What Are Stem Cells, and How Do They Work?
Imagine that your body is a home. In a home, a dripping tap, or slightly chipped paint may not impact your day-to-day life. By the same token, you wouldn’t call a doctor about every pimple, or graze of the knees, but you’d call in a plumber to fix a leak, or a glazier to replace a broken window, or pest-control if you noticed mouse-droppings in the cellar.
Now, imagine if there was one, multi-talented handyman who you could call no matter what kind of domestic problem you needed to fix. Stem cells are the body’s equivalent of this jack-of-all-trades. Depending on where they are in the body, stem cells can configure themselves in different ways and adapt their function, working as needed to promote health and repair damage in that particular area. Stem cells can divide and renew indefinitely, another property which makes them extremely adept at fixing damage to muscle, bone and tissue.
Q If everybody has stem cells defending sites around their body, no one should ever develop damage from conditions which attack the body’s bones and tissues, like arthritis, inflammatory bowel diseases, or irritable bowel syndrome, right?
A Not exactly. Unfortunately, the number of stem cells all over the body, including the gut, decrease as a person gets older. This means that as a person ages, their chances of incurring damage from any conditions they may be affected by, increases. For instance, as a person ages, they become more likely to develop tissue damage such as ulceration or scarring from the intestinal inflammation that features in ulcerative colitis and Crohn’s disease.
Introducing Stem Cell Therapy (SCT) for IBD
What if there was a way to supply stem cells to areas of the body that are in need of repair?
There is: stem cell therapy (SCT) is a promising new treatment which is being developed and trialed in treating many conditions involving muscle, bone and tissue damage. The treatment involves transplanting stem cells to damaged areas of the body. This approach has proven effective in treating a wide variety of conditions, including alleviating symptoms of various gastrointestinal disorders.
How does it work?
The premise of SCT is that stem cells can be injected into the body at the site of the problem, where they can then adapt, repairing particular kinds of damage caused by certain conditions. Different kinds of stem cells can adapt to different extents:
- Stem cells can adapt to become one other cell type.
- Stem cells can adapt to become several cell types.
- Stem cells can adapt to become many cell types
- Stem cells can adapt to become any cell type.
The type of stem cells used for a particular treatment depend on the type of treatment and the stem cell function required.
There are two different kinds of stem cell therapies being developed for digestive health conditions:1
- Autologous transplant
- In which cells from one person are taken from one site in their body and injected into the problem area, such as the colon or small intestine, if SCT is being used to treat a digestive condition.
- Allogeneic transplant
- In which stem cells are taken from a donor whose human leukocyte antigens (HLA) are an acceptable match, and injected into the patient.
The development of stem cell therapy has received a great deal of media attention, with many people suffering from digestive health conditions reporting that it has dramatically reduced their symptoms, bringing about long-awaited periods of remission from conditions which previously had a significant impact on their quality of life.
In medical literature, SCT is being hailed as a promising alternative treatment to biologic therapies,2 which can cause life-threatening allergic reactions in a small proportion of patients, due to the stem cell ability to migrate accurately to areas of injury within the gut, their immunosuppressive properties, and the growing number of cases which document their ability to help heal damage in the colon.
Symptom-Free: How Can SCT Help My Digestive Condition?
Stem cell therapy has been explored, with reports of considerable success, for treating digestive conditions such as irritable bowel syndrome (IBS), Crohn’s disease (CD) and ulcerative colitis (UC). There are many positive reports from patients affected by IBD and IBS, for example, detailing how SCT “changed my life,”3 by reducing troubling symptoms in a significantly long-lasting capacity, in comparison to previous, less effective, treatments such as medications, dietary adaptations, and complementary therapies.
In addition to the dynamic changes it can deliver, SCT has further advantages, including:
It’s natural, the stem cells used will either be from a person’s own body or donor, there is minimal risk of an adverse reaction.
The transplant procedure is quick and simple, usually only a couple of hours in duration and there is no need for general anaesthesia.
Read on to find out about the different ways that SCT may be helpful in treating Crohn’s disease, ulcerative colitis and IBS, and the treatments being developed for each condition.
