Title:Complications Following Stem Cell Therapy in Inflammatory Bowel Disease
Volume: 12
Issue: 6
Author(s): Hongyun Wei, Xiaowei Liu, Chunhui Ouyang, Jie Zhang, Shuijiao Chen, Fanggen Lu and Linlin Chen *
Affiliation:
- Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, Hunan 410008,China
Keywords:
IBD, stem cell therapy, complications, mesenchymal stem cells, hematopoietic stem cells.
Abstract: Backgrounds: Pharmacotherapy and surgery constitute the mainstay of treatment for inflammatory
bowel disease (IBD). But post-treatment relapsing and recurrence persist as concerns in
patients with IBD. Stem cell therapy (SCT) has emerged as a promising treatment strategy in inflammatory
bowel disease (IBD), including hematopoietic stem cells (HST), mensenchymal stem cells (MSCs).
However, severe complications limit the clinical use of SCT in IBD. Therefore, this review aims to
summarize SCT-associated complications, and illustrate possible prevention strategies.
Methods: We searched Pubmed for studies which reported the use of SCT to treat patients with IBD.
Searching terms included ‘IBD’ or ‘Inflammatory bowel disease’ or ‘CD’ or ‘Crohn’s disease’ and
‘stem cell therapy’ or ‘stem cell transplantation’.
Results: HSCT can restore the immune tolerance following chemotherapy-induced immune ablation,
and MSCs could affect immune cells or secret trophic factors to treat IBD. However, severe complications
limit the clinical use of SCT in IBD. Dominant SCT-associated complications include infection,
ectopic tissues, and graft-versus-host disease (GVHD), especially for auto-HSCT. As for infection,
bacteremia and virus infection were found after SCT treatment, and the use of anti-microbial regimens
could reduce incidences of infection. Ectopic tissue formation in the recipient was observed after treatment
with HSCT or MSC. Homing and tissue integration might be the possible mechanisms for not
forming ectopic tissues. In addition, GVHD was also observed in allogeneic HSCT. Therefore, autologous
HSCT and MSCs transplantation were recommended to avoid GVHD.
Conclusions: MSCs with their low immunogenicity property eliminate the need for chemotherapy, and
are over HSCT in reducing the risk of severe complications. For better application of SCT in IBD, antimicrobial
prophylaxis should be used combined with SCT.
