Mesenchymal Stem Cell Therapy for Inflammatory Bowel Disease: A Systematic Review and Meta-analysis

Abstract

Recent advances in inflammatory bowel disease (IBD) therapeutics include novel medical, surgical, and endoscopic treatments. Among these, stem cell therapy is still in its infancy, although multiple studies suggest that the immunomodulatory effect of stem cell therapy may reduce inflammation and tissue injury in patients with IBD. This review discusses the novel avenue of stem cell therapy and its potential role in the management of ulcerative colitis and Crohn's disease. We conducted a comprehensive literature search to identify studies examining the role of stem cell therapy (without conditioning and immunomodulatory regimens) in IBD. Taken together, these studies suggest a promising role for stem cell therapy in IBD although the substantial challenges, such as cost and inadequate/incomplete characterization of effect, limit their current use in clinical practice.

Figures

Figure 1

Different mechanisms of immunoregulation by mesenchymal stem cells

Figure 2

A: Overall quality of the included studies assessed by Cochrane risk of bias assessment tool. B: Risk of bias within studies assessed by Cochrane risk of bias assessment tool. Plus sign denotes low risk. Minus sign denotes high risk. Blank denotes unclear risk.

Figure 2

A: Overall quality of the included studies assessed by Cochrane risk of bias assessment tool. B: Risk of bias within studies assessed by Cochrane risk of bias assessment tool. Plus sign denotes low risk. Minus sign denotes high risk. Blank denotes unclear risk.

Figure 3

Forrest plot of studies evaluating healing of peri-anal fistulas (peri-anal CD) after local administration/injection of MSCs.

Figure 4

Forrest plot of studies evaluating induction of clinical remission after systemic administration of MSCs.