Duran Natalie E, Hommes Daniel W
Center for Inflammatory Bowel Diseases, Melvin and Bren Simon Digestive Diseases Center, David Geffen School of Medicine, University of California at Los Angeles, 10945 Le Conte Avenue #2338D, Los Angeles, CA 90095, USA.
Department of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
Therap Adv Gastroenterol. 2016 Jul;9(4):533-47. doi: 10.1177/1756283X16642190. Epub 2016 Apr 25.
Inflammatory bowel disease (IBD) is a chronic, often relapsing, condition that deeply impacts the quality of life for many patients. Although there have been significant advances in medical treatments, a large proportion of patients become refractory to available therapeutic options. Stem-cell therapy through hematopoietic stem cells (HSCs) or mesenchymal stem (stromal) cells (MSCs) is a promising therapeutic option for severe refractory cases especially when surgery is not feasible. In HSC transplantation, the objective is to destroy the 'autoreactive' immune cells responsible for disease chronicity, and to re-establish gut tolerance to gut microbes. In perianal Crohn's disease (CD), the objective is to deposit MSCs locally in fistulizing tracts to down-regulate the local immune response and induce wound healing. Results from upcoming and ongoing clinical trials will set the path of these novel therapeutic options that have the capability to successfully treat severe refractory Crohn's patients.
炎症性肠病（IBD）是一种慢性疾病，常反复发作，严重影响许多患者的生活质量。尽管医学治疗取得了重大进展，但很大一部分患者对现有的治疗方案产生耐药性。通过造血干细胞（HSC）或间充质干（基质）细胞（MSC）进行干细胞治疗是严重难治性病例的一种有前景的治疗选择，尤其是在手术不可行的情况下。在造血干细胞移植中，目标是破坏导致疾病慢性化的“自身反应性”免疫细胞，并重新建立肠道对肠道微生物的耐受性。在肛周克罗恩病（CD）中，目标是将间充质干细胞局部注入瘘管，以下调局部免疫反应并促进伤口愈合。即将开展和正在进行的临床试验结果将为这些有能力成功治疗重度难治性克罗恩病患者的新型治疗方案指明方向。
