Cx601 (darvadstrocel) for the treatment of perianal fistulizing Crohn's disease. (3rd July 2019)

• Record Type: Journal Article
• Authors: Bislenghi, G.; Wolthuis, A.; Van Assche, G.; Vermeire, S.; Ferrante, M.; D'Hoore, A.
• Is Part Of: Expert opinion on biological therapy. Volume 19:Number 7(2019)
• Page Start: 607
• Page End: 616
• Publication Date: 2019-07-03
• Subjects: Crohn's disease -- perianal fistula -- mesenchymal stem cells; Gene therapy -- Periodicals; Protein drugs -- Periodicals; Peptide drugs -- Periodicals; Immunotherapy -- Periodicals; Drug delivery systems -- Periodicals; 615.5
• DOI: 10.1080/14712598.2019.1623876
• Languages: English
• ISSNs: 1471-2598

Abstract

ABSTRACT: Introduction : Given the well-documented difficulty to treat perianal fistulizing Crohn's disease (pCD), with 40% of patients experiencing recurrence even after reiterative surgery and advanced medical therapy, research in this field has focused on the role of mesenchymal stem cells (MSC). Areas covered : The aim of this article is to furnish an overview of the pathogenetic mechanisms, clinical applications and evidences for the use of MSC for pCD with particular focus on adipose-derived allogenic MSC including darvadstrocel. Expert Opinion : The effect of MSC on fistula healing is probably mediated by their anti-inflammatory properties more than by their ability to engraft and trans-differentiate in the healthy tissue. A holistic treatment of pCD, addressing different pathophysiological factors, may represent the key for an improvement in the healing rate. In this setting, MSC might play a role as 'augmentation' therapy in combination with more conventional treatments. Whether MSC have benefit in non-complex fistula in biological naïve patients, in complex fistula with many tracts and/or in rectovaginal fistulas, are unexplored fields that need further investigation. A central registry of pCD patients undergoing treatment with MSC should be created in order to elucidate the efficacy, safety and costs of stem cells treatment on long term follow up.