eISSN: 1897-4317
ISSN: 1895-5770
Gastroenterology Review/Przegląd Gastroenterologiczny
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4/2018
vol. 13
 
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abstract:
Letter to the Editor

Successful treatment of an enterovesical fistula due to Crohn’s disease with stem cell transplantation: a case report

Andrzej Moniuszko, Anna Sarnowska, Wojciech Rogowski, Marek Durlik, Anna Włuka, Grażyna Rydzewska

Gastroenterology Rev 2018; 13 (4): 332–336
Online publish date: 2018/12/11
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Crohn’s disease (CD) is a chronic, progressive inflammatory disease affecting the digestive tract. Up to 30% of patients develop a fistulising disease during their lifetime, leading to the development of a variety of fistulas between the gastrointestinal tract and nearby tissues, such as enterocutaneous, enterovesical or enterovaginal fistulas. Even in the era of biological agents, including anti-TNF drugs, approximately one-third of patients will suffer from fistulas that are chronic and resistant to standard treatments [1], which may lead to dangerous and life-threatening complications.
Recently, mesenchymal stem cells (MSC) were tested for the treatment of fistulising disease in phase II and phase III clinical trials [2–5]. Thanks to their high anti-inflammatory and regenerative potential, MSC exerted strong paracrine effects in perianal fistulas, producing positive effects [5]. However, in these trials, the regenerative cells were obtained from healthy donors. Among the various methods used to obtain stromal cells, the isolation of autologous adipose tissue-derived regenerative cells (ADRC) using the Celution system is one of the most novel and clinically applicable. Herein, we provide the first report of complete enterovesical fistula resolution following treatment with autologous ADRC.
A 52-year-old female who had been suffering from CD for 12 years was admitted to our clinic with a severe bacterial urinary tract infection. She had never attained clinical remission using steroids, immunosuppressants, anti-TNF agents with a short dosing interval, or alternative treatments such as cyclosporine, tacrolimus, or thalidomide. Consequently, she suffered from numerous complications, which led to a significant number of laparotomies. She had undergone multiple segmental resections of the small intestine and colectomy with ileostomy. Only maintenance therapy with adalimumab once a week with concomitant azathioprine resulted in a relative clinical remission. However, she still suffered from frequent perianal and peristomal fistulas, which led to several surgeries to reposition the stoma.
At the time of admission, the patient was suffering from pyrexia (up to 39°C) and dysuria; she also noted the passage of air and faeces during urination. The general state of the patient was critical because of severe undernutrition (BMI 15) and progressive urinary tract infection. A urine culture revealed severe polybacterial infection with...


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references:
Bougen G, Siproudhis L, Gizard E, et al. Long-term outcome of perianal fistulizing Crohn’s disease treated with infliximab. Clin Gastroenterol Hepatol 2013; 11: 975-81.
Herreros MD, Garcia-Arranz M, Guadalajara H, et al. Autologous expanded adipose-derived stem cells for the treatment of complex cryptoglandular perianal fistulas: a phase III randomized clinical trial (FATT 1: fistula Advanced Therapy Trial 1) and long-term evaluation. Dis Colon Rectum 2012; 55: 762-72.
Garcia-Olmo D, Herreros D, Pascual I, et al. Expanded adipose-derived stem cells for the treatment of complex perianal fistula: a phase II clinical trial. Dis Colon Rectum 2009; 52: 79-86.
Guadalajara H, Herreros D, De-La-Quintana P, et al. Long-term follow-up of patients undergoing adipose-derived adult stem cell administration to treat complex perianal fistulas. Int J Colorectal Dis 2012; 27: 595-600.
de la Portilla F, Alba F, García-Olmo D, et al. Expanded allogeneic adipose-derived stem cells (eASCs) for the treatment of complex perianal fistula in Crohn’s disease: results from a multicenter phase I/IIa clinical trial. Int J Colorectal Dis 2013; 28: 313-23.
Lysak D, Vlas T, Holubova M, et al. In vitro testing of immunosupressive effects of mesenchymal stromal cells on lymphocytes stimulated with alloantigens. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2013; 157: XX.
Garcia-Olmo D, Herreros D, Pascual M, et al. Treatment of enterocutaneous fistula in Crohn’s disease with adipose-derived stem cells: a comparison of protocols with and without cell expansion. Int J Colorectal Dis 2009; 24: 27-30.
Garcia-Olmo D, Herreros D, De-La-Quintana P, et al. Adipose-derived stem cells in Crohn’s rectovaginal fistula. Case Report Med 2010; 2010: 961758.
Lee WY, Park KJ, Cho YB, et al. Autologous adipose tissue-derived stem cells treatment demonstrated favorable and sustainable therapeutic effect for Crohn’s fistula. Stem Cells 2013; 31: 2575-81.
Chang P, Qu Y, Liu Y, et al. Multi-therapeutic effects of human adipose-derived mesenchymal stem cells on radiation-induced intestinal injury. Cell Death Dis 2013; 4: e685.
Kang BJ, Lee SH, Kweon OK, et al. Differentiation of canine adipose tissue-derived mesenchymal stem cells towards endothelial progenitor cells. Am J Vet Res 2014; 75: 685-91.
Shi JG, Fu WJ, Wang XX, et al. Transdifferentiation of human adipose-derived stem cells into urothelial cells: potential for urinary tract tissue engineering. Cell Tissue Res 2012; 347: 737-46.
Jack GS, Almeida FG, Zhang R, et al. Processed lipoaspirate cells for tissue engineering of the lower urinary tract: implications for the treatment of stress urinary incontinence and bladder reconstruction. J Urol 2005; 174: 2041-5.
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