Teamwork Makes the Dream Work: IBD Stem Cell Therapy Needs Us All
Although the data are promising, it may take a long time for this to become a common therapy for patients with IBD.
The narrative surrounding the development of stem cell therapy for the treatment of inflammatory bowel disease was best said by Amy Lightner, MD, when she noted that we as gastroenterologists and colorectal surgeons are still in the early phases of navigating this therapy.
However, the most obvious use of stem cells in IBD seems to be within the fistulizing population with Crohn’s disease. There’s a pressing need in fistulizing Crohn’s disease because patients may likely not respond completely to medical therapy, especially if it’s a long-standing fistula. That’s where stem cells may be a useful adjunctive therapy. The stem cells can either be directly injected at the time of an exam under anesthesia, such as the TiGenix trials, or with a stem-cell coated fistula plug.
I had one of my patients enter the phase 1 trial he was a part of that was published in Gastroenterology and that patient clearly improved in the trial. I have seen firsthand how this therapy can be effective.
I agree with Lightner and Faubion that a collaborative, multidisciplinary team is necessary for the success of stem cell therapy in IBD. Which is why this may be an effort that stays at specialized centers until we work out all the details. Tertiary centers likely have the sufficient expertise that is needed across multiple areas for it to work.
Lightner highlighted that the stem cells are fragile and need to be handled properly, as well as frozen or thawed properly, which likely will take them out of community-based care locations.
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