Labidi Asma, Serghini Meriem, Ben Mustapha Nadia, Fekih Monia, Boubaker Jalel, Filali Azza
Tunis Med. 2014 Nov;92(11):655-9.
Crohn's disease is a chronic relapsing- remitting affection. It has a strong immunologic component which represent the target of standard therapies including immunosppressants and biological therapies. However, many patients remain refracory or intolerant to these therapies.
The aim of this review is to determine the effects of stem cell transplantation in patients with refractory Crohn's disease.
Systematic review of observational studies, clinical trials and case reports that focused on the effectiveness and safety of stem cell transplantation in patients with refractory Crohn's disease.
Hematopoietic stem cell transplantation seems to be efficient in maintaining clinical and endoscopic remission in patients with Crohn's disease refractory or intolerant to current therapies. However, it has been associated to high morbidity and mortality due to chemotherapy. Mesenchymal stem cell transplantation could induce remission in patients with fistulising refractory Crohns disease with no severe side effects. Its impact on luminal Crohns disease is still controversial.
Stem cell transplantation seems to hold promising in patients with refractory Crohn's disease. However, because of the high morbidity and mortality related to chemotherapy, hematopoietic stem cell transplantation should be used as last resort to control this disease. Effectiveness of mesenchymal stem cell transplantation in luminal Crohn's disease has yet to be proven.
克罗恩病是一种慢性复发-缓解性疾病。它具有很强的免疫成分，这是包括免疫抑制剂和生物疗法在内的标准疗法的靶点。然而，许多患者对这些疗法仍然难治或不耐受。
本综述的目的是确定干细胞移植对难治性克罗恩病患者的影响。
系统回顾观察性研究、临床试验和病例报告，这些研究聚焦于干细胞移植对难治性克罗恩病患者的有效性和安全性。
造血干细胞移植似乎能有效维持对当前疗法难治或不耐受的克罗恩病患者的临床和内镜缓解。然而，由于化疗，它与高发病率和死亡率相关。间充质干细胞移植可诱导瘘管性难治性克罗恩病患者缓解，且无严重副作用。其对肠腔型克罗恩病的影响仍存在争议。
干细胞移植似乎为难治性克罗恩病患者带来了希望。然而，由于与化疗相关的高发病率和死亡率，造血干细胞移植应作为控制该病的最后手段。间充质干细胞移植对肠腔型克罗恩病的有效性尚未得到证实。
