Anticytokine therapy with anti-TNF-alpha drugs contributes to the achievement of stable remission of Crohn's disease (CD). For the treatment of CD are also using mesenchymal stromal cells (MSCs).Objective:
To examine the long-term efficacy (7 yr) therapy mesenchymal stromal cells (MSCs) from the bone marrow of patients with luminal Crohn's disease (CD).Methods:
Eighty patients with luminal form CD (terminal ileitis, colitis and ileokolit) were divided into 2 groups. The first group of patients aged 19 to 58 years old (Me-29) (n = 34) received the culture of MSCs under the scheme (0-1-2-3, then every 26 wk). The second group of patients with CD (n = 46) aged 20 to 62 years (ME-28) received standard anti-inflammatory therapy with 5-aminosalicylic acid (5-ASA), glucocorticosteroids (GCS) and immunosuppressive (IS). Evaluation of the effectiveness of therapy on the level of the index of activity of Crohn's disease (CDAI <150 point) was carried out at 12, 24, 36, 48, 60, 72 and 84 months after initiation of therapy.Results:
Among the patients in 1-st group relapse in the 12 months of observation occurred in 4/36 patients (11.76%). In 2-st group, relapse occurred in 5/46 (10.8%) (P = 0.82). After 24 months in the 1-st group of patients receiving MSC, relapse occurred in 6/34 (17.6%). In the 2-nd group of patients relapse in 19/27 (41.3%) (P = 0.044). After 36 months in 1-st group patients with a relapse of the disease in 11/34 (32.3%). In the 2-nd group relapse 29/46 (63.1%) (P = 0.01). After 48 months in 1-st group, receiving MSCs, relapsed in 15/34 (44.1%). In the 2-nd group relapse in 33/46 (71.7%) (P = 0.023). After 60 months in the first group relapse in 19/34 (55.9%). In the second group relapse 40/46 (86.9%) (P = 0.004). After 72 months in first group relapse 25/34 (73.5%). In second group relapse of the CD in 45/46 (97.8%) (P = 0.001). After 84 months in first group relapse CD in 29/34 (85.3%). In the second group of patients CD relapse occurred in 46/46 (100.0%) (P = 0.011).Conclusions:
Mesenchymal stromal cells transplantation helps to maintain a long-term clinical remission in patients with luminal Crohn's disease compared with GCS/IS therapy.