Stem Cell Therapy: A Crohn's Disease Breakthrough in 2023?

Louis A. Cona, MD
Updated on
Jan 25, 2023
7

minute read

Learn how stem cell therapy is revolutionizing treatment for Crohn's disease. Improve your life expectancy and quality of life with this cutting-edge therapy.

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In Crohn's disease, the immune system mistakenly attacks the gut, leading to bowel obstruction, severe diarrhea, painful bowel movements, rectal bleeding, and other severe symptoms through damage to the intestinal tissue. Individuals with Crohn's tend to have a shorter average life expectancy compared to those without the condition.

Stem cells have the potential to repair and regenerate damaged tissue while also reducing inflammation in the gut. This can help to improve symptoms, such as abdominal pain, diarrhea, and weight loss, and may also help slow the disease's progression.  Stem cell therapy may also help digestive diseases by healing scar tissue in the large intestine through differentiation.

Stem cell research has shown that cell therapy may have the ability to promote the repair of diseased, dysfunctional, or injured tissue. There have been many positive and exciting outcomes for patients with little success with conventional treatments.

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Stem cell therapy for Crohn's Disease

Stem cell therapy for Crohn's disease is an exciting and innovative treatment option that has the potential to revolutionize the way we treat the condition. Stem cell therapy has been vastly studied and is not a new treatment for Crohn's disease. Studies have shown that stem cells can reduce inflammation and promote healing. This cutting-edge therapy is promising in clinical trials and is being researched further to understand its long-term efficacy.

With continuing research and development, stem cell therapy has the potential to become a widely available and highly effective treatment option for those living with Crohn's disease. Stem cell therapy may help Crohn's Patients through these processes:

  • Reduction in inflammation throughout the digestive tract
  • Regulating the immune system (to control immune response)
  • Repairing injured tissue within the gastrointestinal tract (through stem cell differentiation)

Multiple peer-reviewed studies have found that Mesenchymal stem cell therapy is an effective and safe treatment for complex perianal fistulas in patients with Crohn's disease who did not respond to traditional or biological therapies.

Stem cell therapy for Crohn's Disease

Stem cells reduce inflammation by positively influencing the immune system

Mesenchymal stem cells (MSCs) are a type of stem cell found to have immunomodulatory properties. They can modulate the immune response, benefiting individuals with Crohn's disease.

T-cell activation within the gastrointestinal tract leads the body to conduct an immune response leading to chronic inflammation causing pain and discomfort. Mesenchymal Stem Cells (MSCs) can target inflammation within the body and repair damaged tissue. This makes stem cell infusions an effective treatment for inflammatory conditions such as Crohn's, Ulcerative Colitis, or other inflammatory bowel diseases (IBD).

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Reducing inflammation in the digestive tract

Research has shown that MSCs can suppress the pro-inflammatory response in the gut and promote the production of anti-inflammatory cytokines. In a study published in the Journal of Crohn's and Colitis, MSCs were found to reduce the inflammatory response in a mouse model of Crohn's disease and improve the healing of the gut tissue.

In another study published in the Journal of Translational Medicine, MSCs were found to reduce the activity of T-helper 17 cells, which are known to be involved in developing chronic inflammation in severe Crohn's disease.

MSCs have also been found to differentiate into different types of cells, including those found in the gut, which can further help repair and regenerate damaged tissue in the stomach.

inflammation of the gut

Stem cells are not a new Crohn's Disease treatment

Stem cells are the body's raw materials, from which all other cells with specialized functions are created. Mesenchymal stem cells are adult stem cells with self-renewal, immunomodulatory, anti-inflammatory, signaling, and differentiation properties.

Mesenchymal stem cells (MSCs) self-renewal capacity is characterized by their ability to divide and develop into multiple specialized cell types in a specific tissue or organ. MSCs are widely used in treating various diseases due to their self-renewable, differentiation, anti-inflammatory, and immunomodulatory properties. In-vitro (performed in a laboratory setting) and in-vivo (taking place in a living organism) studies have supported the understanding of the mechanisms, safety, and efficacy of MSC therapy in clinical applications. (3)

Stem cells promote regeneration

According to a 2018 study conducted by Cigna et al., mesenchymal stem cells (MSCs) mainly exert their regenerative effects through paracrine and endocrine action modes, including immunomodulatory, anti-inflammatory, mitogenic, anti-apoptotic, anti-oxidative stress, anti-fibrotic, and angiogenic influences." (1)

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What are the benefits of stem cell treatment for Crohn's Disease?

