Stem cell treatment for inflammatory bowel disease

Stem cell treatment for inflammatory bowel disease.   In recent years, inflammatory bowel disease has also become a hot spot in the field of stem cell research. A large number of basic and clinical trials have shown that stem cells are safe and effective for most patients with IBD by intravenous drip or local injection, even for refractory Crohn The sick patients can play a role in rescue treatment, which greatly improves the quality of life of the patients.

Inflammatory bowel disease is an idiopathic intestinal inflammatory disease involving the ileum, rectum, and colon. The etiology of inflammatory bowel disease is still unclear, and it has a tendency to relapse throughout life. In addition, severe patients are prolonged and have a poor prognosis.

Generally speaking, the onset is slow, a few abrupt, the severity of the disease varies, and it is easy to recur. Often manifested as abdominal pain, diarrhea, mucus pus and blood in the stool, intestinal obstruction, intestinal perforation and even cancer. Due to repeated illnesses and prolonged unhealing, the quality of daily life of patients is seriously affected.

Its pathogenesis is not yet fully clarified, and it is an extremely active area of ​​research in recent years. At present, it is believed that the disease is the result of multi-factor interaction, including infection, immunity, and environmental factors. A variety of reasons cause the destruction of the intestinal mucosal barrier, and the imbalance of immune cells and their secreted cytokines, resulting in an imbalance in the immune response to intestinal microorganisms and chronic intestinal mucosal damage.

Treatment of inflammatory bowel disease:

When IBD occurs, there is a large amount of inflammatory cell infiltration in the intestinal mucosa. The current treatment is mainly carried out by blocking the inflammatory response and regulating the immune function. Commonly used therapeutic drugs include aminosalicylic acid drugs, adrenal cortex hormones, immunosuppressants and biological agents. However, there are still some patients who are resistant or unresponsive to existing treatments, and even some patients with refractory IBD will eventually require surgery, which seriously affects their quality of life. At present, the traditional intervention methods for ulcerative colitis at home and abroad are not satisfactory. Reports have shown that even if the above combination therapies fail to achieve clinical relief of ulcerative colitis within 16 weeks, it is still as high as 60%. This has prompted people to study new treatments. At present, cell therapy is considered a new treatment strategy.

Mesenchymal stem cells treat inflammatory bowel disease

Mesenchymal stem cells (MSC) are a type of adult stem cells with self-replication and multi-differentiation potential. They have homing, tissue repair and immune regulation functions. In recent years, numerous studies have shown that MSC has unique advantages in the treatment of IBD . MSC can selectively migrate to damaged tissues and inflammation sites, promote the regeneration and angiogenesis of the damaged intestinal epithelium; regulate endoplasmic reticulum stress and improve intestinal inflammation; up-regulate the expression of tight junction proteins and reduce matrix metalloproteinases Expression to improve the barrier function of the intestinal mucosa; promote the transformation of T cells and macrophages infiltrated from inflammatory sites to anti-inflammatory phenotypes, and regulate the inflammatory response. MSC can also rebuild intestinal immune tolerance.

According to reports, in the clinical trial treatment of 31 cases of refractory IBD with allogeneic MSCs, about 60% of the patients turned to negative IBD clinical response index, and about 40% of the patients achieved clinical remission. Liang and other studies have shown that bone marrow MSC can enhance the immunosuppressive effect of traditional treatment. The results of Mayar et al. showed that in the 50 CD patients treated with placental-derived MSC combined with a stable dose of immunosuppressive agents or biological agents, 36% of the patients reached the clinical response index, and 14% achieved clinical remission.

A phase II clinical study conducted by Forbes et al. showed that 15 patients with CD who were ineffective in biologics treatment after intravenous infusion of allogeneic fat MSC, the disease activity index decreased, 12 patients achieved clinical response, and 8 patients achieved clinical remission. Seven patients achieved endoscopic improvement, and one patient had serious adverse reactions (may be unrelated to treatment). In order to study the tumorigenicity of MSCs, a 5-year follow-up study was conducted. There was no significant difference in tumor incidence between 103 IBD patients treated with MSCs and control patients.

As early as 2009, the US FDA approved the marketing of allogeneic bone marrow stem cell product prochymal for the treatment of Crohn’s disease and severe complications caused by hematopoietic stem cell transplantation-acute graft versus host disease (GVHD). In March 2018, Cx601 was approved for marketing by the European Union under the new name Alofisel for inactive/lightly active intravascular Crohn’s disease (CD) adult patients whose fistula did not respond to at least one traditional or biological therapy. Complexity Treatment of perianal fistula (CPF). This is the first allogeneic stem cell product approved by a centralized marketing authorization (MA) in the European market.

In recent years, inflammatory bowel disease has also become a hot spot in the field of stem cell research. A large number of basic and clinical trials have shown that stem cells are safe and effective for most patients with IBD by intravenous drip or local injection, even for refractory Crohn The sick patients can play a role in rescue treatment, which greatly improves the quality of life of the patients. We look forward to relevant stem cell products to rescue Crohn’s disease patients from the pain as soon as possible!

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