Yantian Cao1, Qi Su2, Bangjie Zhang1, Fangfang Shen3, Shaoshan Li4. 1. Department of Gastroenterology, The Third Affiliated Hospital of Xinxiang Medical University, Hua Lan Avenue, Xinxiang, 453003, Henan Province, China. 2. Department of General surgery, The Third Affiliated Hospital of Xinxiang Medical University, Hua Lan Avenue, Xinxiang, 453003, Henan Province, China. 3. The Key Laboratory for Tumor Translational Medicine, The Third Affiliated Hospital of Xinxiang Medical University, Hua Lan Avenue, Xinxiang, 453003, Henan Province, China. 4. Department of General surgery, The Third Affiliated Hospital of Xinxiang Medical University, Hua Lan Avenue, Xinxiang, 453003, Henan Province, China. shaoshanlioo1@sina.com.
Abstract
BACKGROUND: Fistulas have puzzled us all the time and stem cell therapy for it is still in its infancy. We conducted a meta-analysis and systematic review to evaluate the efficacy of stem cells and its potential mechanisms in the management of Crohn's fistula. METHODS: Electronic databases were searched comprehensively for studies reporting the efficacy and safety of stem cells in patients with any form of Crohn's fistula. A random-effects model was used, and all outcomes were calculated by SPSS 24.0. RESULTS: Twenty-nine articles with 1252 patients were included. It showed that stem cell group had a higher rate of fistula healing compared to placebo group in patients of Crohn's fistula (61.75% vs 40.46%, OR 2.21, 95% CI 1.19 to 4.11, P < 0.05). 3 × 107 cells/mL stem cell (SC) group had an advantage in fistula healing rate with 71.0% compared to other doses group of stem cells (RR 1.3, 95% CI 0.76 to 2.22). And the healing rates of patients with perianal and transsphincteric fistulas (77.95%, 76.41%) were higher than those with rectovaginal fistulas. It was an amazing phenomenon that CDAI and PDAI scores occurred an obviously transient rise with the use of stem cells after 1 month (both of P < 0.05), while they returned to the baseline level by giving stem cells 3 months later. Furthermore, the incidence rate of treatment-related adverse events in the stem cell group was significantly lower than in the placebo group (RR 0.58, 95% CI 0.30 to 1.14). CONCLUSIONS: Our study has highlighted that stem cells was a promising method in the treatment of Crohn's fistula based on its higher efficacy and lower incidence of adverse events, especially ADSCs and Cx601. While it also needs more clinical and pre-clinical studies to strengthen evidences in the future.
BACKGROUND: Fistulas have puzzled us all the time and stem cell therapy for it is still in its infancy. We conducted a meta-analysis and systematic review to evaluate the efficacy of stem cells and its potential mechanisms in the management of Crohn's fistula. METHODS: Electronic databases were searched comprehensively for studies reporting the efficacy and safety of stem cells in patients with any form of Crohn's fistula. A random-effects model was used, and all outcomes were calculated by SPSS 24.0. RESULTS: Twenty-nine articles with 1252 patients were included. It showed that stem cell group had a higher rate of fistula healing compared to placebo group in patients of Crohn's fistula (61.75% vs 40.46%, OR 2.21, 95% CI 1.19 to 4.11, P < 0.05). 3 × 107 cells/mL stem cell (SC) group had an advantage in fistula healing rate with 71.0% compared to other doses group of stem cells (RR 1.3, 95% CI 0.76 to 2.22). And the healing rates of patients with perianal and transsphincteric fistulas (77.95%, 76.41%) were higher than those with rectovaginal fistulas. It was an amazing phenomenon that CDAI and PDAI scores occurred an obviously transient rise with the use of stem cells after 1 month (both of P < 0.05), while they returned to the baseline level by giving stem cells 3 months later. Furthermore, the incidence rate of treatment-related adverse events in the stem cell group was significantly lower than in the placebo group (RR 0.58, 95% CI 0.30 to 1.14). CONCLUSIONS: Our study has highlighted that stem cells was a promising method in the treatment of Crohn's fistula based on its higher efficacy and lower incidence of adverse events, especially ADSCs and Cx601. While it also needs more clinical and pre-clinical studies to strengthen evidences in the future.
Authors: Gert Van Assche; Axel Dignass; Julian Panes; Laurent Beaugerie; John Karagiannis; Mathieu Allez; Thomas Ochsenkühn; Tim Orchard; Gerhard Rogler; Edouard Louis; Limas Kupcinskas; Gerassimos Mantzaris; Simon Travis; Eduard Stange Journal: J Crohns Colitis Date: 2010-01-15 Impact factor: 9.071
Authors: Julián Panés; Damián García-Olmo; Gert Van Assche; Jean Frederic Colombel; Walter Reinisch; Daniel C Baumgart; Axel Dignass; Maria Nachury; Marc Ferrante; Lili Kazemi-Shirazi; Jean C Grimaud; Fernando de la Portilla; Eran Goldin; Marie Paule Richard; Mary Carmen Diez; Ignacio Tagarro; Anne Leselbaum; Silvio Danese Journal: Gastroenterology Date: 2017-12-24 Impact factor: 22.682
Authors: Ilse Molendijk; Bert A Bonsing; Helene Roelofs; Koen C M J Peeters; Martin N J M Wasser; Gerard Dijkstra; C Janneke van der Woude; Marjolijn Duijvestein; Roeland A Veenendaal; Jaap-Jan Zwaginga; Hein W Verspaget; Willem E Fibbe; Andrea E van der Meulen-de Jong; Daniel W Hommes Journal: Gastroenterology Date: 2015-06-25 Impact factor: 22.682
Authors: Francesco Colombo; Francesco Cammarata; Caterina Baldi; Francesco Rizzetto; Andrea Bondurri; Stefania Carmagnola; Daniele Gridavilla; Giovanni Maconi; Sandro Ardizzone; Piergiorgio Danelli Journal: Front Surg Date: 2022-02-07