Published online Oct 26, 2018. doi: 10.4252/wjsc.v10.i10.134
Peer-review started: June 30, 2018
First decision: July 9, 2018
Revised: August 15, 2018
Accepted: August 28, 2018
Article in press: August 28, 2018
Published online: October 26, 2018
Crohn’s disease (CD) is an inflammatory bowel disease that can affect any site of the digestive system. It occurs due to an immunological imbalance and is responsible for intestinal mucosal lesions and complications such as fistulas and stenoses. Treatment aims to stabilize the disease, reducing the symptoms and healing intestinal lesions. Surgical procedures are common in patients. Cell therapy was initially used to treat this disease in patients who also suffered from lymphoma and leukemia and were considered to be good candidates for autologous and allogeneic transplantation. After transplantation, an improvement was also observed in their CD. In 2003, the procedure began to be used to treat the disease itself, and several case series and randomized studies have been published since then; this approach currently comprises a new option in the treatment of CD. However, considerable doubt along with significant gaps in our knowledge continue to exist in relation to cell therapy for CD. Cell therapy is currently restricted to the autologous modality of hematopoietic stem cell transplantation and, experimentally, to mesenchymal stromal cells to directly treat lesions of the anal mucosa. This article presents the supporting claims for transplantation as well as aspects related to the mobilization regime, conditioning and perspectives of cell therapy.
Core tip: Crohn’s disease (CD) is an inflammatory bowel disease that can affect any part of the digestive tract. Hematopoietic stem cell transplantation is considered an option in cases of severe disease refractory to conventional treatment. To date, the results are promising, however many gaps and doubts remain regarding procedures for and indications of cell therapy, which still require improvement. The aim of this editorial is to discuss these aspects and the future of cell therapy in CD.