Three-year outcome of local injection of autologous stromal vascular fraction cells and microfat in refractory perianal fistulas of Crohn’s disease

Stem Cell Research & Therapy

Françoise Dignat-George¹  Fanny Grimaud²  Julie Veran²  Jérémy Magalon³  Florence Sabatier³  Marc Leone⁴  Caroline Prost⁵  Carine Visee⁶  Laura Beyer-Berjot⁶  Fanny Houser⁷  Ariadne Desjeux⁷  Mélanie Serrero⁷  Lucas Guillo⁸  Jean-Charles Grimaud⁹  Maxime Abellan^1,10  Cécile Philandrianos^1,10  Elisabeth Jouve^1,11 

[1] C2VN, INSERM UMR 1263, Faculté de Pharmacie de Marseille, Aix Marseille University, Marseille, France;Cell Therapy Department, INSERM CBT-1409, Assistance Publique Hôpitaux de Marseille, Aix-Marseille University, Marseille, France;Cell Therapy Department, INSERM CBT-1409, Assistance Publique Hôpitaux de Marseille, Aix-Marseille University, Marseille, France;C2VN, INSERM UMR 1263, Faculté de Pharmacie de Marseille, Aix Marseille University, Marseille, France;Department of Anaesthesia and Intensive Care, Assistance Publique Hôpitaux de Marseille, Marseille, France;Department of Radiology, Assistance Publique Hôpitaux de Marseille, Marseille, France;Digestive Surgery Department, Assistance Publique Hôpitaux de Marseille, Marseille, France;Gastroenterology Department, Assistance Publique Hôpitaux de Marseille, University Hospital of Marseille Nord (AP-HM), Chemin des Bourrely, 13015, Marseille, France;Gastroenterology Department, Assistance Publique Hôpitaux de Marseille, University Hospital of Marseille Nord (AP-HM), Chemin des Bourrely, 13015, Marseille, France;Cell Therapy Department, INSERM CBT-1409, Assistance Publique Hôpitaux de Marseille, Aix-Marseille University, Marseille, France;Gastroenterology Department, Assistance Publique Hôpitaux de Marseille, University Hospital of Marseille Nord (AP-HM), Chemin des Bourrely, 13015, Marseille, France;Centre d’Investigation Clinique 1409, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, Marseille, France;Plastic Surgery Department, Assistance Publique Hôpitaux de Marseille, Marseille, France;Statistical Department, Assistance Publique Hôpitaux de Marseille, Marseille, France;

关键词: Stromal vascular fraction;    Crohn’s disease;    Perianal fistulas;    Long-term outcome;   

DOI  :  10.1186/s13287-022-02738-x

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY