A new clinical trial will see hospitals from across the country come together in a bid to treat Crohn’s disease with stem cell therapy.

The new ASTIClite trial, led by Queen Mary University of London and Barts Health NHS trust, follows on from a 2015 study that found stem cells could improve patients’ quality of life.

Researchers will now attempt to treat the source of the disease, rather than the symptoms, by obliterating patients’ immune systems with chemotherapy and then administering stem cells.

What is Crohn’s disease?

Crohn’s disease is a condition that causes inflammation in the digestive system and leads to the formation of fistulae, which are abnormal connections between organs.

People with Crohn’s disease suffer from a range of debilitating symptoms – including diarrhoea, bleeding ulcers, severe pain, bloating, cramping, weight loss, and anaemia.

Over time, gut inflammation spreads to other parts of body – including the joints and eyes. The condition is incurable.

How is Crohn’s disease currently treated?

Currently, patients with Crohn’s disease take drugs to reduce inflammation and suppress their immune system. In some cases, surgery is required to remove the affected area of the bowel.

Unfortunately, patients become less receptive to medication as time goes on.

Crohn’s disease in the UK

  • 250,000 people suffer from Crohn’s in the UK
  • Young people are more likely to be affected
  • Since 2000, the amount of people requiring treatment for Crohn’s has quadrupled
  • 35% of patients will have 1 or 2 relapses
  • 145 people per 100,000

What does the ASTIClite trial involve?

The trial is designed to reduce gut inflammation through stem cell transplants, which completely reset patients’ immune systems.

How it works…

  1. Patients receive chemotherapy and hormone treatment to mobilise stem cells
  2. Stem cells are extracted from their blood
  3. Chemotherapy is administered to deplete their immune system
  4. Stem cells are re-introduced into the blood stream
  5. The transplant creates new immune cells, which create a new immune system.

This new immune system should accept the patient’s gut, and inflammation should subside.

Although not a cure, treatment therefore offers hope of dramatically improving quality of life for Crohn’s sufferers around the globe. The same method is also being tested for the treatment of multiple sclerosis.

“Stem cell therapies are an important, active and growing area of research with great potential,” said Professor Tom Walley, Director of the NIHR Evaluation, Trials and Studies programmes, which funded the trial. “There are early findings showing a role for stem cells in replacing damaged tissue. In Crohn’s disease, this approach could offer real benefits for the clinical care and long term health of patients.”

Stem cells and Crohn’s around the world…

    • In Thailand, doctors are using haematopoietic mesenchymal stem cells to “permanently” treat Crohn’s disease. MSCs, taken from patients’ bone marrow, shift the body from producing pro-inflammatory cytokines to beneficial anti-inflammatory cytokines. Therapy takes place over 14-16 nights, with 2-6 mesenchymal infusions per treatment stage.
    • The European Commission approved a new stem cell treatment called Alofisel in April 2018. The therapy uses adipose-derived mesenchymal stem cells to treat Crohn’s disease, and was found to be 42% more efficacious than standard therapy.

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