Efficacy of mesenchymal stem cell-based therapies in the treatment of perianal fistulizing Crohn’s disease: a systematic review and meta-analysis
Abstract Background Perianal lesions of Crohn’s disease (CD) are complex and disabling conditions. Mesenchymal stem cell (MSC)-based therapies have emerged as an innovative approach in managing refractory perianal fistulizing CD. We conducted a systematic review and meta-analysis to describe and com...
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BMC
2025-03-01
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| Series: | Stem Cell Research & Therapy |
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| Online Access: | https://doi.org/10.1186/s13287-025-04272-y |
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| author | Lucas Guillo Robinson Gravier Dumonceau Mélanie Vélier Mélanie Serrero Fanny Grimaud Florence Sabatier Jérémy Magalon |
| author_facet | Lucas Guillo Robinson Gravier Dumonceau Mélanie Vélier Mélanie Serrero Fanny Grimaud Florence Sabatier Jérémy Magalon |
| author_sort | Lucas Guillo |
| collection | DOAJ |
| description | Abstract Background Perianal lesions of Crohn’s disease (CD) are complex and disabling conditions. Mesenchymal stem cell (MSC)-based therapies have emerged as an innovative approach in managing refractory perianal fistulizing CD. We conducted a systematic review and meta-analysis to describe and compare combined remission and clinical outcomes of MSC-based therapies, and then whether one approach stands out from the rest. Methods We searched in MEDLINE, EMBASE and CENTRAL (up to December 31, 2023) all prospective studies assessing a local injection of MSC-based therapy in perianal fistulas of CD. The primary outcome was achievement of combined remission. MSC-based therapy strategies were compared. Results Twenty-five studies were included in the meta-analysis, enrolling 596 patients with perianal fistulizing CD. The combined remission rate at 3, 6 and 12 months were 36.2% (95% confidence interval (CI), 24.5–49.7), 57.9% (95% CI 51.3–64.2) and 52% (95% CI 38.8–64.8), respectively. MSC-based therapies demonstrated a significant effect in achieving combined remission compared to placebo at 3 months (relative risk (RR) = 1.6; 95% CI 1.0–2.8) and at 6 months (RR = 1.5; 95% CI 1.1–1.9). At 6 months, the combined remission rate was 57.2% (95% CI 47.2–66.6) for adipose-derived stem cells (ASCs) and 55.7% (95% CI 26.4–81.5) for bone marrow-derived stem cells (BMSCs). In the network meta-analysis, allogeneic ASCs and BMSCs did not demonstrate superiority over each other (RR = 0.74; 95% CI 0.31–1.77). Conclusion MSC-based therapies are effective for achieving combined remission of refractory and/or complex perianal fistulizing CD. The optimal efficacy effect is reached after 6 months of treatment. No superiority has yet been demonstrated between ASCs and BMSCs therapies |
| format | Article |
| id | doaj-art-526ed7bfec2f40c380ae4dba6e98cc12 |
| institution | DOAJ |
| issn | 1757-6512 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | Stem Cell Research & Therapy |
| spelling | doaj-art-526ed7bfec2f40c380ae4dba6e98cc122025-08-20T02:49:26ZengBMCStem Cell Research & Therapy1757-65122025-03-0116111310.1186/s13287-025-04272-yEfficacy of mesenchymal stem cell-based therapies in the treatment of perianal fistulizing Crohn’s disease: a systematic review and meta-analysisLucas Guillo0Robinson Gravier Dumonceau1Mélanie Vélier2Mélanie Serrero3Fanny Grimaud4Florence Sabatier5Jérémy Magalon6Department of Gastroenterology, University Hospital of Marseille Nord, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix-Marseille UniversityAPHM, INSERM, IRD, SESSTIM (Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale), ISSPAM, BioSTIC (Biostatistique et Technologies de l’Information et de la Communication), Aix Marseille UniversityC2VN, INSERM UMR 1263, Faculté de