By:

Louis A. Cona, MD

Reviewed:

Robert J. Hancock

In Crohn's patient, human umbilical cord mesenchymal stem cell implantations led to significant improvement in bowel movements, abdominal discomfort, and blood per rectum. The subject was able to cease steroid medications following treatment and note a sustained increase in quality of life.

Improvement of bowel function after human umbilical cord mesenchymal stem cell treatment for Crohn’s Disease: A Case Study

Introduction

Crohn's is an Inflammatory Bowel Disease (IBD) that typically affects the terminal ileum (outer ends of the intestines) but can affect the entire gastrointestinal tract, from mouth to anus. Left untreated, Crohn’s Disease can result in a full-thickness inflammation in the gastrointestinal tract causing pain, discomfort, irregular bowel movements, and digestive issues. The anti-inflammatory properties of mesenchymal stem cells have the potential for alleviating the negative symptoms associated with Crohn’s Disease.

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Case Presentation

We report a case of a 25-year-old Caucasian American woman previously diagnosed as having Crohn’s Disease. She had been diagnosed with Crohn’s in 2011, and was also presenting adrenal and thyroid issues, as well as anemia related to gastrointestinal bleeding. She was treated with human umbilical cord mesenchymal stem cell implantation protocol. This protocol consists of implantation of 300 million human umbilical cord mesenchymal stem cells intravenously at a rate of 1cc per minute. Three months post-treatment the patient reported significant improvement of symptoms. During a follow up physical exam, she reported a complete reversal of her bowel and abdominal pain symptoms, and significant improvements in energy, allowing her to return to school for the first time in years.

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Conclusions

Human umbilical cord mesenchymal stem cell implantations led to significant improvement in bowel movements, abdominal discomfort, and blood per rectum. The subject was able to cease steroid medications following treatment and note a sustained increase in quality of life.

Background

Currently, there is no known cure for Crohn's Disease.  Fortunately, the condition can be managed with the proper treatment regime. Common medications used to manage Crohn's include anti-inflammatories (steroids, etc.), painkillers, immunosuppressants (to control the body’s inflammatory response), antibiotics, and surgery (to remove the affected area of the intestinal tract).

Unfortunately, all of these medications aim at merely reducing the severity of symptoms and can have little effect on the underlying cause of the disease, inflammation.  Also, anti-inflammatory drugs may cause a plethora of adverse side effects, many of which can cause even more discomfort or even induce serious complications.

Stem cell therapy may help Crohn's Patients through reduction in inflammation throughout the digestive tract, regulating the immune system (to control immune response), and repairing injured tissue within the gastrointestinal tract.

Stem cell research has shown that cell therapy may have the ability to promote the repair of diseased, dysfunctional or injured tissue.

The therapeutic uses of stem cells as a potential therapy for a variety of diseases have been explored immensely. The number of clinical trials conducted with Mesenchymal Stem Cells has increased exponentially over the past few years.

Stem cells have a unique, intrinsic property that attracts them to inflammation in the body. Studies have shown that stem cells can regenerate damaged or diseased tissues, reduce inflammation and modulate the immune system promoting better health and quality of life. Mesenchymal stem cells (MSCs) do this by influencing tissue repair via paracrine effects (cell signaling to change the behavior of existing cells) or direct cell-to-cell contact.

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Case Presentation

We present a 25-year old Caucasian American woman previously diagnosed with Crohn’s Disease and having a history of postural orthostatic tachycardia syndrome (POTS), as well as adrenal, thyroid, and anemia issues. She had been living largely without these indications until 2011 when her condition worsened, prompting medical intervention. She reported low energy, frequent bowel movement, bloody diarrhea, abdominal pain, and cramps. She was prescribed Decedron 0.75mg and a Remicade infusion (TNF Alpha blocker) for inflammation, as well as medications for diarrhea, nausea, and reflux. She was also using the narcotic Norco for pain management. The patient reported not being able to function day to day, having quit school due to her ailments.

Pre-treatment lab work was conducted to determine baseline condition. The required labs include inflammation markers to document any abnormally high levels of inflammation that would be expected with Crohn’s patients. Her bloodwork indicated a TNF Alpha of 8.3 (normal range 0.0-2.2). The patient also completed a vitality questionnaire which determined her subjective condition across 24 different overall health metrics for comparison post-treatment.

