Células estromales mesenquimales como tratamiento de la enfermedad de Crohn perianal

Abstract

Crohn's disease (CD) and its perianal manifestation, Perianal Crohn's disease (pCD), represent significant clinical challenges due to their complexity and recurrence. Cellular therapy, especially with mesenchymal stem cells (MSCs), has emerged as a promising option to address complex pCD. The multifactorial pathophysiology of CD and pCD involves genetic, immunological, and environmental factors. The clinical presentation includes perianal symptoms such as bleeding, pain, and fistulas, with a higher incidence in certain demographic groups. Diagnostic methods like MRI and ultrasound are essential for accurate evaluation. Meanwhile, conventional treatments, including medical and surgical therapies, are often satisfactory. The review highlights the emerging efficacy of cellular treatment with MSCs of complex pCD, with encouraging results in the healing of refractory perianal fistulas. The administration of MSCs, whether from bone marrow or adipose tissue, shows favorable clinical results and an acceptable safety profile. This cell therapy offers an optimistic and hopeful alternative for patients refractory to conventional therapies, with the important potential to improve predictions so the patient can have a better quality of life.