Doctors in Spain Use Adult Stem Cell Therapy for the Treatment of Crohn's Disease

MedicalNewsToday.com, February 21, 2009

Physicians in Barcelona are using autologous adult stem cells derived from bone marrow to treat Crohn's disease. In other countries such as the U.S. and Italy the same procedure has already obtained excellent results, with 80% of all patients still in total remission as long as 6 years after treatment, and considerable improvement also observed even in the 20% of patients who experience partial but not complete remission.

Dr. Julian Panes and Dr. Elena Ricart of the gastroenterology department at the Hospital Clinic in Barcelona have treated 6 patients thus far, 3 of whom have already completed the therapy and the other 3 of whom are still undergoing therapy. All patients are confident that they will improve.

However, the procedure in Barcelona begins with an initial treatment of chemotherapy for the specific purpose of destroying the patient's immune system - the logic and necessity of which are being increasingly questioned. While such a procedure had previously been considered a necessary part of such therapy, even though it exposes the patient to potentially life-threatening risks, today an increasing number of doctors are questioning the medical wisdom and scientific validity of subjecting their patients to deliberate immune destruction, and in fact there is a growing body of evidence to support the idea that such dangerous immunosuppression is unnecessary. In a publication that appeared in the Journal of Translational Medicine over two years ago, in January of 2007, Dr. Neil H. Riordan et al. posed the following question: "...in patients who are not suffering from a disease that is associated with an aberrant bone marrow such as hematological malignancies or immunological dysfunctions, how is it justifiable to subject them to the high levels of morbidity and mortality associated with immune suppression?" Dr. Riordan and his team of scientists then examined compelling evidence which strongly indicates that pre-stem cell transplant immune suppression is unnecessary for many types of autologous hematopoietic cell therapies and even for some allogeneic therapies that utilize "universal donor" cells such as mesenchymal stem cells and the CD34+ stem cells that are found in umbilical cord blood, and from which immune rejection is not even a concern. As Dr. Riordan and his colleagues wrote in their 2007 paper in a section that is subtitled, "Mesenchymal stem cells do not need myeloablation for efficacy": "Currently there are several ongoing clinical trials in Phase I-III using 'universal donor' mesenchymal stem cells in non-conditioned recipients of Crohn's disease, GVHD (graft-versus-host disease) and myocardial infarction. Although these cells are bone marrow expanded mesenchymal cells, the superior proliferative potential of cord blood mesenchymal cells may allow them not only to escape immune destruction, but also to expand in vivo and mediate therapeutic effects superior to those derived from bone marrow. The fact that regulatory agencies have allowed advancement of 'off-the-shelf' universal donor mesenchymal stem cells supports the numerous reports of clinical efficacy in an allogeneic setting."

Although a total remission rate of 80% is quite impressive, one can only conclude that the rate would be even higher if the patients did not have to recover from the deliberate and life-threatening destruction of their immune systems prior to receiving the stem cell therapy, and also if the stem cell therapy would utilize the "superior proliferative potential" of the "immune privileged" adult stem cells that are found in umbilical cord blood.

Crohn's disease is a painful, inflammatory, chronic, autoimmune disease of the digestive tract for which there has previously been no known cure and which, if left untreated, is potentially fatal. Complications are numerous, conventional medical treatments are ineffective and carry a high risk of dangerous side effects, and although the precise causes are unknown there seems to be a strong genetic component associated with the disease, which afflicts approximately half a million people in the U.S. alone and over 150,000 people in Spain. Now, adult stem cells offer the first therapy that has ever actually been shown not only to reverse the course of the disease but also to heal the patient of associated physiological injury.