P645 Dynamics of proinflammatory cytokines in patients with Crohn's disease who received combined therapy with mesenchymal stromal cells of bone marrow and azathioprine. (16th January 2018)

• Record Type: Journal Article
• Authors: Knyazev, O; Fadeeva, N; Babayan, A; Dobroluybova, E; Donchenko, I
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S437
• Page End: S437
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.772
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: Mesenchymal stromal cells (MSCs) are used for the treatment of chronic inflammatory and autoimmune diseases in recent years, including inflammatory bowel disease (IBD). In most cases, together with the MSC, patients receiving concomitant immunosuppressive therapy. It is found that immunomodulatory drugs (azathioprine (AZA), methotrexate, 6-mercaptopurine, infliximab (IFX). The aim of this study was to evaluate the effectiveness of therapy MSCs of the bone marrow of patients with Crohn's disease (CD) receiving azathioprine. Methods: Thirty-four patients with luminal form CD were divided into two groups. The first group of patients aged 19–58 years old (Me-29) ( n = 15) was treated with anti-inflammatory therapy with MSCs culture in combination with AZA. The second group of patients with CD ( n = 19) aged 23–60 years old (Me-31) received MSCs according to the recommended scheme without AZA. To assess the effectiveness of anti-inflammatory therapy was determined by the dynamics of the level of pro-inflammatory interleukins (IL) – TNF-α, IFN-γ and IL-1β at 2, 6, and 12 months from the start of MSC therapy. Initial level of IFN-γ in the first group was 110.4 ± 12.5 pg/ml, in the second − 450.8 ± 22.4 pg/ml ( p < 0.05), TNF-α in first group – 13.9 ± 1.9 pg/ml, in the second – 66.7 ± 14.2 pg/ml ( p < 0.05), IL-1β in first group–5.7 ± 0.28 pg/ml, in the second – 9.2 ± 0.2 pg/ml ( p < 0.05). Results: After 2 months of therapy MSCs level of IFN-γ in first group was significantly decreased from baseline and was 86.5 ± 9.1 pg/ml, the second was 96.9 ± 12.1 pg/ml (between groups p = 0.5), TNF-α in first group decreased to 39.6 ± 8.4 pg/ml, in the second – 56.5 ± 10.7 pg/ml (between groups p = 0.2), IL-1β in first group −50.7 ± 9.3 pg/ml, in the second – 56.2 ± 10.2 pg/ml (between groups p = 0.7). After 6 months of therapy MSCs level of IFN-γ in first group decreased and amounted to 79.4 ± 8.5 pg/ml, in the second – 80.8 ± 7.3 pg/ml (between groups p = 0.9), TNF-α in first group decreased to 44.9 ± 6.3 pg/ml, in the second – 49.7 ± 10.4 pg/ml (between groups p = 0.7). IL-1β in first group – 45.6 ± 7.3 pg/ml, in the second – 54.2 ± 9.2 pg/ml (between groups p = 0.45). After 12 months of initiation of therapy MSCs level of IFN-γ in first group decreased and amounted to 90.8 ± 6.5 pg/ml, in the second – 128.8 ± 12.3 pg/ml (between groups p = 0.02), TNF-α in the first group – 78.9 ± 10.5 pg/ml, in the second – 116.9 ± 13.2 pg/ml (between groups p = 0.04), IL-1β in first group – 68.7 ± 8.9 pg/ml, in the second – 96.9 ± 9.6 pg/ml (between groups p = 0.03) Conclusions: After 1 year of observation, combined treatment of AZA and MSC significantly reduces the level of pro-inflammatory cytokines, which may have a more pronounced anti-inflammatory therapeutic effect.