Abstract
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gut that can lead to severe gastrointestinal symptoms, malnutrition, and complications such as fistulas and cancer. Mesenchymal stem/stromal cells (MSCs) are being investigated as a novel therapy for IBD and have been demonstrated to be safe and effective for perianal fistulizing Crohn’s disease (PFCD). This systematic review aims to present the most recent studies on the safety and efficacy of MSC therapy in IBD. A detailed search strategy of clinical trials on MSCs and IBD was performed on PubMed, with 32 studies selected for inclusion in this review. The newest studies on local MSC injection for PFCD continue to support long-term efficacy while maintaining a favorable safety profile. The evidence for systemic MSC infusion in luminal IBD remains mixed due to marked methodological heterogeneity and unclear safety profiles. Although further studies are needed to better establish the role of this novel treatment modality, MSCs are proving to be a very exciting addition to the limited therapies available for IBD.
Highlights
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gut that can lead to severe gastrointestinal symptoms, malnutrition, and complications such as fistulas and cancer
Studies were selected based on the following inclusion criteria: (i) human studies, (ii) included patients with IBD, (iii) Mesenchymal stem/stromal cells (MSCs) or MSC-containing tissue products were used for treatment of IBD, (iv) efficacy and adverse effects (AEs) were reported, (v) the study was published as peer-reviewed paper, letter, or abstract
The study is limited by small sample size and lack of blinding and control group; the authors are planning a larger study to establish safety, efficacy, and feasibility of their MSC-MATRIX technology in perianal fistulizing Crohn’s disease (PFCD)
Summary
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gut that can lead to severe gastrointestinal symptoms, malnutrition, and complications such as fistulas and cancer. Mesenchymal stem/stromal cells (MSCs) are being investigated as a novel therapy for IBD and have been demonstrated to be safe and effective for perianal fistulizing Crohn’s disease (PFCD). This systematic review aims to present the most recent studies on the safety and efficacy of MSC therapy in IBD. In long industrialized regions such as North America and Europe, it is estimated that IBD carries an overall stable prevalence of 0.3% [2,4]. Given the already significant disease burden in North America and Europe and the increasing incidence in other parts of the world, IBD carries a significant economic burden globally, one that is only expected to grow moving forward [4]. Depending on the severity and extent of disease, the management of IBD can range from topical anti-inflammatory agents (e.g., 5-aminosalicylates [5-ASA]) to major abdomi-
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