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Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2018; 6(12): 493-500
Published online Oct 26, 2018. doi: 10.12998/wjcc.v6.i12.493
One more chance of fistula healing in inflammatory bowel disease: Stem cell therapy
Erica P Turse, Francis E Dailey, Maliha Naseer, Edward K Partyka, Veysel Tahan
Erica P Turse, Francis E Dailey, Maliha Naseer, Edward K Partyka, Veysel Tahan, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Missouri Health Center, Columbia, MO 65212, United States
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest.
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: Veysel Tahan, FACG, FACP, FEBG, MD, Assistant Professor, Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Missouri, One Hospital Drive, CD 405, Columbia, MO 65212, United States. tahanv@health.missouri.edu
Telephone: +1-573-8846044 Fax: +1-573-8844595
Received: July 10, 2018
Peer-review started: July 10, 2018
First decision: July 31, 2018
Revised: August 9, 2018
Accepted: August 28, 2018
Article in press: August 28, 2018
Published online: October 26, 2018
Processing time: 108 Days and 23.8 Hours
Abstract

Patients with fistulizing inflammatory bowel disease are traditionally difficult to treat. This patient population often experiences delayed or insufficient healing of fistulas using current standard regimens including antibiotics, immunomodulators, anti-tumor necrosis factor-αdrug, placement of setons, and surgical repair. Several studies over the last ten to fifteen years have been conducted using stem cell therapies with promising results in this patient population. These studies show stem cell therapy in fistulizing disease to be successful in healing between 60%-88% compared to currently 50% with infliximab. Moreover, remission was seen 24 wk to 52 wk in these studies. Further research with a multi-approach treatment using medications, stem cell therapy, and surgical interventions will likely be the future of this innovative treatment approach.

Keywords: Crohn’s disease; Stem cells; Mesenchymal; Fistulizing; Fistula; Inflammatory bowel disease

Core tip: There appear to be limited adverse events as well as significant benefit to multi-approach therapy using stem cells to treat fistulizing inflammatory bowel disease. Comparing studies to current treatment rates of fistula healing, which has a less than 50% success rate, stem cell therapy for fistulizing Crohn’s disease appears to be beneficial, as the majority of studies claim 60%-88% fistula healing and maintenance of remission at 24-52 wk. Further large-scale studies analyzing a multi-approach therapy including stem cells should be conducted, especially in a randomized double-blind approach.