Stem Cell Therapy in Inflammatory Bowel Disease: A Review of Achievements and Challenges

Cheng-Mei Tian; Yuan Zhang; Mei-Feng Yang; Hao-Ming Xu; Min-Zheng Zhu; Jun Yao; Li-Sheng Wang; Yu-Jie Liang; De-Feng Li

doi:10.2147/JIR.S400447

Stem Cell Therapy in Inflammatory Bowel Disease: A Review of Achievements and Challenges

J Inflamm Res. 2023 May 16:16:2089-2119. doi: 10.2147/JIR.S400447. eCollection 2023.

Authors

Cheng-Mei Tian^#^{1

2}, Yuan Zhang^#³, Mei-Feng Yang^#⁴, Hao-Ming Xu⁵, Min-Zheng Zhu⁶, Jun Yao¹, Li-Sheng Wang¹, Yu-Jie Liang⁷, De-Feng Li¹

Affiliations

¹ Department of Gastroenterology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, People's Republic of China.
² Department of Emergency, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, People's Republic of China.
³ Department of Medical Administration, Huizhou Institute of Occupational Diseases Control and Prevention, Huizhou, Guangdong, People's Republic of China.
⁴ Department of Hematology, Yantian District People's Hospital, Shenzhen, Guangdong, People's Republic of China.
⁵ Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People's Republic of China.
⁶ Department of Gastroenterology and Hepatology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People's Republic of China.
⁷ Department of Child and Adolescent Psychiatry, Shenzhen Kangning Hospital, Shenzhen, Guangdong, People's Republic of China.

^# Contributed equally.

Abstract

Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is a group of chronic inflammatory diseases of the gastrointestinal tract. Repeated inflammation can lead to complications, such as intestinal fistula, obstruction, perforation, and bleeding. Unfortunately, achieving durable remission and mucosal healing (MH) with current treatments is difficult. Stem cells (SCs) have the potential to modulate immunity, suppress inflammation, and have anti-apoptotic and pro-angiogenic effects, making them an ideal therapeutic strategy to target chronic inflammation and intestinal damage in IBD. In recent years, hematopoietic stem cells (HSCs) and adult mesenchymal stem cells (MSCs) have shown efficacy in treating IBD. In addition, numerous clinical trials have evaluated the efficiency of MSCs in treating the disease. This review summarizes the current research progress on the safety and efficacy of SC-based therapy for IBD in both preclinical models and clinical trials. We discuss potential mechanisms of SC therapy, including tissue repair, paracrine effects, and the promotion of angiogenesis, immune regulation, and anti-inflammatory effects. We also summarize current SC engineering strategies aimed at enhancing the immunosuppressive and regenerative capabilities of SCs for treating intestinal diseases. Additionally, we highlight current limitations and future perspectives of SC-related therapy for IBD.

Keywords: Crohn’s disease; HSCs; immunosuppression; inflammatory bowel disease; mesenchymal stromal cells; stem cells; ulcerative colitis.

Publication types

Review

Grants and funding

This work was supported by Science and Technology Innovation Committee of Shenzhen (No. JCYJ20200109150700942, No. JCYJ20150403101028164, No. JCYC20170307100911479, No. JCYJ20190807145617113 and No. JCYJ20210324113802006), the Guangdong Basic and Applied Basic Research Foundation (No. 2020A1515011581) and National Natural Science Foundation of China (No. 81800489).