  1. Cost-effective: Intravenous stem cell therapy may be more cost-effective in the long term than biologics, which can be expensive and require ongoing treatment.
  2. Potential for extended remission: Intravenous stem cell therapy can induce long-lasting remission and improve the quality of life for individuals with inflammatory bowel disease.
  3. Symptom improvement without side effects: Intravenous stem cell therapy may improve symptoms of inflammatory bowel disease without the adverse side effects associated with other treatments.
  4. Safe: Intravenous stem cell therapy is considered safe, with minimal risks and complications associated with the procedure.
  5. Improve fistulas: A recent study found that mesenchymal stem cells can effectively improve fistula tracts and other Crohn's disease symptoms.

Mesenchymal Stem Cells effectively treat Crohn's Disease Perianal Fistulas

According to a study by Barnhoorn et al., stem cell treatment was associated with significantly lower clinical disease activity for people with Crohn's disease and improved quality of life four years post-treatment. The study examined the patient's medical history and the diameter of the group's Fistula tracts (an abnormal connection between two body parts, often causing pain).

Study results

The study found that 75% [3/4] of the patients had complete clinical fistula closure after four years, as determined by the absence of discharge. MRI evaluation after four years showed an improvement in the fistula tracts in 67% [6/9] of MSC-treated patients [Figure 1]. We have shown that the efficacy of mesenchymal stem cell therapy for perianal Crohn's disease fistulas was maintained for up to 4 years after treatment.

Fistula thickness Credit: Barnhoorn, et al

Is there a cure for Crohn's Disease?

Crohn's disease is a chronic disease that sometimes leads to severe complications; currently, no known cure exists. However, treatment options are available to manage symptoms and improve the quality of life for individuals living with Crohn's disease. These options include medications, such as anti-inflammatory drugs, immunosuppressants, and surgery in some cases. However, surgery does not cure Crohn's disease; it aims to reduce associated complications.  Certain risk factors, including smoking, family history, and specific genetic mutations, can make a person more susceptible to developing Crohn's disease.

Stem cell research for Crohn's disease

Stem cell therapy is also being researched as an option to treat complications associated with Crohn's disease. Research has shown that stem cell therapy can effectively promote disease remission and significantly improve symptoms of Crohn's disease. Advances in stem cell therapy have already improved serious complications with Crohn's disease and, in the future, may make Crohn's disease curable over the next decade.

Stem cells may promote remission

Additionally, some people with Crohn's disease may experience periods of remission with no or mild symptoms. Maintaining remission for extended periods with appropriate treatment is possible, but relapse is still common.

Working with a healthcare provider to develop an individualized treatment plan that addresses the patient's specific needs is vital. Treatment aims to improve the quality of life, not to provide a complete cure.

Using stem cells as an Inflammatory Bowel Disease Treatment

Inflammation is prevalent in disorders ranging from heart disease and diabetes to IBD and Crohn's Disease. Treatment of these diseases, as well as many other common conditions, usually addresses reducing inflammation in the body. Whether through drugs, diet and lifestyle changes, or other natural methods, the goal is to eliminate as much inflammation from the body as possible.

Researchers have shown over the years that Mesenchymal Stem Cells (MSCs) are among today's most robust anti-inflammatory tools. Many patients are turning to stem cell therapy to meet their needs.

Studies show promising results

According to a study by Shimizu et al, MSCs have been reported to have an immunosuppressive effect by polarizing anti-inflammatory M2 macrophages and reducing both dendritic cells and neutrophils through prostaglandin E2 (PGE2) and IL-10 at the wound site. MSCs can also reduce T and B lymphocytes' activity by modulating their proliferation and differentiation. Several phase I/II clinical studies have been conducted for autologous and allogeneic MSC transplantation (MSCT). In this trial, 53% of patients had clinical remission, and endoscopic improvement was observed in 47% at 42 days after transplantation.

