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Predictive modeling to evaluate long-term treatment effectiveness of darvadstrocel in patients with complex perianal fistulas in Crohn's disease.

BMC Gastroenterol

December 2024

Formerly Gastroenterology Department, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Hospital Clínic de Barcelona, Barcelona, Spain.

Background: Current therapies for complex Crohn's perianal fistulas (CPF) have a limited ability to achieve long-term healing. Darvadstrocel (DVS) is an expanded allogeneic adipose-derived mesenchymal stem cell therapy that has demonstrated efficacy in treating complex CPF in clinical trials. There are, however, limited long-term comparative data with standard of care (SoC).

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Background: Perianal fistula refers to an abnormal connection between the anal canal and the perianal skin or perineum. Magnetic Resonance Imaging (MRI) plays a crucial role in accurately characterizing perianal fistulas, which informs surgical strategies and helps minimize recurrence.

Methods: This cross-sectional study was conducted at a single diagnostic imaging center in Addis Ababa, utilizing retrospectively collected data from May 2023 to June 2024.

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This case is relevant for describing a rare presentation of intestinal tuberculosis with perianal manifestations, complicated by abscesses and recurrent fistulas. The clinical manifestations mimicked Crohn's disease and other inflammatory conditions, making the diagnosis challenging and requiring a differentiated and meticulous diagnostic process. A 45-year-old male patient presented with a chronic abscess in the left buttock lasting for two years, characterized by spontaneous purulent drainage and multiple recurrences despite surgical and clinical treatments.

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Exosomes derived from umbilical cord mesenchymal stem cells promote healing of complex perianal fistulas in rats.

Stem Cell Res Ther

December 2024

National Colorectal Disease CenterNanjing Hospital of Chinese Medicine, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210022, Jiangsu, People's Republic of China.

Background: Complex perianal fistulas, challenging to treat and prone to recurrence, often require surgical intervention that may cause fecal incontinence and lower quality of life due to large surgical wounds and potential sphincter damage. Human umbilical cord-derived MSCs (hUC-MSCs) and their exosomes (hUCMSCs-Exo) may promote wound healing.

Methods: This study assessed the efficacy, mechanisms, and safety of these exosomes in treating complex perianal fistulas in SD rats.

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Introduction: Complex perianal fistula, which is characterized by high occurrence and is difficult to treat with current surgical techniques, negatively affects the life quality of patients. Mesenchymal stem cells (MSCs) have emerged as a new innovative therapy in recent years due to their potent anti-inflammatory and immunomodulatory properties. Considering the high recurrence rate of complex perianal fistula, we performed this systematic review and meta-analysis to assess the long-term effects of MSCs on complex perianal fistula.

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