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P143. Transplantation of allogeneic mesenchymal stromal cells of bone marrow reduces the level of antibodies to infliximab in patients with Crohn's disease

L. Lazebnik1, O. Knyazev1, V. Sagynbaeva1, A. Konoplyannikov2, P. Shcherbakov1, A. Parfenov1

1Central Scientific Research Institute of Gastroenterology, Moscow, Russian Federation; 2Medical Radiological Research Center of Russian Academy of Medical Sciences, Obninsk, Russian Federation

Episodic infliximab (INFL) infusion in most cases lead to the formation of antibodies to INFL (AINFL). In some patients regular infusions of infliximab also may lead to the formation of antibodies to INFL – up to 13–46% of cases. Elevated AINFL can lead to infu sion reactions, reducing the effectiveness and duration of response from this therapy. Combination therapy using immunosuppressive prevents the formation of antibodies to infliximab in Crohn's disease.

Aim: To study the effects of transplanted allogenic me senchymal stromal cells (MSCs) of bone marrow at the level of antibodies to infliximab in patients with Crohn's Disease (CD).

Materials and Methods: In the Department of Pathology intestinal INFL monotherapy at a dose of 5 mg/kg received 15 patients with CD. Induction was carried out under the scheme 0–2–6, maintenance therapy after 8 weeks during the year. The total number of infusions was 8. After a year of therapy was determined the level of antibodies to infliximab. The level of antibodies to infliximab in the serum of patients was determ ined by enzyme multiplied immunoassay using test-systems "Bender Med systems" (Austria).

Results: After a one year in 4 (26.6%) patients with CD antibodies to INFL from 165 to 314 ng/ml, an average of 235.5±37.5 ng/ml. In these patients increase AINFL accompanied by deterioration of the clinical picture – the appearance of pain, increased stool fre quency, decrease in hemoglobin levels. CDAI in average increased from 103.9±13.2 to 135.2±15.0 (p > 0.05). Patients performed s ingle systemic allogeneic transplantation of allogeneic mesenchymal stromal cells (MSCs) of bone marrow to increase the effectiveness of ongoing anti-inflammatory therapy. After 2 weeks the level AINFL in all four patients dropped to 7–15 ng/ml, an average of 8.5±2.2 ng/ml (p < 0.001). This decrease was associated with improved clinical course of Crohn's disease and reduces in the CDAI to 68.5±4.6.

Conclusion: Transplantation of allogeneic mesenchymal stromal bone marrow cells reduces the level of antibodies to infliximab in patients with Crohn's disease and enhances the effectiveness of infliximab therapy.