Intest Res.  2019 Jul;17(3):311-316. 10.5217/ir.2019.00043.

Stem cell-based therapy for inflammatory bowel disease

• Shimizu H
• Suzuki K
• Watanabe M
• Okamoto R

• KMID: 2454739
• DOI: http://doi.org/10.5217/ir.2019.00043

Abstract

Inflammatory bowel disease (IBD) is an idiopathic, multi-etiological disease characterized by inflammation and mucosal destruction of the gastrointestinal tract. Despite the remarkable advance in immunomodulating therapies, there still remains a certain population of patients who are refractory to conventional as well as biologic therapies and fail to achieve mucosal healing. To improve the prognosis of those patients, at least 2 types of stem cells have been tested for their potential therapeutic use. Transplantation of hematopoietic stem cells or mesenchymal stem cells have been tested in several clinical studies, but their beneficial effect still remains controversial. In this review, we would like to overview the recent clinical challenges of stem cell-based therapies in IBD and also introduce our new therapeutic plan of intestinal stem cell transplantation for IBD, based on our ex vivo intestinal organoid culture technique.

Keyword

Mucosal healing; Hematopoietic stem cell; Mesenchymal stem cell; Intestinal stem cell; Organoids

MeSH Terms

Biological Therapy
Culture Techniques
Gastrointestinal Tract
Hematopoietic Stem Cells
Humans
Inflammation
Inflammatory Bowel Diseases*
Mesenchymal Stromal Cells
Organoids
Prognosis
Stem Cell Transplantation
Stem Cells

Figure

• 

  Fig. 1. Intestinal epithelial cells (IECs) are the first barrier against outer environment. The gastrointestinal tract, formed of an IEC monolayer, interacts with the commensal microbiome and protects the organism from pathogenic microbes by secreting antimicrobial peptides and mucins. Further, IECs coordinate with stromal cells, including immune cells and mesenchymal cells, via antigen presentation and cytokine-mediated signaling, to maintain gastrointestinal homeostasis.

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  Fig. 2. Autologous intestinal stem cell (ISC) transplantation on IBD patients. Organoids are generated from biopsy samples taken through colonoscopy of an IBD patient, and further cultured and expanded for transplantation on the wound bed of the same patient. Transplantation is planned to be through colonoscopy.

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