Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland.
Curr Drug Targets. 2020;21(14):1405-1416. doi: 10.2174/1389450121666200504074922.
Inflammatory Bowel Disease (IBD) is categorized as Crohn's disease (CD) and Ulcerative colitis (UC) and is characterized by chronic inflammation in the gastrointestinal (GI) tract. Relapsing symptoms, including abdominal pain, increased stool frequency, loss of appetite as well as anemia contribute to significant deterioration of quality of life. IBD treatment encompasses chemotherapy (e.g. corticosteroids, thiopurines) and biological agents (e.g. antibodies targeting tumour necrosis factor α, interleukin 12/23) and surgery. However, efficacy of these therapies is not satisfactory. Thus, scientists are looking for new options in IBD treatment that could induce and maintain remission.
To summarize previous knowledge about role of different intestinal cells in IBD pathophysiology and application of stem cells in the IBD treatment.
Recent studies have emphasized an important role of innate lymphoid cells (ILCs) as well as intestinal epithelial cells (IECs) in the IBD pathophysiology suggesting that these types of cells can be new targets for IBD treatment. Moreover, last studies show that stem cells transplantation reduces inflammation in patients suffering from IBD, which are resistant to conventional therapies.
Both hematopoietic stem cells (HSCs) and mesenchymal stem cells (MSCs) are able to restore damaged tissue and regulate the immune system. Autologous HSCs transplantation eliminates autoreactive cells and replace them with new T-cells resulting a long-time remission. Whereas MSCs transplantation is effective therapy in one of the major complications of IBD, perianal fistulas.
炎症性肠病(IBD)分为克罗恩病(CD)和溃疡性结肠炎(UC),其特征是胃肠道(GI)道的慢性炎症。反复发作的症状,包括腹痛、粪便频率增加、食欲不振以及贫血,导致生活质量显著恶化。IBD 的治疗包括化疗(如皮质类固醇、硫嘌呤)和生物制剂(如针对肿瘤坏死因子α、白细胞介素 12/23 的抗体)和手术。然而,这些治疗的疗效并不令人满意。因此,科学家们正在寻找新的 IBD 治疗选择,以诱导和维持缓解。
总结不同肠道细胞在 IBD 病理生理学中的作用以及干细胞在 IBD 治疗中的应用的相关知识。
最近的研究强调了固有淋巴细胞(ILCs)和肠上皮细胞(IECs)在 IBD 病理生理学中的重要作用,表明这些类型的细胞可以成为 IBD 治疗的新靶点。此外,最近的研究表明,干细胞移植可减少对常规治疗耐药的 IBD 患者的炎症。
造血干细胞(HSCs)和间充质干细胞(MSCs)都能够修复受损组织并调节免疫系统。自体 HSCs 移植可消除自身反应性细胞,并以新的 T 细胞替代它们,从而实现长时间的缓解。而 MSCs 移植是 IBD 的主要并发症之一,即肛周瘘的有效治疗方法。