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Growing new immune system could end misery of Crohn’s disease

This article was taken from: https://www.telegraph.co.uk/science/2018/08/06/growing-new-immune-system-could-end-misery-crohns-disease/

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Stem cell transplants could the end misery of Crohn’s disease, scientists hope.

A clinical trial has begun which will use stem cells to grow a new immune system for people with the condition which causes inflammation in the digestive system, leading to chronic pain and extreme tiredness.

Around 115,000 people in Britain suffer from Crohn’s and many fail to respond to current treatments.

Chief investigator Professor James Lindsay, from Queen Mary University of London, said: “We’re hoping that by completely resetting the patient’s immune system through a stem cell transplant, we might be able to radically alter the course of the disease.

“While it may not be a cure, it may allow some patients to finally respond to drugs which previously did not work.”

The use of stem cell transplants to wipe out and replace patients’ immune systems has recently been found to be successful in treating multiple sclerosis and the new trial will investigate whether it could also reduce gut inflammation in Crohn’s.

For the procedure, patients have stem cells harvested from their blood and then chemotherapy is used to wipe out their faulty immune system.

When the stem cells are re-introduced back into the body, they develop into new cells which give the patient a fresh immune system.

Q&A | Stem cell therapy

What are stem cells?

They are cells with the ability to propagate themselves and to differentiate into other types of cell. Found in various parts of the body, they enable growth and renewal of tissues and organs.

How are they used medically?

The most common form of stem cell therapy is the longstanding practice of transplanting bone marrow stem cells to patients who have undergone chemotherapy.

There are also several stem cell-derived treatments available for blood and immune disorders.

What are the potential uses?

Due to stem cells’ ability to rebuild tissues and organs, there is promising research in repairing brain and spinal cord injury. They have potential uses in combating neurodegenerative conditions such as Alzheimer’s, treatment of heart disease, repairing the immune system, regrowing teeth and hair, restoring vision to damaged eyes.

What are the down sides?

Lab-created stem cells have a propensity to form tumours. The bone marrow stem cell transplant has a 38 per cent treatment-associated mortality rate due to risks including cystitis, carcinoma, liver injury and graft-versus-host disease, where transplanted tissues reject their recipient.

Some lines of stem cell research are highly controversial involving, for example, the creation of clones and the treatments that may infringe the rights of early-stage, pre-implantation embryos.

In theory, the new immune system will no longer fight the patient’s own gut.

The current clinical trial, is a follow up to the team’s 2015 trial which investigated a similar stem cell therapy but which was found to serious side effects, which led to the death of one participant. The follow-up trial will be using a lower dose of the treatment to minimise risks due to toxicity.

Helen Bartlett, a Crohn’s disease patient who had stem cell therapy in the original trial, said: “I’ve been in and out of hospital for the last twenty years, operation after operation, drug after drug, to try to beat this disease. It’s frustrating, it’s depressing and you just feel so low.

“When offered the stem cell transplant, it was a complete no brainer as I didn’t want to go through yet more failed operations. I cannot describe how much better I feel since the treatment. I still have problems and I’m always going to have problems, but I’m not in that constant pain.”

Patients will be recruited to the trial through the following NHS trusts: Barts, Cambridge, Guy’s & St Thomas, NHS Lothian, Nottingham University, Oxford University, Royal Liverpool and Broadgreen and Sheffield Teaching Hospitals.