The patient did not have significant changes in blood pressure, blood oxygen level, or body temperature during treatment. She did not report any adverse responses within 24 hours of her treatment date.

Three months post-treatment the patient reported significant improvement of symptoms. During a follow up physical exam, she reported a complete reversal of her bowel and abdominal pain symptoms. Her post-treatment vitality questionnaire indicated a 95% improvement in bowel movements, abdominal discomfort, and blood per rectum, as well as a 70% improvement in energy level. Her bowel movements had decreased from 12 to 15 per day to 1 per day, and blood per rectum from 8 to 10 per day to zero. She reported that she had not taken Dacedron since her treatment, without any adverse effect. She had sustained higher levels of energy, and reported that she had begun attending school once again to pursue higher education, which was not possible prior to treatment.

Six months post-treatment, the patient underwent a colonoscopy and endoscopy with her home specialists. No signs of abnormal inflammation of the bowel, scarring, or fistulas were noted. She had discontinued steroid use completely as well. Patient noted sustained higher levels of energy, regular bowel movements, and less fatigue, leading to quality of life increase.

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Discussion

Crohn’s Disease affects an estimated 3.1 million adults in the United States, which show signs of the condition, as well as IBD symptoms. While the official cause remains unknown, the symptoms can be tied to inflammation of the gastrointestinal tract from the mouth to the anus. Symptoms include abdominal pain, diarrhea, fever, and weight loss. It is currently believed that a combination of environmental, immune, and bacterial factors in genetically susceptible individuals can trigger Crohn’s Disease.

Mesenchymal stem cells (MSCs) are primal or “undifferentiated” cells. They are essentially “blank” and have the ability to become almost any other type of cell. In the body, their function is to seek out damaged or diseased tissue and repair or replace it. We all have a supply of stem cells when we’re born, but it decreases with time, and their effectiveness diminishes with age. A stem cell transplant seeks to boost the body’s number of stem cells by the hundreds of millions. Through the use of donated cord tissue-derived stem cells, the cells used in treatment are “brand new”, with the highest potency and healing potential. Additionally, the treatment involves only natural cell products, avoiding the use of potentially harmful additives and drugs.

Stem cells have been proven to have strong anti-inflammatory properties. Through the use of large cell quantity transplants, the youthful stem cells have a regulatory nature on the body. They can reduce the immuno-effect that the body cannot regulate on its own. Specifically, MSCs can inhibit the overproduction and use of T-cells in the body. This effect occurs without compromising the body’s natural immune system and leaving the patient vulnerable to disease. The effect of the transplant is a return of the body to normal immune function and a drastic reduction in a patient’s inflammation markers. This anti-inflammatory effect can last for years at a time without the need for another transplant. What this means for patients with autoimmune and degenerative diseases is a natural solution to their symptoms, a respite from discomfort, and an overall increase in quality of life. Additionally, not only will the body better be able to heal damaged tissue with the inflammation reduced, but the stem cells will also assist is more rapid healing within the body. It is for this reason that even healthy patients have turned to stem cell therapy as a form of “body maintenance” and to keep naturally occurring inflammation at manageable levels.

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Conclusion

Human umbilical cord stem cells have been shown to have important anti-inflammatory and regenerative properties that have shown a positive impact on the symptoms of Crohn’s Disease with no adverse reactions reported.

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References

Rendi, M., & Swanson, P. (2019, November 9). Crohn Disease Pathology. Retrieved from https://emedicine.medscape.com/article/1986158-overview#a3

Mao, Fei, et al. "Mesenchymal Stem Cells and Their Therapeutic Applications in Inflammatory Bowel Disease." Oncotarget, Impact Journals LLC, 6 June 2017, https://www.ncbi.nlm.nih.gov/pubmed/28402942.

Watt, Fiona M, and Ryan R Driskell. “The Therapeutic Potential of Stem Cells.” Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, The Royal Society, 12 Jan. 2010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842697/.

Levy, Michael L., et al. “Phase I/II Study of Safety and Preliminary Efficacy of Intravenous Allogeneic Mesenchymal Stem Cells in Chronic Stroke.” Stroke, vol. 50, no. 10, 2019, pp. 2835–2841., DOI:10.1161/strokeaha.119.026318.