title: Treatment of enterocutaneous fistula in Crohn's Disease with adipose-derived stem cells: a comparison of protocols with and without cell expansion.
abstract: BACKGROUND
  Expanded adipose-derived stem cells (ASC) have been shown to be effective in treating Crohn's patients with enterocutaneous fistulas. It is possible that unexpanded cells corresponding to the stromal vascular fraction (SVF) may also be effective.
  
  
  METHODS
  A subpopulation of patients from a previous proof-of-concept phase I study with enterocutaneous fistulas received autologous expanded ASCs. The same selection criteria for inclusion were applied to patients who underwent SVF implantation to treat enterocutaneous fistulas. After tract curettage, cell suspensions (either SVF cells from lipoaspirate or expanded ASCs) were injected into the tract walls, and the fistulous tract was sealed with fibrin adhesive (with or without cells).
  
  
  RESULTS
  In the series that received ASCs, four fistulas could be evaluated, and cure was achieved in three out of four cases. In the series that received SVF cells, four fistulas were evaluated, with cure achieved in one out of four cases.
  
  
  CONCLUSIONS
  Although a comparison of case series cannot be considered firm evidence, a therapeutic protocol that uses expansion prior to implantation does seem to be more effective than one that uses SVF cells directly from a lipoaspirate sample.
authors.affiliation: Department of Surgery, La Paz University Hospital, Madrid, Spain. damian.garcia@uam.es
authors.forename: Damian
authors.initials: D
authors.lastname: Garcia-Olmo
authors.forename: Dolores
authors.initials: D
authors.lastname: Herreros
authors.forename: Maria
authors.initials: M
authors.lastname: Pascual
authors.forename: Isabel
authors.initials: I
authors.lastname: Pascual
authors.forename: Paloma
authors.initials: P
authors.lastname: De-La-Quintana
authors.forename: Jacobo
authors.initials: J
authors.lastname: Trebol
authors.forename: Mariano
authors.initials: M
authors.lastname: Garcia-Arranz
mesh_terms: D000273:Adipose Tissue / Q000166:cytology*; D000328:Adult; D002469:Cell Separation; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation; D017154:Stromal Cells / Q000166:cytology; D014014:Tissue Adhesives / Q000627:therapeutic use; D014182:Transplantation, Autologous; D014945:Wound Healing
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives