Discussion
fistula, inflammation, Crohn’s fistula, Crohn’s disease
ANORECTAL FISTULAS, INFLAMMATION, COMPLICATION, COLON, REMISSION, EXANIMATION, ANORECTAL ABSCESS
Symptomatic pfCD is a devastating complication. In this pilot study, the number of draining fistulas decreased in most patients (90%) at 12 weeks after UC-MSCs administration. More than half of patients (60%) showed closure of all treated external openings at 24 weeks and did not recur during the 1-year follow-up. All patients reported significantly improved quality of life.As pfCD is characterized by increased inflammation that impedes epithelial healing [The preliminary results showed that UC-MSCs might be superior to adipose-derived MSCs (AD-MSCs) at the same cell dose [Although anti-TNF monoclonal antibody treatment provides a new option for the management of Crohn’s fistula [We found the improvement of MRI score was not parallel to remission of clinical symptoms. Clinical symptoms began to alleviate about 7 days after cell injection, while significant improvement shown by MRI only appeared about 12 weeks later. We think this is because the hole between two openings needs longer time to be filled by new tissue than the time that closure of the openings needs. Therefore, follow-up MRI exanimation may be performed after 12 weeks.Most recently, the American Society of Colon and Rectal Surgeons has published clinical practice guidelines on the management of anorectal abscess, fistula-in-ano, and rectovaginal fistula and recommends that for select patients with Crohn’s disease who have refractory anorectal fistulas, local treatment with MSCs is considered effective and safe [