Role of Stem Cell Transplantation in the Treatment of Ulcerative Colitis

Abstract

Ulcerative colitis is an inflammatory bowel disease leading to inflammation of the colon and causing painful ulcers which can bleed, cause mucous production and infection. Common symptoms include bloody diarrhea, abdominal pain and weight loss which may be mild to severe and affect individual's quality of life. Currently, therapy is most often implemented in a stepwise fashion, progressing through amino salicylates, corticosteroids, immunosuppressives, and anti-TNF drugs. Primary and secondary failure to respond to approved therapies represents unmet needs in the treatment of IBD. A novel and exciting approach could be offered through the current development in the field of stem cell biology. Two streams of research, experimental and clinical, are the origin of the increasing utilization of stem cell therapies for severe immune-mediated diseases (IMIDs) including IBD. Other medical researches reflect that SCT has made improvement in the quality of life to patients of UC but the mechanism for the effect isn't clear but it interpreted through the powerful immunomodulatory effects of SCs and its ability to stimulate regeneration of intestinal mucosa.

The present pilot study is a clinical trial that was done in Ain Shams University to investigate the role of bone marrow stem cell transplantation as a potential line of treatment in ulcerative colitis patients. It was conducted on 10 patients diagnosed and managed according to European Crohn's and Colitis Organization. They were selected randomly of various extents and severity, and they were assessed according to The Montreal classification, Truelove & Witts severity scoring system and Mayo activity score index. This study hypothesized that infusion of HSCs may help to reverse the inflammatory process in patients with ulcerative colitis. Thus, we conducted a human trial to evaluate safety and feasibility of autologous bone marrow HSC transplantation in Egyptian patients with ulcerative colitis and to evaluate the HSC transplantation as a therapeutic option compared to the conventional treatment. All patients assessed before and 3 months after autologous hematopoietic stem cells transplantation and follow up includes comparison the changes in the patient's clinical assessment, nutritional status, biochemical profile, endoscopic findings, medication requirement, and quality of life of those patients before and after potential therapy.