학술논문
Three-year outcome of local injection of autologous stromal vascular fraction cells and microfat in refractory perianal fistulas of Crohn's disease.
Document Type
Article
Author
Guillo, Lucas; Grimaud, Fanny; Houser, Fanny; Prost, Caroline; Jouve, Elisabeth; Philandrianos, Cécile; Abellan, Maxime; Veran, Julie; Visee, Carine; Beyer-Berjot, Laura; Desjeux, Ariadne; Dignat-George, Françoise; Leone, Marc; Grimaud, Jean-Charles; Sabatier, Florence; Serrero, Mélanie; Magalon, Jérémy
Source
Subject
*CROHN'S disease
*FISTULA
*MESENCHYMAL stem cells
*INJECTIONS
*REFRACTORY materials
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Language
ISSN
1757-6512
Abstract
Perianal fistulas in Crohn's disease are frequent and disabling, with a major impact on patients' quality of life. Cell-based therapy using mesenchymal stem cells represents new hope for these patients, but long-term efficacy remains challenging. In a pilot study, including patients with refractory complex perianal fistulas, autologous adipose-derived stromal vascular fraction (ADSVF) combined with microfat achieved combined remission in 60% of cases, with a good safety profile at 1 year. The purpose of this study is to assess whether these results were maintained at longer term. The safety and efficacy data of the ten patients were evaluated retrospectively 3 years after injection on the basis of clinical and radiological data. MRI were analysed according to the MAGNIFI-CD score. No adverse event was attributed to the experimental stem-cell treatment. Combined remission was achieved in 7 patients (70%) and associated with a significant improvement in the MAGNIFI-CD MRI score. In conclusion, the safety and efficacy of ADSVF and microfat injection in Crohn's disease fistulas were maintained at 3 years, demonstrating that this innovative strategy is effective in producing a long-lasting healing effect. The ongoing multicentre randomized placebo-controlled trial (NCT04010526) will be helpful to define the place for this approach in the current therapeutic arsenal. [ABSTRACT FROM AUTHOR]