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Mesenchymal stromal cell therapy in intestinal diseases

Ciccocioppo, Rachel; Fioravante, Marzia; Frulloni, Luca

Current Opinion in Organ Transplantation: October 8, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MOT.0000000000000586
REVIEW: PDF Only

Purpose of review The advent of cell therapies, mainly based on the use of mesenchymal stromal cells (MSCs), represents a great step forward in the treatment of immune-mediated conditions. Here, we focus on those intestinal disorders wherein MSCs have been applied for immunotherapeutic purposes and whose results are available.

Recent findings By virtue of their ability to favour both tissue regeneration and immune tolerance, together with a substantial lack of immunogenicity, MSCs have gained huge attention in the last decade. Following abundant positive experimental data, a sizable number of clinical trials using MSCs as a new treatment in chronic inflammatory intestinal diseases were carried out with promising results and several are still ongoing. The main indication was refractory Crohn's disease wherein both feasibility and safety clearly emerged when treating the luminal phenotype with intravenous infusion/s, albeit no definitive conclusion on efficacy may be drawn. By contrast, the availability of robust demonstration also on the efficacy when treating the fistulizing phenotype through local injection/s of MSCs has led to approval of the marketing of an industrial preparation (darvadstrocel).

Summary Successful clinical implementation of this attractive option is hampered by a number of obstacles arising from methodology and regulation issues, which require the institution of interdisciplinary task forces before this cell therapy becomes a bedside reality.

Gastroenterology Unit, Department of Medicine, AOUI Policlinico G.B. Rossi & University of Verona, Verona, Italy

Correspondence to Professor Rachel Ciccocioppo, MD, Gastroenterology Unit, Department of Medicine, AOUI Policlinico G.B. Rossi & University of Verona, Piazzale L.A. Scuro 10, Verona 37134, Italy. Tel: +39 045 8124466; fax: +39 045 8027495; e-mail: rachele.ciccocioppo@univr.it

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