title: Modern Treatments and Stem Cell Therapies for Perianal Crohn's Fistulas.
abstract: Crohn's disease (CD) is a complex disorder with important incidence in North America. Perianal fistulas occur in about 20% of patients with CD and are almost always classified as complex fistulas. Conventional treatment options have shown different success rates, yet there are data indicating that these approaches cannot achieve total cure and may not improve quality of life of these patients. Fibrin glue, fistula plug, topical tacrolimus, local injection of infliximab, and use of hematopoietic stem cells (HSC) and mesenchymal stem cells (MSC) are newly suggested therapies with variable success rates. Here, we aim to review these novel therapies for the treatment of complex fistulizing CD. Although initial results are promising, randomized studies are needed to prove efficacy of these approaches in curing fistulizing perianal CD.
authors.affiliation: St Paul's Hospital, Vancouver BC, Canada.
authors.forename: Alghalya Khalid Sulaiman
authors.initials: AK
authors.lastname: Al-Maawali
authors.affiliation: University of British Columbia, Vancouver BC, Canada.
authors.forename: Phuong
authors.initials: P
authors.lastname: Nguyen
authors.affiliation: St Paul's Hospital, Vancouver BC, Canada; University of British Columbia, Vancouver BC, Canada.
authors.forename: P Terry
authors.identifier: 0000-0001-6995-9285
authors.initials: PT
authors.lastname: Phang
mesh_terms: D003424:Crohn Disease / Q000150:complications*; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab / Q000627:therapeutic use; D045164:Mesenchymal Stem Cell Transplantation; D012003:Rectal Fistula / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D016559:Tacrolimus / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D015718:Fibrin Tissue Adhesive; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D016559:Tacrolimus