Biomedical Engineering Reference
In-Depth Information
12.7.7.3 Peritoneal Adherences
Several studies with animal models have been undertaken to assess whether SCs
can be used to prevent their formation [
75
,
76
]. Our group is also working in this
research line.
12.8 Ongoing and Published Studies with Human Application
of Stem Cells for Gastrointestinal Diseases
Crohn's disease, fistulising disease, ulcerative colitis and fecal incontinence are the
main diseases tested so far. In the last years, the number of registered clinical trials
with SCs is increasing continuously (more than 500 new the last year) and
digestive diseases (included liver) are among the main application fields.
If we review the main official clinical trials registry, provided by the US
National Institutes of Health (NIH) in the
www.clinicaltrials.gov
Web page, we
can find by June 2011 3,563 trials with SCs, of which 26 are applied to gastro-
intestinal tract diseases, excluded liver and endocrine pancreas. We summarize
them in Table
12.2
. We also represent them schematically in Fig.
12.2
.In
www.clinicaltrials.gov
, every trial is coded as ''NCT'' followed by a number (for
example NCT0027853).
12.8.1 Crohn's Disease
The presumed therapeutic mechanisms in the clinical setting are the capacity to
reset the native immune system (HSCs) and the immunomodulatory properties
(MSCs). Native immune system replacement is obtained because the precondi-
tioning treatments eliminate T cells and naive cells could be generated by HSCs
derived hematopoiesis and if HSCs are allogeneic, they also produce a graft-
versus-autoreactive response [
66
].
12.8.1.1 Relevant Published Studies
Preliminary support came from retrospective analyses of hematological trans-
plantations. We are going to highlight two case series. In the first, Crohn's
remission was observed in four out of five patients (without immunosuppressants
at least 6 months) with leukemia after allogeneic bone marrow transplantation [
77
]
with a median follow-up of 4.5-15.3 years. In the second [
78
], symptoms
remission occurred in all patients (six with Crohn's and four with ulcerative
colitis) after myeloablative treatment and allogeneic transplantation; the follow-up
