Mesenchymal Stem Cell as a Potential Therapeutic for Inflammatory Bowel Disease- Myth or Reality?

Abstract

Background: Inflammatory bowel diseases (IBD), which include Crohn's disease and Ulcerative Colitis, are inflammatory autoimmune diseases which severely affect the quality of life. Till date, no long-lasting cure has been found for the disease and all the current treatment strategies are mainly focused on dampening the symptomatic inflammatory process that has certain side effects. In addition, a large number of patients remain refractory to conventional therapies. Mesenchymal stem cells (MSCs) can be looked upon as a biodrug to treat IBD owing to their immune-suppressive and regenerative capabilities. MSCs provide an advantage over the other widely used adult stem cells- hematopoietic stem cells in the aspects of lower side effects and enhanced tolerability. MSCs have had reasonable success thus far in clinical trials to treat IBD via systemic delivery as well as in local delivery (perianal Crohn's disease).

Objective: In order to optimize and standardize, MSC based therapy for IBD, a better understanding of cellular and molecular mechanisms of the therapeutic activities of MSCs, is extremely mandatory. There has been a plethora of publications in the last decade which elucidates the biologic rationale that makes MSC a promising therapeutic tool for IBD. Recent studies have witnessed a replacement of hypotheses regarding the mechanism of MSCs in curing IBD. The present review summarizes all these discussions, the results of the trials carried out to date and the future prospects in this field.

Conclusion: Based on the current development of MSC-based clinical trials and the ever-increasing rate of in-vitro studies, with a purpose to unveil the mechanism of curative approach of these cells, MSC based therapy for IBD can be expected to achieve clinical relevance in the near future.

Keywords: Crohn's disease; Mesenchymal stem cells; immune-suppression; inflammatory bowel disease; ulcerative colitis.