Sanz-Baro Raquel, García-Arranz Mariano, Guadalajara Hector, de la Quintana Paloma, Herreros Maria Dolores, García-Olmo Damián
Department of Obstetrics and Gynecology, Cell Therapy Laboratory, Health Research Institute, and Department of Surgery, IIS-FJD Fundación Jiménez Díaz University Hospital, Madrid, Spain; Surgery Department, Autónoma University of Madrid, Madrid, Spain; Department of Colorectal Surgery, La Paz University Hospital, Madrid, Spain
Department of Obstetrics and Gynecology, Cell Therapy Laboratory, Health Research Institute, and Department of Surgery, IIS-FJD Fundación Jiménez Díaz University Hospital, Madrid, Spain; Surgery Department, Autónoma University of Madrid, Madrid, Spain; Department of Colorectal Surgery, La Paz University Hospital, Madrid, Spain.
Stem Cells Transl Med. 2015 Jun;4(6):598-602. doi: 10.5966/sctm.2014-0255. Epub 2015 Apr 29.
The aim of this study was to determine whether treatment with adipose-derived stem cells (ASCs) had any influence on fertility, course of pregnancy, newborn weight, or physical condition of newborns. We performed a retrospective study of patients with a desire to become pregnant after having received intralesional injection of autologous ASCs for the treatment of perianal or rectovaginal fistula associated with Crohn's disease. We collected data on the resulting pregnancies, deliveries, and newborns of these patients. ASCs were expanded in vitro and characterized according to the international guidelines for cell surface markers (clusters of differentiation) and differentiated to adipocytes, chondrocytes, and osteocytes prior to implantation (except first implant in 2002). We analyzed five young women with Crohn's disease treated with ASCs: one for rectovaginal and perianal fistula, two for rectovaginal fistula only, and two for perianal fistula only. All patients received 2 doses of 20 million and 40 million cells at an interval of 3-4 months. Another patient received 2 doses of 6.6 million and 20 million ASCs with 9 months between each dose. Fertility and pregnancy outcomes were not affected by cell therapy treatment. No signs of treatment-related malformations were observed in the neonates by their respective pediatricians. In the patients studied, cell therapy with ASCs did not affect the course of pregnancy or newborn development.
Local treatment with mesenchymal stem cells derived from adipose tissue seems not to affect the ability to conceive, the course of pregnancy, pregnancy outcomes, or newborns' health in female patients. This is the first publication about pregnancy outcome in women with perianal fistula and Crohn's disease treated with stem cell therapy, and could be of interest for doctors working in cell therapy. This is a very important question for patients, and there was no answer for them until now.
本研究的目的是确定脂肪来源干细胞（ASC）治疗是否对生育能力、妊娠过程、新生儿体重或新生儿身体状况有任何影响。我们对因克罗恩病相关的肛周或直肠阴道瘘接受病灶内注射自体ASC治疗后希望怀孕的患者进行了一项回顾性研究。我们收集了这些患者的妊娠、分娩及新生儿的数据。ASC在体外扩增，并根据细胞表面标志物（分化簇）的国际指南进行表征，在植入前（2002年首次植入除外）分化为脂肪细胞、软骨细胞和骨细胞。我们分析了5例接受ASC治疗的克罗恩病年轻女性：1例为直肠阴道和肛周瘘，2例仅为直肠阴道瘘，2例仅为肛周瘘。所有患者均间隔3 - 4个月接受2剂，分别为2000万和4000万个细胞。另1例患者接受2剂，分别为660万和2000万个ASC，每剂间隔9个月。细胞治疗未影响生育能力和妊娠结局。各自的儿科医生在新生儿中未观察到与治疗相关的畸形迹象。在所研究的患者中，ASC细胞治疗未影响妊娠过程或新生儿发育。
脂肪组织来源的间充质干细胞局部治疗似乎不影响女性患者的受孕能力、妊娠过程、妊娠结局或新生儿健康。这是关于干细胞治疗肛周瘘和克罗恩病女性患者妊娠结局的首次发表，可能会引起从事细胞治疗工作的医生的兴趣。这对患者来说是一个非常重要的问题，而在此之前他们一直没有答案。