Pharmacie de Marseille, Aix Marseille UniversityDepartment of Gastroenterology, University Hospital of Marseille Nord, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix-Marseille UniversityDirection of Health Research, Assistance Publique-Hôpitaux de Marseille (AP-HM)C2VN, INSERM UMR 1263, Faculté de Pharmacie de Marseille, Aix Marseille UniversityC2VN, INSERM UMR 1263, Faculté de Pharmacie de Marseille, Aix Marseille UniversityAbstract Background Perianal lesions of Crohn’s disease (CD) are complex and disabling conditions. Mesenchymal stem cell (MSC)-based therapies have emerged as an innovative approach in managing refractory perianal fistulizing CD. We conducted a systematic review and meta-analysis to describe and compare combined remission and clinical outcomes of MSC-based therapies, and then whether one approach stands out from the rest. Methods We searched in MEDLINE, EMBASE and CENTRAL (up to December 31, 2023) all prospective studies assessing a local injection of MSC-based therapy in perianal fistulas of CD. The primary outcome was achievement of combined remission. MSC-based therapy strategies were compared. Results Twenty-five studies were included in the meta-analysis, enrolling 596 patients with perianal fistulizing CD. The combined remission rate at 3, 6 and 12 months were 36.2% (95% confidence interval (CI), 24.5–49.7), 57.9% (95% CI 51.3–64.2) and 52% (95% CI 38.8–64.8), respectively. MSC-based therapies demonstrated a significant effect in achieving combined remission compared to placebo at 3 months (relative risk (RR) = 1.6; 95% CI 1.0–2.8) and at 6 months (RR = 1.5; 95% CI 1.1–1.9). At 6 months, the combined remission rate was 57.2% (95% CI 47.2–66.6) for adipose-derived stem cells (ASCs) and 55.7% (95% CI 26.4–81.5) for bone marrow-derived stem cells (BMSCs). In the network meta-analysis, allogeneic ASCs and BMSCs did not demonstrate superiority over each other (RR = 0.74; 95% CI 0.31–1.77). Conclusion MSC-based therapies are effective for achieving combined remission of refractory and/or complex perianal fistulizing CD. The optimal efficacy effect is reached after 6 months of treatment. No superiority has yet been demonstrated between ASCs and BMSCs therapieshttps://doi.org/10.1186/s13287-025-04272-yCrohn’s diseaseFistulaMesenchymal stem cellsStromal vascular fractionMeta-analysis |
| spellingShingle | Lucas Guillo Robinson Gravier Dumonceau Mélanie Vélier Mélanie Serrero Fanny Grimaud Florence Sabatier Jérémy Magalon Efficacy of mesenchymal stem cell-based therapies in the treatment of perianal fistulizing Crohn’s disease: a systematic review and meta-analysis Stem Cell Research & Therapy Crohn’s disease Fistula Mesenchymal stem cells Stromal vascular fraction Meta-analysis |
| title | Efficacy of mesenchymal stem cell-based therapies in the treatment of perianal fistulizing Crohn’s disease: a systematic review and meta-analysis |
| title_full | Efficacy of mesenchymal stem cell-based therapies in the treatment of perianal fistulizing Crohn’s disease: a systematic review and meta-analysis |
| title_fullStr | Efficacy of mesenchymal stem cell-based therapies in the treatment of perianal fistulizing Crohn’s disease: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy of mesenchymal stem cell-based therapies in the treatment of perianal fistulizing Crohn’s disease: a systematic review and meta-analysis |
| title_short | Efficacy of mesenchymal stem cell-based therapies in the treatment of perianal fistulizing Crohn’s disease: a systematic review and meta-analysis |
| title_sort | efficacy of mesenchymal stem cell based therapies in the treatment of perianal fistulizing crohn s disease a systematic review and meta analysis |
| topic | Crohn’s disease Fistula Mesenchymal stem cells Stromal vascular fraction Meta-analysis |
| url | https://doi.org/10.1186/s13287-025-04272-y |
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