Evidence supporting the use of: Stem Cells
For the health condition: Crohn's Disease

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Stem cell therapy, particularly hematopoietic stem cell transplantation (HSCT) and mesenchymal stem cell (MSC) therapy, has emerged as a promising treatment for Crohn's disease, especially in patients with severe, refractory forms unresponsive to conventional therapies. The rationale for stem cell use is grounded in their immunomodulatory and regenerative properties. HSCT aims to "reset" the immune system, which plays a central role in Crohn's pathogenesis. MSCs, derived from sources such as bone marrow or adipose tissue, can reduce inflammation and promote tissue repair. Several clinical trials and systematic reviews provide scientific validation for this approach. For example, a 2017 randomized controlled trial (AUTOCROHN) demonstrated that autologous HSCT led to clinical remission in a significant proportion of patients with refractory Crohn's disease. Additionally, MSC therapy, particularly for treating complex perianal fistulas, has received regulatory approval in Europe (e.g., darvadstrocel/aloCURE). Meta-analyses suggest improved fistula healing rates and a favorable safety profile in this context. However, these therapies are not first-line and are generally reserved for patients who have failed standard immunosuppressive or biologic treatments. Risks, including infection and procedure-related complications, must be considered. In summary, scientific evidence supports the use of stem cells in select cases of Crohn's disease, particularly for refractory disease and complex fistulas, with growing but still evolving data on long-term efficacy and safety.

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