of anti-TNF agents have been associated with improved outcomes in perianal Crohn’s disease. Currently, it is unknown whether anti-TNF agent levels can be detected in tissue from fistula tracts themselves and whether this is associated with response. Methods We undertook a pilot study to develop a method to measure fistula tissue levels of anti-TNF medication (infliximab and adalimumab) using a targeted proteomic technique that employs ‘signature peptide detection’ following trypsin digestion called ultraperformance liquid chromatography–mass spectrometry (UPLC-MS), to quantify a protein. The targeted UPLC- MS/MS detection and quantification method implemented were previously validated. Biopsies were obtained from patients with Crohn’s disease who underwent an examination under anaesthesia for worsening fistula symptoms despite maintenance anti-TNF therapy. Idiopathic (cryptoglandular) tissues from purposively sampled matched (age/gender) patients were analysed as negative controls and these samples were spiked with anti-TNF drugs as positive controls. Results Tissue was sampled from the fistula tracts of seven patients with Crohn’s perianal disease (5 patients were on adalimumab and 2 patients were on infliximab). The limit of detection (LOD) and linearity range of the method was assessed for each drug in the spiked idiopathic fistula samples. Infliximab and adalimumab had a LOD of 0.004 and 2 μg/ml respectively with linearity demonstrated for both drugs. The anti-TNF drugs, infliximab and adalimumab, were not detected in fistula samples from any of the Crohn’s patients despite detection in ‘spiked’ positive control samples. In addition, to validate the result, samples were concentrated (x10) and still there was no detection of the drugs in the test samples. Conclusion The anti-TNF drugs adalimumab and infliximab were not detected in fistula biopsy samples from patients with Crohn ́s perianal fistulas with refractory symptoms despite maintenance therapy. This raises the question on the role of tissue penetrance of anti-TNF drugs in response to therapy. Further work is required in a larger number of patients to validate the findings observed and investigate whether any correlation exists between tissue and serum levels of anti-TNF and clinical outcome.

scholarly journals Practical Medical Management of Crohn’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Bulent Baran ◽  
Cetin Karaca
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Inflammatory Disease ◽  
Clinical Judgment ◽  
Medical Management ◽  
Management Strategy ◽  
Treatment Options ◽  
Chronic Inflammatory Disease ◽  
Current Treatment ◽  
Proper Diagnosis

Crohn’s disease is a chronic inflammatory disease of diagnostic and therapeutic challenges. After proper diagnosis, treatment decisions must be made on precise clinical judgment. During the course of the disease there are variable clinical features, so each case must be managed individually. Physicians who care for patients with Crohn’s disease should be prepared for treatment options in different states of the disease and possible complications of both the disease and medications. This paper will focus on the management of Crohn’s disease. We aim to discuss current treatment options in different presentations of the disease and to provide algorithmic management strategy.

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