SCT and Crohn’s Disease (CD)
Crohn’s disease (CD) is one of the main forms of inflammatory bowel disease (IBD), the other being ulcerative colitis (UC) (see SCT-and-Ulcerative-colitis-(UC)). The condition is thought to result from an overactive immune response, which precipitates inflammation within the digestive system. When this inflammation occurs, it can produce an array of debilitating symptoms, which usually involve bowel obstructions, nausea, chronic diarrhea, and abdominal pain.
Most commonly, the inflammation within the digestive system that occurs in Crohn’s disease affects sections of the terminal ileum ‒ the final segment of the small intestine ‒ and the colon ‒ the large intestine ‒ but it can affect any of the gastrointestinal organs.
How can stem cell therapy help treat Crohn’s disease?
One of the main reasons that SCT is being developed as a treatment for CD is that stem cells have immunosuppressive properties, which can counteract the problematic immune response that is causing the inflammation, thereby reducing symptoms.
There are two different kinds of cells that may be used in SCT for Crohn’s disease. They are called mesenchymal stem cells (MSCs), or hematopoietic stem cells (HSCs).
- Can be found in many different tissues in the body, including fat and bone marrow. One important way these stem cells can help treat Crohn’s disease is by promoting the formation of T-cells, a kind of cell with immunosuppressive properties, which research has shown can be lacking or can fail to function in people affected by IBD. While the number of T-cells in the gut increase following a stem cell transplant, they can help heal areas affected by CD, and symptoms will diminish accordingly.
- Can adapt in more possible different ways than MSCs, and they can help change digestive tissue, re-establishing the gut’s tolerance to microbes which would previously have caused CD to flare up. In transplant procedures in which a person is given HSCs to treat Crohn’s disease, the areas of the gut that are affected will be targeted with a specialized form of chemotherapy first,4 in order to destroy the reactive immune cells which are causing Crohn’s disease.5
Good to know
For an HCS procedure, a person will usually require a hospital stay of 4-6 weeks in total, while undergoing chemotherapy, followed by the transplant itself.6 MSC transplants are currently much more popular than HCS transplants, due to the elimination of the need for chemotherapy.
What can I expect during a stem cell transplant procedure for Crohn’s disease?
There are many different stem cell treatment clinics and treatment specifics. For example, the number of stem cells and where in the body they are derived from varies between clinics. Here is an example of a possible MSC stem cell transplant procedure which can be used to treat Crohn’s disease, from Swiss Medica 21, a regenerative medicine clinical group with centers in several European countries and the U.S.
For the MSC transplant, between 200 and 300 million stem cells are extracted using a syringe from bone marrow or fat tissue. This is an autologous transplant.7 The cells are then activated in a laboratory, and injected into the large or small intestine, where they can heal areas affected by the inflammation that is characteristic of Crohn’s disease. After the procedure, the patient will gradually begin to notice relief from their symptoms over the next 2-4 months.8
What’s on the horizon for developing SCT for Crohn’s disease?
Current SCT treatments involve systemic distribution of cells, meaning that once injected, the activated cells can travel anywhere in the digestive system. In Crohn’s disease, different parts of the small or large intestine can be affected, sometimes with intervals in between. Because of this, it is suggested that a targeted treatment which can direct stem cells to the specific areas of the gut affected by CD should be developed, and would be an optimum form of stem cell therapy for treating Crohn’s disease.9
SCT and Ulcerative Colitis (UC)
Ulcerative colitis (UC) is the other main form of IBD. Like Crohn’s disease, it is believed to develop due to an abnormal immune response, and is a chronic condition. UC usually affects the colon (large intestine or bowel) and the rectum (the last part of the bowel, ending with the anus). The symptoms most commonly experienced include recurring diarrhea, often with blood or pus, and cramping pain in the belly. Current treatments aim to bring about or prolong periods of remission.
Unlike Crohn’s disease, it is possible to treat UC permanently in the sense that a colostomy (a procedure in which the colon is removed) can result in a termination of symptons, at a great cost. This is exactly the scenario we’re trying to avoid.
Because this is a major surgical procedure with serious health and lifestyle implications, a colostomy is not considered to be a cure for UC, but an advanced treatment option in cases where other treatments, such as medications that calm the inflammation in the bowel and colon, have proven insufficient, or where the risk of associated disease, like cancer, is elevated. SCT offers an alternative to a colostomy that may be preferable for many people, along with a fresh hope of long-lasting relief from symptoms of UC.
