DOP058 Combined stem cells and anticytokine therapy contributes to a more pronounced decrease in the degree of inflammation of the intestinal mucosa in Crohn's disease. (16th January 2018)

• Record Type: Journal Article
• Authors: Fadeeva, N; Knyazev, O; Kagramanova, A; Dobroluybova, E; Donchenko, I; Khomeriki, S; Babayan, A; Lishchinskaya, A; Konoplyannikov, A
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S071
• Page End: S071
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.095
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: One of the new promising methods of treatment of Crohn's disease (CD) is biological therapy with the use of mesenchymal stromal cells (MSCs) of the bone marrow. In a number of cases simultaneously with MSCs, patients receive concomitant anticytokine therapy. Currently, a new strategy for the treatment of Crohn's disease is deep remission of the disease. Objective: to compare the level of immunobiological and histological markers of inflammation - C-reactive protein (CRP), the index of Geboes (IG) and fecal calprotektin (FCP) - in patients with CD receiving cell therapy of MSCs, anticytokine therapy with infliximab (IFX) and combination therapy MSCs of bone marrow and IFX. Methods: A total of 67 patients with luminal form of CD in the form of colitis and ileocolitis of moderate severity were divided into groups depending on the therapy. The first group of patients aged 19 to 58 years (Me-29) ( n = 21) received anti-inflammatory therapy with a culture of MSC 2 million/kg according to the scheme, the second group of patients with CD ( n = 30) aged 23 to 60 years (Me-31) received IFX, the third group of patients with CD ( n = 16) aged 20 to 57 years (Me-33) received MSCs+IFX. The level of CRP, PCP and IG was evaluated at 26 weeks from the start of the therapy. The baseline CRP level was 24.0 ± 1.9; 22.5 ± 2.1 and 23.0 ± 2.4 mg/l, respectively. The initial IG in the patient groups was 4.4 ± 0.2; 4.35 ± 0.2 and 4.6 ± 0.3 points, respectively. The baseline FCP level was 804.8 ± 88.8; 848.3 ± 83.9 and 937.5 ± 125.6 µg/g, respectively. Results: After 26 weeks from the start of the therapy in the first group of patients, the level of C-RP was 9.8 ± 1.1 mg/l, in the second group -8.4 ± 1.3 mg/l, in the third - 7.9 ± 0.9 mg/l ( p > 0.05). After 26 weeks from the start of the therapy the level of FCP in the first group was 88.8 ± 5.3 µg/g, in the second group - 90.6 ± 6.8 µg/g, in the third group - 68, 8 ± 3.3 µg/g (p <0.05 as compared with the first and second groups). After 26 weeks from the start of the therapy the level of the IG in the first group was 0.7 ± 0.1, in the second group -0.66 ± 0.1, in the third group -0.5 ± 0.06 points ( p < 0.001 in comparison with the first and second groups). Conclusions: Combined mesenchymal stromal cells and anticytokine therapy contributes to a more pronounced decrease in the degree of inflammation from the intestinal mucosa in Crohn's disease.