Use of Mesenchymal Stem Cells (MSC) in Chronic Inflammatory Fistulizing and Fibrotic Diseases: a Comprehensive Review (original) (raw)
2013, Clinical Reviews in Allergy & Immunology
Mesenchymal stem cells (MSC), multipotent adult stem cells, feature the potential to regenerate tissue damage and, in parallel, inhibit inflammation and fibrosis. MSC can be safely transplanted in autologous and allogeneic ways as they are non-immunogenic, and consequently represent a therapeutic option for refractory connective tissue diseases, fibrosing diseases like scleroderma and fistulizing colitis like in Crohn's disease. Actually, there are more than 200 registered clinical trial sites for evaluating MSC therapy, and 22 are on autoimmune diseases. In irradiationinduced colitis, MSC accelerate functional recovery of the intestine and dampen the systemic inflammatory response. In order to provide rescue therapy for accidentally overirradiated prostate cancer patients who underwent radiotherapy, allogeneic bone marrow-derived MSC from family donors were intravenously infused to three patients with refractory and fistulizing colitis resembling fistulizing Crohn's disease. Systemic MSC therapy of refractory irradiation-induced colitis was safe and effective on pain, diarrhoea, hemorrhage, inflammation and fistulization accompanied by modulation of the lymphocyte subsets towards an increase of T regulatory cells and a decrease of activated effector T cells. The current data indicate that MSC represent a promising alternative strategy in the treatment of various immune-mediated diseases. Encouraging results have already been obtained from clinical trials in Crohn's disease and SLE as well as from case series in systemic sclerosis. MSC represent a safe therapeutic measure for patients who suffer from chronic and fistulizing colitis. These findings are instructional for the management of refractory inflammatory bowel diseases that are characterized by similar clinical and immunopathological features.
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Citation: Emanuele Sinagra (2013) Mesenchimal Stem Cells in Inflammatory Bowel Diseases: Clinical Evi-dences And Potential Insights for The Clinicians 1:301 Abstract Mesenchymal stem cells (MSCs) have been used experimentally and clinically in the treatment of a wide variety of pathologies. MSCs can be safely transplanted in autologous and allogeneic ways as they are non-immunogen-ic, and consequently represent a therapeutic option for refractory connective tissue diseases, fibrosing diseases like scleroderma and fistulizing colitis like in Crohn's disease (CD). The immunomodulatory properties of MSCs have already shown promise when used as therapy for otherwise medically refractory CD. Accumulating evidence suggests that these properties may also be exploited in the treatment of several other conditions. The currently available experimental and clinical data indicate that, similar to previously obtained data in the setting of HSCT, MSC treatment for IBD is feasible and safe. Aim of this review is to analyze the pathophysiologi-cal insights for the use of MSCs in inflammatory bowel diseases, and to summarize the clinical evidences about the efficacy and safety of stem cell therapy in such disorders.
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