Editorial
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Oct 26, 2018; 10(10): 134-137
Published online Oct 26, 2018. doi: 10.4252/wjsc.v10.i10.134
Hematopoietic stem cell transplantation for Crohn’s disease: Gaps, doubts and perspectives
Milton Artur Ruiz, Roberto Luiz Kaiser Junior, Lilian Piron-Ruiz, Tatiana Peña-Arciniegas, Priscila Samara Saran, Luiz Gustavo De Quadros
Milton Artur Ruiz, Roberto Luiz Kaiser Junior, Lilian Piron-Ruiz, Tatiana Peña-Arciniegas, Priscila Samara Saran, Luiz Gustavo De Quadros, Bone Marrow Transplant Department, Associação Portuguesa de Beneficência, São José do Rio Preto, SP 15090 470, Brazil
Author contributions: Ruiz MA and Kaiser Junior RL conceived the study and drafted the manuscript; Piron-Ruiz L, Peña-Arciniegas T, Saran PS and De Quadros LG contributed to review the literature, discuss the subject and review the final manuscript text; all the authors approved the final version of the article.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: 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/
Correspondence to: Milton Artur Ruiz, MD, PhD, Emeritus Professor, Bone Marrow Transplant Department, Associação Portuguesa de Beneficência, Rua Catarina Nucci Parise 760, São José do Rio Preto, SP 15090 470, Brazil. milruiz@yahoo.com.br
Telephone: +55-17-33047091 Fax: +55-17-988263264
Received: June 26, 2018
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
Processing time: 119 Days and 18.4 Hours
Abstract

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.

Keywords: Stem cell therapy; Hematopoietic stem cell transplantation; Treatment; Crohn’s disease

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.