Stem cell therapy – new approach in treatment of complex perianal fistulas in Crohn’s disease

Abstract:

Treatment of complex perianal Crohn‘s disease is based on a combination of medications and surgical procedures. Mesenchymal stem cells (MSC) are heterogeneous group of adult stem cells with multipotent ability to differentiate into numerous mature tissues such as bone, muscle, cartilage and many others. Due to the pathogenesis of the fistulas formation which involves lymphocyte and dendritic cells, the MSC properties may be particularly relevant in context of perianal fistulas in Crohn‘s disease. Clinical efficacy and safety of local administration of expanded human allogeneic mesenchymal adult stem cells extracted from adipose tissue (eASC) under the name darvadstrocel was evaluated in a randomized, double-blind, placebo-controlled multicentric clinical trial to confirm the efficacy and safety of darvadstrocel in the treatment of complex perianal fistulas in patients with Crohn‘s disease (ADMIRE CD study). The results of ADMIRE-CD study have shown that local application of darvadstrocel stimulates the closure of complex perianal fistulas in patients with Crohn‘s disease. This therapy may be particularly useful in patients with active perianal fistulas with or without mild luminal disease. Treatment has a localized effect and has been proven to be safe. 

Key words:
complex perianal fistulas; Crohn‘s disease; darvadstrocel; expanded human allogenous mesenchymal stem cells (eASC); mesenchymal stem cells