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Umbilical Cord Mesenchymal Stem Cell Treatment for Crohn’s Disease: A Randomized Controlled Clinical Trial

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Background/Aims: Stem cell therapy has been applied to treat a variety of autoimmune diseases, including Crohn’s disease (CD), but few studies have examined the use of umbilical cord mesenchymal stem cells (UC-MSCs). This trial sought to investigate the efficacy and safety of UC-MSCs for the treatment of CD. Methods: Eighty-two patients who had been diagnosed with CD and had received steroid maintenance therapy for more than 6 months were included in this study. Forty-one patients were randomly selected to receive a total of four peripheral intravenous infusions of 1×106 UC-MSCs/kg, with one infusion per week. Patients were followed up for 12 months. The Crohn’s disease activity index (CDAI), Harvey-Bradshaw index (HBI), and corticosteroid dosage were assessed. Results: Twelve months after treatment, the CDAI, HBI, and corticosteroid dosage had decreased by 62.5±23.2, 3.4±1.2, and 4.2±0.84 mg/day, respectively, in the UC-MSC group and by 23.6±12.4, 1.2±0.58, and 1.2±0.35 mg/day, respectively, in the control group (p<0.01, p<0.05, and p<0.05 for UC-MSC vs control, respectively). Four patients developed a fever after cell infusion. No serious adverse events were observed. Conclusions: UC-MSCs were effective in the treatment of CD and produced mild side effects.

Abstract

Background/Aims: Stem cell therapy has been applied to treat a variety of autoimmune diseases, including Crohn’s disease (CD), but few studies have examined the use of umbilical cord mesenchymal stem cells (UC-MSCs). This trial sought to investigate the efficacy and safety of UC-MSCs for the treatment of CD. Methods: Eighty-two patients who had been diagnosed with CD and had received steroid maintenance therapy for more than 6 months were included in this study. Forty-one patients were randomly selected to receive a total of four peripheral intravenous infusions of 1×106 UC-MSCs/kg, with one infusion per week. Patients were followed up for 12 months. The Crohn’s disease activity index (CDAI), Harvey-Bradshaw index (HBI), and corticosteroid dosage were assessed. Results: Twelve months after treatment, the CDAI, HBI, and corticosteroid dosage had decreased by 62.5±23.2, 3.4±1.2, and 4.2±0.84 mg/day, respectively, in the UC-MSC group and by 23.6±12.4, 1.2±0.58, and 1.2±0.35 mg/day, respectively, in the control group (p<0.01, p<0.05, and p<0.05 for UC-MSC vs control, respectively). Four patients developed a fever after cell infusion. No serious adverse events were observed. Conclusions: UC-MSCs were effective in the treatment of CD and produced mild side effects.

참고문헌 (21)

  1. Bouguen G, "Surgery for adult Crohn's disease: what is the actual risk?", Gut, 60, pp.1178~1181 (2011)[DOI]
  2. Hanauer SB, "Crohn's disease: step up or top down therapy", Best Pract Res Clin Gastroenterol, 17, pp.131~137 (2003)[DOI]
  3. Shaffer VO, "Surgical management of Crohn's disease", Langenbecks Arch Surg, 398, pp.13~27 (2013)[DOI]
  4. Fornaro R, "Crohn's disease surgery: problems of postoperative recurrence", Chir Ital, 60, pp.761~781 (2008)
  5. Bouma G, "The immunological and genetic basis of inflammatory bowel disease", Nat Rev Immunol, 3, pp.521~533 (2003)[DOI]
  6. Wainstein C, "Mesenchymal stem cells and platelet-rich plasma in the treatment of patients with perineal Crohn's disease", Int J Colorectal Dis, 31, pp.725~726 (2016)[DOI]
  7. Jauregui-Amezaga A, "Long-lasting remission induced by syngeneic haematopoietic stem cell transplantation in a patient with refractory Crohn's disease", J Crohns Colitis, 10, pp.1122~1124 (2016)[DOI]
  8. Panes J, "Expanded allogeneic adipose-derived mesenchymal stem cells (Cx601) for complex perianal fistulas in Crohn's disease: a phase 3 randomised, double-blind controlled trial", Lancet, 388, pp.1281~1290 (2016)[DOI]
  9. Jauregui-Amezaga A, "Improving safety of autologous haematopoietic stem cell transplantation in patients with Crohn's disease", Gut, 65, pp.1456~1462 (2016)[DOI]
  10. Hawkey CJ, "Autologous hematopoetic stem cell transplantation for refractory Crohn disease: a randomized clinical trial", JAMA, 314, pp.2524~2534 (2015)[DOI]
  11. Mayer L, "Safety and tolerability of human placenta-derived cells (PDA001) in treatment-resistant Crohn's disease: a phase 1 study", Inflamm Bowel Dis, 19, pp.754~760 (2013)[DOI]
  12. Cai J, "Umbilical cord mesenchymal stromal cell with autologous bone marrow cell transplantation in established type 1 diabetes: a pilot randomized controlled open-label clinical study to assess safety and impact on insulin secretion", Diabetes Care, 39, pp.149~157 (2016)[DOI]
  13. Garcia-Olmo D, "Expanded adipose-derived stem cells for the treatment of complex perianal fistula including Crohn's disease", Expert Opin Biol Ther, 8, pp.1417~1423 (2008)[DOI]
  14. Gonzalez MA, "Adipose-derived mesenchymal stem cells alleviate experimental colitis by inhibiting inflammatory and autoimmune responses", Gastroenterology, 136, pp.978~989 (2009)[DOI]
  15. Duijvestein M, "Autologous bone marrow-derived mesenchymal stromal cell treatment for refractory luminal Crohn's disease: results of a phase I study", Gut, 59, pp.1662~1669 (2010)[DOI]
  16. Forbes GM, "A phase 2 study of allogeneic mesenchymal stromal cells for luminal Crohn's disease refractory to biologic therapy", Clin Gastroenterol Hepatol, 12, pp.64~71 (2014)[DOI]
  17. Nemeth K, "Bone marrow stromal cells attenuate sepsis via prostaglandin E(2)-dependent reprogramming of host macrophages to increase their interleukin-10 production", Nat Med, 15, pp.42~49 (2009)[DOI]
  18. Cai J, "Cotransplantation of bone marrow mononuclear cells and umbilical cord mesenchymal stem cells in avascular necrosis of the femoral head", Transplant Proc, 46, pp.151~155 (2014)[DOI]
  19. Cyranoski D, "Korean deaths spark inquiry", Nature, 468, pp.485~ (2010)[DOI]
  20. Aggarwal S, "Human mesenchymal stem cells modulate allogeneic immune cell responses", Blood, 105, pp.1815~1822 (2005)[DOI]
  21. Wu Z, "Autologous bone marrow mononuclear cell infusion and hyperbaric oxygen therapy in type 2 diabetes mellitus: an open-label, randomized controlled clinical trial", Cytotherapy, 16, pp.258~265 (2014)[DOI]

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