Inflammatory bowel disease: Therapeutic limitations and prospective of the stem cell therapy

Abstract

Inflammatory bowel disease (IBD), consisting primarily of ulcerative colitis and Crohn’s disease, is a group of debilitating auto-immune disorders, which also increases the risk of colitis-associated cancer. However, due to the chronic nature of the disease and inconsistent treatment outcomes of current anti-IBD drugs (e.g., approximately 30% non-responders to anti-TNFα agents), and related serious side effects, about half of all IBD patients (in millions) turn to alternative treatment options. In this regard, mucosal healing is gaining acceptance as a measure of disease activity in IBD patients as recent studies have correlated the success of mucosal healing with improved prognosis. However, despite the increasing clinical realization of the significance of the concept of mucosal healing, its regulation and means of therapeutic targeting remain largely unclear. Here, stem-cell therapy, which uses hematopoietic stem cells or mesenchymal stem cells, remains a promising option. Stem cells are the pluripotent cells with ability to differentiate into the epithelial and/or immune-modulatory cells. The over-reaching concept is that the stem cells can migrate to the damaged areas of the intestine to provide curative help in the mucosal healing process. Moreover, by differentiating into the mature intestinal epithelial cells, the stem cells also help in restoring the barrier integrity of the intestinal lining and hence prevent the immunomodulatory induction, the root cause of the IBD. In this article, we elaborate upon the current status of the clinical management of IBD and potential role of the stem cell therapy in improving IBD therapy and patient’s quality of life.

Keywords: Crohn′s disease; Ulcerative colitis; Mesenchymal stem cells; Hematopoietic stem cells; Mucosal healing

Core Tip: Mucosal healing is gaining acceptance as a measure of the disease activity remission in inflammatory bowel disease (IBD) patients, however, its regulation and means of therapeutic targeting remain unclear. In this article, we elaborate upon stem-cell therapy, which uses hematopoietic or mesenchymal stem cells, as a promising therapeutic option for IBD. The over-reaching concept is that the stem cells can migrate to the damaged areas of the intestine and differentiate into the mature intestinal epithelial cells to restore the barrier integrity of the intestinal lining, and hence, prevent the immunomodulatory induction, the root cause of IBD, and thus patient’s quality of life.