Stem Cell Therapy and IBD
Can stem cell transplants treat inflammatory bowel disease?
IBD is one of the most actively researched areas of medicine, each year bringing a better understanding of the disease and possible new treatments. One treatment that is being investigated is stem cell therapy with the recent research showing hope that it could be used for many autoimmune diseases. It has to be stressed, however, that clinical trials are still in their early stages. Whilst there are online advertisements for ‘stem cell tourism’ overseas, rigorous Australian research and health care standards (treatment must be evaluated through registered trials and receive government approval to be used) do not apply in these countries and CCA does not recommend participating in these treatments.
What is stem cell therapy?
Stem cells can become any type of cell in the human body. The immature stem cells found in the bone morrow (the hematopoietic stem cells) can be characterised by self-regeneration and ability to become a white cell, a red blood cell or a platelet. Stem cell therapy (also referred to as regenerative medicine) intends, in theory, to repair or even replace diseased cells restoring patient’s healthy functioning. Stem cell therapy (or stem cell transplant) is used effectively in treating patients with certain types of cancer, assisting in recovery after intensive radiotherapy and/or chemotherapy. In the case of leukaemia and lymphoma, stem cell transplants can be used to attack malignant cells directly. The process involves using chemotherapy or radiation (conditioning) to destroy the body’s own immune system along with the cancerous cells and then transplanting hematopoietic stem cells to replace the lost cells. Additionally, the donor’s stem cells (person other than a patient) eradicate any residual cancer cells, an effect known as graft-versus-tumour.
What are the risks?
Stem cell therapy has proven effectiveness for treating leukaemia and lymphoma, but it also has significant risks at every stage of the treatment. During the chemotherapy stage, the destruction of the body’s immune system can increase the risk of infection from bacterial and viral agents. Also, even when the new hematopoietic stem cells are placed inside the body, there is a risk that the new immune cells that grow from the transplanted stem cells could attack the host body, and this is known as graft versus host disease. Overall, there is a significant mortality rate from stem cell therapy due to these risks and death can even occur years after the initial transplant.
What does current research show for hematopoietic (immature cells) stem cell therapy and IBD?
Stem cell therapy (the use of patient’s own stem cells) can generate new immune cells and consequently reset patient’s immune system. For IBD patients it means that the patient’s rebuilt immune system does not recognise the intestinal system as a target to attack. There have been somecases of patients with IBD who received stem cell therapy for another disease and then had remission of their IBD. Unfortunately, it still is not a cure as in many patients IBD will flare after a few years since the transplant. The only stem cell treatment type permitted in Australia is a transplant that uses patient’s own stem cells. This treatment is available for treating disorders of the blood and immune system. However, it is not offered as a treatment for IBD, as there is not enough evidence that the risks outweigh the benefits.
For example, the UK study (2022), focused on testing effectiveness of the hematopoietic stem cell therapy for IBD patients (who did not respond to currently available treatment) reported that among all 23 participants (13 in the stem cell treatment experimental group, and 10 in the standard treatment in the control group) had developed at least one of the serious complications (including two deaths).
What does the future hold?
Immature stem cells (i.e., hematopoietic – described above) are not the only type of stem cells used for stem cell therapy. There is yet another type of stem cells found in the bone marrow (i.e., mesenchymal). These, so called multi-purpose stem cell, can become bone cells, cartilage cells and muscle and fat cells. The use of this cellular material constitutes a new direction in the research in IBD treatment as it offers potential for internal tissue regeneration.
The article has been inspired by the recent published paper available and presented by Bowen Xia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9368934/
To read more about stem cell transplantation go here: