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间充质干细胞治疗克罗恩病肛瘘

Mesenchymal Stem Cells to Treat Crohn's Disease with Fistula.

作者信息

Zhang Xiao-Mei, Zhang Yu-Jing, Wang Wei, Wei Yu-Quan, Deng Hong-Xin

机构信息

1 State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University , Chengdu, P.R. China .

2 Laboratory Animal Center, Sichuan University , Chengdu, P.R. China .

出版信息

Hum Gene Ther. 2017 Jul;28(7):534-540. doi: 10.1089/hum.2016.095.

Abstract

Crohn's disease, which mainly affects the gastrointestinal tract, is a refractory inflammatory disease that has clinical manifestations of abdominal pain, fever, bowel obstruction, and diarrhea with blood or mucus. Together, these symptoms can severely impair a patient's quality of life. Besides the common complication of intestinal obstruction, fistulas, particularly anorectal fistulas, are common in Crohn's disease patients. Since radical surgical cures can be difficult to achieve and relapse is common, Crohn's disease patients often seek other effective treatments in addition to surgery. Stem-cell therapies have recently been proposed as a method to address the challenges and prospective medical needs of Crohn's disease patients in general and those with fistulas. Several studies suggest that mesenchymal stem cells (MSCs) could improve Crohn's disease and Crohn's fistula. Moreover, studies concerning MSC transplantation or local rejection of stem cells derived from bone marrow or adipose tissue-derived stem cells have assessed stem cell-based treatments for refractory Crohn's disease. Many patients in these studies are now in remission. A number of clinical trials for refractory Crohn's disease have also evaluated transplantation of autologous or allogenic MSCs and showed that MSCs can be safely administered to Crohn's disease patients, with some achieving positive clinical responses.

摘要

克罗恩病主要影响胃肠道,是一种难治性炎症性疾病,临床表现为腹痛、发热、肠梗阻以及伴有血便或黏液便的腹泻。这些症状加在一起会严重损害患者的生活质量。除了常见的肠梗阻并发症外,瘘管,尤其是肛瘘,在克罗恩病患者中很常见。由于根治性手术难以实现且复发常见,克罗恩病患者除手术外通常还寻求其他有效治疗方法。干细胞疗法最近被提议作为一种应对克罗恩病患者总体挑战和预期医疗需求以及瘘管患者需求的方法。多项研究表明,间充质干细胞(MSC)可以改善克罗恩病和克罗恩瘘。此外,有关MSC移植或源自骨髓或脂肪组织的干细胞局部排斥反应的研究已经评估了基于干细胞的难治性克罗恩病治疗方法。这些研究中的许多患者目前已缓解。多项针对难治性克罗恩病的临床试验也评估了自体或异体MSC的移植,并表明可以将MSC安全地给予克罗恩病患者,一些患者取得了积极的临床反应。

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