Stem cell therapies for inflammatory bowel disease - efficacy and safety

Orlando Garcia-Bosch (1) , Elena Ricart (1) , Julian Panes (2)

1 Gastroenterology
2 Gastroenterology Dept.

Background: Drugs available for the treatment of inflammatory bowel disease fail to induce and maintain remission in a significant number of patients. Aim: To assess the value of stem cell therapies for treatment of inflammatory bowel disease based on published studies. Methods: Publications were identified through a MEDLINE search using the Medical Subject Heading terms: inflammatory bowel diseases, or Corhn disease, or ulcerative colitis, and stem cell, or stromal cell or transplant. Results: Hematopoietic stem cell therapy as a primary treatment for inflammatory bowel disease was originally supported by animal experiments, and by remissions in patients undergoing transplant for hematological disorders. Later, transplantation specifically performed for patients with refractory Crohn's disease showed long lasting clinical remission and healing of inflammatory intestinal lesions. Use of autologous non-myeloablative regimens, and concentration of the procedures in centers with large experience, are key in reducing treatment-related mortality. Initial trials of mesenchymal stem cell therapy with local injection in Crohn's perianal fistulas had positive results. Conclusions: Autologous hematopoietic stem cell transplant changes the natural course of Crohn's disease, and may be a therapeutic option in patients with refractory disease if surgery is not feasible due to disease location or extension.

Mots clés: Medicine

Orlando Garcia-Bosch, Elena Ricart, Julian Panes. Stem cell therapies for inflammatory bowel disease - efficacy and safety. Alimentary Pharmacology and Therapeutics, 2010, 32 (8), pp.939. ⟨10.1111/j.1365-2036.2010.04439.x⟩. ⟨hal-00599489⟩