Bhatnagar P, Elhariri S, Burud IAS, Eid N. Perianal fistulizing Crohn’s disease: Mechanisms and treatment options focusing on cellular therapy. World J Gastroenterol 2025; 31(9): 100221 [DOI: 10.3748/wjg.v31.i9.100221]
Corresponding Author of This Article
Nabil Eid, Associate Professor, Academic Editor, Senior Lecturer, MD, PhD, Department of Anatomy, Division of Human Biology, School of Medicine, IMU University, No. 126 Jalan Jalil Perkasa 19, Kuala Lumpur 57000, Malaysia. nabilsaleheid@imu.edu.my
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Mar 7, 2025; 31(9): 100221 Published online Mar 7, 2025. doi: 10.3748/wjg.v31.i9.100221
Perianal fistulizing Crohn’s disease: Mechanisms and treatment options focusing on cellular therapy
Payal Bhatnagar, Sherreen Elhariri, Ismail A S Burud, Nabil Eid
Payal Bhatnagar, Department of Pharmaceutical Technology, School of Pharmacy, IMU University, Kuala Lumpur 57000, Malaysia
Sherreen Elhariri, Ismail A S Burud, Department of Surgery, IMU University, Clinical Campus, Seremban 70300, Negeri Sembilan, Malaysia
Nabil Eid, Department of Anatomy, Division of Human Biology, School of Medicine, IMU University, Kuala Lumpur 57000, Malaysia
Author contributions: Bhatnagar P designed the figure; Burud IAS revised the manuscript; Bhatnagar P, Elhariri S, and Eid N wrote the manuscript; Eid N approved the final draft; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nabil Eid, Associate Professor, Academic Editor, Senior Lecturer, MD, PhD, Department of Anatomy, Division of Human Biology, School of Medicine, IMU University, No. 126 Jalan Jalil Perkasa 19, Kuala Lumpur 57000, Malaysia. nabilsaleheid@imu.edu.my
Received: August 10, 2024 Revised: January 6, 2025 Accepted: January 21, 2025 Published online: March 7, 2025 Processing time: 192 Days and 2.9 Hours
Core Tip
Core Tip: Perianal fistulizing Crohn’s disease (PFCD) is a common complication of CD, characterized by complex pathogenic mechanisms involving inflammatory cell accumulation, particularly macrophages, and enhanced cytokine production. These processes drive epithelial-to-mesenchymal transition, myofibroblast activation, upregulation of matrix metalloproteinases, ultimately leading to fistula formation. While various medical and surgical options target inflammatory processes in this disease, recurrence remains a substantial challenge. Local administration of mesenchymal stem cells or their derived extracellular vesicles has emerged as a promising therapeutic strategy through suppression of the inflammatory cells and promotion of fistula healing in PFCD. Here we summarize the various mechanisms involved in PFCD pathogenesis, with particular emphasis on mesenchymal stem cell therapy and their derived extracellular vesicles.
