Although the exact cause of inflammatory bowel disease (IBD) is unknown, it is thought to be the result of a combination of immunological disturbances, genetic alterations, and environmental factors. IBD is a chronic inflammatory disorder of the gastrointestinal tract where patients experience mucosal ulceration, rectal bleeding, diarrhea, and abdominal pain.
Treatment for IBD was once challenging due to the lack of effective medications. However, the development of biological agents has improved the prognosis for many patients. Despite the use of these agents, some patients still experience multidrug resistance and do not respond to treatment, which impedes mucosal healing and necessitates surgical intervention.
Mesenchymal stem cells (MSCs) hold great promise for the treatment of a variety of diseases and injuries due to their ability to differentiate into multiple cell types and their immunosuppressive effect. MSCs are derived from the bone marrow, umbilical cord, and adipose tissue. They retain pluripotency, transforming into adipocytes, osteoblasts, myocytes, and chondroblasts.
MSCs have also been shown to have an immunosuppressive effect, helping to reduce inflammation at the site of a wound. This is accomplished by polarizing M2 macrophages and reducing the activity of both dendritic cells and neutrophils. In addition, MSCs can modulate the proliferation and differentiation of T lymphocytes and B lymphocytes.
These properties make them ideal for treating Inflammatory diseases, such as Crohn’s disease. The medical community is investigating the use of stem cells for IBD conditions. Clinical trials are underway to test the safety and efficacy of MSCs in patients with these diseases. A study, Stem cell-based therapy for inflammatory bowel disease, looked into the current research and clinical trials for treating IBD with stem cells.
Results of the Study – Stem Cell therapy for inflammatory bowel disease
The researchers first discussed how the gut repairs itself. Tissue repair and regeneration is a complex process that is crucial to the health of the gut. It can be divided into three distinct phases: restitution, proliferation, and reconstitution. Restitution refers to the migration of IECs (intestinal epithelial cells) over the damaged and ulcerated areas. This is the very first step of regeneration and is facilitated by TGF-β, intestinal trefoil factor, and trefoil factor.
Proliferation refers to the supply of IECs to cover the wound bed. This is achieved by the proliferation of ISCs (intestinal stem cells) in crypts adjacent to the wound bed. These ISCs form channel-like structures that supply IECs to the wounded area. Reconstitution refers to the formation of new crypts in the wounded area. This is achieved by the invagination of the channel-like structures to form multiple fissions. Ultimately, tissue repair and regeneration is a vital process that ensures the health of the gut.
The researchers then discussed the current research on stem cell therapy for IBD. Crohn’s disease patients with fistulas have been the subject of many clinical studies using adipose-derived mesenchymal stem cells (ASCs). Panés et al. finished a phase III study using allogeneic ASC transplantation for Crohn’s disease patients.
212 patients were randomly assigned to either the stem cell therapy or placebo group (107 patients vs. 105 patients). 50% of the stem cell therapy group achieved remission, compared with 34% of the placebo group 24 weeks after receiving the treatment. After 52 weeks, the researchers found that stem cells achieved remission for 59.2% of patients, while only 41.6% of patients treated with a placebo achieved remission. This study suggests that ASCs may be a promising new treatment option for Crohn’s disease patients with fistulas.
Several clinical trials and studies have shown that stem cell-based therapy is safe and efficacious in IBD patients. There is still more work to be done to optimize this approach, but stem cell-based therapy shows great promise as a potential new treatment for IBD.
More clinical trials are currently underway to assess the safety and efficacy of this new treatment modality in humans. If these trials are successful, stem cell-based therapy could become a valuable addition to the current IBD treatment paradigm.