How can stem cell therapy help treat UC?
The results of a study recently presented at the 4th International Conference on Gastroenterology, suggest that SCT is “of high value” in treating UC. As is common in treating UC with SCT, patients received an allogeneic procedure10 in which stem cells were taken from the blood of an umbilical cord of an embryo, and transplanted to the affected person via injection. The improvement of their symptoms was compared to a control group, who underwent traditional treatments for UC, such as anti-inflammatory medications.11
Positive treatment outcomes following the administration of SCT for UC included:
- Decreased intestinal inflammation, where inflammation was shown to have disappeared, on examination via colonoscopy.
- Healthier blood vessels, previously inflamed or broken blood vessels became clear.
- Inflammatory polyps reduced in size and number.
How is SCT for UC being developed further?
A groundbreaking 2017 study from Cincinnati Children’s Hospital Medical Center has demonstrated the possibility that pluripotent stem cells can be used to grow a human colon in its entirety. This research has the potential to improve current treatments for UC on two counts: colons affected by UC can now be created in a laboratory setup, and studied in much closer detail than previously possible, with a view to developing treatments for UC. Furthermore, the research demonstrates the significance of the potential of SCT to treat damage to the gastrointestinal system from UC or CD, as an alternative to current treatment options.
SCT for Treating Irritable Bowel Syndrome (IBS)
Like Crohn’s disease and ulcerative colitis, IBS can cause abdominal pain, cramping and diarrhea, and constipation. However, in IBS, these symptoms are due to the lining of the gut becoming irritated due to food intolerances and the buildup of harmful bacteria, rather than inflamed. The key difference between IBS, CD and UC is that IBS is not an autoimmune12 reaction. This means that different properties are required of stem cells, when they are used to treat IBS rather than IBD.
Some important functions which mesenchymal stromal cells (MSCs) can perform, when used in SCT for IBS, include:13
- MSCs stimulate the birth of new, healthy cells.
- They reduce inflammation and irritation.
- And the promote secretion of helpful cells to help regulate expression of glutamate receptors in sensory neurons.
Those seeking stem cell therapy as a treatment for IBS or other gastrointestinal conditions may wish to participate in a clinical trial.
- For information on upcoming clinical trials in the US and worldwide, visit this database from the US National Library of Medicine.
- For information on upcoming clinical trials in the UK, see the UK Clinical Trials Gateway.
- “Autologous vs. Allogenic Stem Cell Transplants: What’s the Difference?” Dana-Farber Cancer Institute. 06 March 2017. Accessed: 19 June 2018.
- Vaccines, proteins and blood components derived from living sources, used for treating autoimmune and allergic conditions.
- “How stem cell treatment changed my life.” Irritable Bowel Syndrome Self-Help and Support Group. 30 April 2014. Accessed: 19 June 2018.
- “Stem cell transplants?” Crohn’s & Colitis UK. 2012. Accessed: 19 June 2018.
- “Stem cell-based therapies in inflammatory bowel disease: promises and pitfalls.” Therapeutic Advances in Gastroenterology. 25 April 2016. Accessed: 19 June 2018.
- “Autologous Stem Cell Transplant for Crohn’s Disease.” Clinicaltrials.gov. 28 February 2018. Accessed: 19 June 2018.
- That is, your own cells are collected.
- “Crohn’s disease treatment – Stem cells treatment clinic.” Swiss Medica 21. Accessed: 19 June 2018.
- “Stem cell therapy for inflammatory bowel disease.” Clinical and Translational Gastroenterology. March 2017. Accessed: 19 June 2018.
- That is, where stem cells are colleced from a donor
- “Umbilical cord blood stem cell transplantation for the treatment of ulcerative colitis.” Journal of Gastrointestinal & Digestive System. July 2015. Accessed: 19 June 2018.
- Where your immune system, meant to cull invasive cells and pathogens, overeacts and attacks healthy cells.
- “Stem Cells in the Intestine: Possible Roles in Pathogenesis of Irritable Bowel Syndrome.” Journal of Neurogastroenterology and Motility. 2016. Accessed: 19 June 2018.