Crohn’s disease and Stem Cells
Crohn’s disease is a chronic condition of the intestines. It causes inflammation in the digestive system and leads to the formation of ulcers and fistulae, which are abnormal connections between organs.
Sufferers struggle with many debilitating symptoms, including diarrhoea, bleeding ulcers, severe pain, bloating, cramping, weight loss and anaemia.
The condition also generates an excessive quantity of Tumour Necrosis Factor (TNF) that indiscriminately kills gut flora and therefore compromises food digestion.
Over time, inflammation from the stomach spreads throughout the body and into the joints and eyes.
The exact cause is unclear, but scientists suspect it has something to do with genetic disposition and a range of environmental factors, including a possible microbiological infection.
Crohn’s disease facts
- People aged 16-30 or 60-80 are most at risk.[1]
- It is more prevalent in women than men.[2]
- Crohn’s disease is more prevalent in white people.[3]
- 90,000 people with Crohn’s disease in the UK.[4]
- Since 2000, the amount of people needing treatment for Crohn’s disease has quadrupled.
Crohn’s disease and stem cells
While standard management of Crohn’s relies on medication and surgery, regenerative medicine is an active area of clinical research. There are 47 studies investigating the application of stem cells to treat Crohn’s disease[5]; 5 of these are using umbilical cord blood and tissue.[6]
A trial using expanded allogeneic adipose-derived stem cells reported a reduction in fistulae in 69.2% of patients; for 30% of patients, stem cells completely closed all fistulae.[7] While these early results are highly encouraging, further large-scale trials are necessary to confirm the long-term safety and efficacy of these approaches for the wider patient population.
A new trial is investigating the potential of stem cells to ‘reboot’ patients’ immune systems. In this protocol, doctors administer chemotherapy and hormone treatments to patients as a way of mobilising their stem cells. They then extract cells from their blood. Once more chemotherapy is undertaken, stem cells are reintroduced into the blood stream to create a new immune system. It is important to understand that this is a highly specialised, experimental procedure taking place within strictly monitored clinical settings. However, the hope is that this new immune system should accept the patient’s gut and inflammation should subside.
In China, a completed clinical trial at the Shaanxi Provincial People’s Hospital concluded that umbilical cord mesenchymal stem cells could be an effective treatment for Crohn’s disease, although there were some mild side effects. However, doctors also highlighted the necessity of a better method to distribute cells right through the entire intestine.[8]
At the moment, there is no cure for Crohn’s disease, but stem cells offer hope that there may be new treatment options in the future. For families looking ahead, banking cord tissue provides a rich source of mesenchymal stem cells that could potentially be utilised should this clinical research progress.
References
- https://www.ibdrelief.com/learn/what-is-ibd/what-is-crohns-disease
- https://www.ncbi.nlm.nih.gov/pubmed/11374696
- https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0104859
- https://www.nice.org.uk/guidance/cg152/resources/costing-statement-pdf-248594797
- https://clinicaltrials.gov/ct2/results?cond=Crohn+Disease&term=stem+cell&cntry=&state=&city=&dist=&Search=Sea
- https://clinicaltrials.gov/ct2/results?cond=Crohn+Disease&term=umbilical+cord&cntry=&state=&city=&dist=&Search=Searchrch
- https://www.ncbi.nlm.nih.gov/pubmed/23053677
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753687/
- International journal of colorectal disease, 28(3), 313–323. https://doi.org/10.1007/s00384-012-1581-9
- Lancet (London, England), 388(10051), 1281–1290. https://doi.org/10.1016/S0140-6736(16)31203-X
- Stem cell research & therapy, 12(1), 463. https://doi.org/10.1186/s13287-021-02533-0
