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Hépato-Gastro & Oncologie Digestive

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Contribution of mesenchymal stem cells in management of Crohn's Disease peri-anal fistulas: Science fiction or near future? Volume 25, issue 5, Mai 2018

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Authors
1 Groupe hospitalier Paris Saint-Joseph, Institut Léopold Bellan, Service de Proctologie Médico-Chirurgicale, 185, rue Raymond Losserand, 75014 Paris, France
2 Hôpital Beaujon, Service de MICI et assistance nutritive, 100 boulevard du Général Leclerc, 92110 Clichy, France
3 Hôpital Européen Georges Pompidou, Service d’hépato-gastroentérologie et endoscopies, 20 rue Leblanc, 75015 Paris, France
* Tirés à part

The specific anoperineal involvement of Crohn's disease (CD) occurs in one third of patients after 20 years of evolution, and reach fistulas healing is often difficult with conventional treatments. The injection of mesenchymal stem cells (MSCs) has great theoretical interests because of their immunomodulatory, antifibrotic and pro-angiogenic properties. Several open-label studies have evaluated the efficacy of fistula-tract filling with MSCs with variable short-term fistula closure rates (30-70%). The patients were refractory to anti TNF and the injection modalities in these studies were diverse. Three controlled trials confirmed the superiority of local injection treatment with CSM over placebo in the short and long term. Several questions remain unresolved to determine the best way to use this promising therapy.

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