title: Autologous adipose tissue-derived stem cells treatment demonstrated favorable and sustainable therapeutic effect for Crohn's fistula.
abstract: Fistula is a representative devastating complication in Crohn's patients due to refractory to conventional therapy and high recurrence. In our phase I clinical trial, adipose tissue-derived stem cells (ASCs) demonstrated their safety and therapeutic potential for healing fistulae associated with Crohn's disease. This study was carried out to evaluate the efficacy and safety of ASCs in patients with Crohn's fistulae. In this phase II study, forty-three patients were treated with ASCs. The amount of ASCs was proportioned to fistula size and fistula tract was filled with ASCs in combination with fibrin glue after intralesional injection of ASCs. Patients without complete closure of fistula at 8 weeks received a second injection of ASCs containing 1.5 times more cells than the first injection. Fistula healing at week 8 after final dose injection and its sustainability for 1-year were evaluated. Healing was defined as a complete closure of external opening without any sign of drainage and inflammation. A modified per-protocol analysis showed that complete fistula healing was observed in 27/33 patients (82%) by 8 weeks after ASC injection. Of 27 patients with fistula healing, 26 patients completed additional observation study for 1-year and 23 patients (88%) sustained complete closure. There were no adverse events related to ASC administration. ASC treatment for patients with Crohn's fistulae was well tolerated, with a favorable therapeutic outcome. Furthermore, complete closure was well sustained. These results strongly suggest that autologous ASC could be a novel treatment option for the Crohn's fistula with high-risk of recurrence.
authors: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Woo Yong
authors: WY
authors: Lee
authors: Kyu Joo
authors: KJ
authors: Park
authors: Yong Beom
authors: YB
authors: Cho
authors: Sang Nam
authors: SN
authors: Yoon
authors: Kee Ho
authors: KH
authors: Song
authors: Do Sun
authors: DS
authors: Kim
authors: Sang Hun
authors: SH
authors: Jung
authors: Mihyung
authors: M
authors: Kim
authors: Hee-Won
authors: HW
authors: Yoo
authors: Inok
authors: I
authors: Kim
authors: Hunjoo
authors: H
authors: Ha
authors: Chang Sik
authors: CS
authors: Yu
mesh_terms: D000273:Adipose Tissue / Q000166:cytology / Q000637:transplantation*; D000328:Adult; D048708:Cell Growth Processes / Q000502:physiology; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D005402:Fistula / Q000601:surgery*; D006801:Humans; D008297:Male; D012003:Rectal Fistula / Q000209:etiology / Q000601:surgery*; D033581:Stem Cell Transplantation / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: Adipose tissue-derived stem cells; Autologous stem cells; Complete closure of fistula; Crohn's fistula; Sustained response