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Crohn's Disease Case Study | DVC Stem

In February 2020, DVC Stem conducted a Crohn's case study with impressive results. This study presented a 25-year-old Caucasian American woman previously diagnosed with Crohn’s Disease and has a history of postural orthostatic tachycardia syndrome (POTS) and adrenal, thyroid, and anemia issues.

Patient history

She lived mainly without these indications until 2011, when her condition worsened, prompting medical intervention. She reported low energy, frequent bowel movement, bloody diarrhea, abdominal pain, and cramps. She has been prescribed Decadron 0.75mg, a Remicade infusion (TNF Alpha blocker) for inflammation, and medications for diarrhea, nausea, and reflux. She was also using the narcotic Norco for pain management. The patient reported being unable to function daily and quitting school due to her ailments.

Inflammatory marker improvement

Pre-treatment lab work was conducted to determine baseline conditions. The required labs include inflammation markers to document any abnormally high levels of inflammation expected in Crohn’s patients. Her bloodwork indicated a TNF Alpha of 8.3 (normal range 0.0-2.2). The patient also completed a vitality questionnaire which determined her subjective condition across 24 different overall health metrics for comparison post-treatment.

The patient did not have significant changes in blood pressure, oxygen level, or body temperature during treatment. She did not report any adverse responses within 24 hours of her treatment date.

Human digestive tract

Treatment results after three months

Three months post-treatment, the patient reported significant improvement in symptoms. During a follow-up physical exam, she said a complete reversal of her bowel and abdominal pain symptoms. Her post-treatment vitality questionnaire indicated a 95% improvement in bowel movements, abdominal discomfort, and blood per rectum and a 70% improvement in energy level.

Reduced intestinal inflammation

Her bowel movements had decreased from 12 to 15 per day to 1 per day, and blood per rectum from 8 to 10 per day to zero. She reported not taking Dacedron since her treatment without any adverse effects. She had sustained higher levels of energy and said that she had begun attending school once again to pursue higher education, which was not possible before the treatment

In Conclusion

The study concluded that Stem cell-based therapy is one of the promising new treatment options for refractory IBD patients, making mesenchymal stem cell therapy an exciting new treatment option for patients with chronic inflammation within the digestive tract. One may argue that these findings can transfer to Crohn's disease patients, as reducing inflammation may decrease symptoms and lower the chance of further flare-ups. Barnhoorn et al. concluded that long-term stem cell therapy for Crohn's disease is safe. Mesenchymal stem cells also have a solid immunomodulatory effect, preventing the immune system from mistakenly responding to incorrect threats.

References:  

(1) Rendi, M., & Swanson, P. (2019, November 9). Crohn's Disease Pathology. Retrieved from https://emedicine.medscape.com/article/1986158-overview#a3

(2) Mao, Fei, et al. "Mesenchymal Stem Cells and Their Therapeutic Applications in Inflammatory Bowel Disease." Oncotarget, Impact Journals LLC, 6 June 2017, https://www.ncbi.nlm.nih.gov/pubmed/28402942.

(3) Watt, Fiona M, and Ryan R Driskell. “The Therapeutic Potential of Stem Cells.” Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, The Royal Society, 12 Jan. 2010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842697/.

(4) Levy, Michael L., et al. “Phase I/II Study of Safety and Preliminary Efficacy of Intravenous Allogeneic Mesenchymal Stem Cells in Chronic Stroke.” Stroke, vol. 50, no. 10, 2019, pp. 2835–2841., DOI:10.1161/strokeaha.119.026318.

(5) Zhang XM, Zhang YJ, Wang W, Wei YQ, Deng HX. Mesenchymal Stem Cells to Treat Crohn's Disease with Fistula. Hum Gene Ther. 2017 Jul;28(7):534-540. doi: 10.1089/hum.2016.095. PMID: 28132518.

(6) National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Crohn's Disease. (https://www.niddk.nih.gov/health-information/digestive-diseases/crohns-disease) Accessed 5/25/2020.

(7) Rubin DT, Feld LD, Goeppinger SR, Margolese J, Rosh J, Rubin M, Kim S, Rodriquez DM, Wingate L. The Crohn's and Colitis Foundation of America Survey of Inflammatory Bowel Disease Patient Health Care Access. Inflamm Bowel Dis. 2017 Feb;23(2):224-232. doi: 10.1097/MIB.0000000000000994. PMID: 27997434.

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