P575 The use of mesenchymal stromal cells in order to achieve deep (biological) remission of Ulcerative Colitis
O. Knyazev1, A. Kagramanova*1, A. Churikova1, A. Konoplyannikov2, S. Khomeriki3, A. Parfenov1, I. Ruchkina1
1Moscow Clinical Research Center, Department of Inflammatory Bowel Disease, Moscow, Russian Federation, 2Medical Radiological Scientific Center, Department of Stem Cells Therapy, Obninsk, Russian Federation, 3Moscow Clinical Research Center, Department of Pathology, Moscow, Russian Federation
Currently, the concept of remission ulcerative colitis (UC) should be defined as a condition in which there is no biological and histological signs of inflammation - «remission beyond symptoms». Biological remission UC involves the absence of symptoms, healing of intestinal mucosa, as well as normalization of serum and fecal biomarkers active inflammation.
Objective: To study the effect of mesenchymal stromal cells (MSCs) of bone marrow to achieve biological remission in patients with ulcerative colitis.
68 patients with UC were divided into two groups. The first group of patients (n=36) received standard anti-inflammatory therapy with 5-aminosalicylic acid (5-ASA) and glucocorticosteroids (GCS) + MSCs. Age - 19 to 58 years old (ME-29). The second group of patients (n=32) received the standard anti-inflammatory therapy with 5-ASA and corticosteroids. Age of this group 20 to 62 years (ME-28). Immunobiological treatment efficacy were assessed by the level of CRP and fecal calprotectin (FCP). Histopathology evaluation was performed on the index Geboes. Evaluate the effectiveness of therapy was performed at 2, 6 and 12 months. Baseline CRP in acute disease in the 1-st group was 28,6 ± 2,4 mg/l, in the 2-nd - 28,0 ± 3,0 mg/l (p=0.363). Baseline FCP in the 1-st group was 730 ± 23,4 mcg/g, in the 2-nd - 810 ± 30,1 mcg/g (p=0.086). Index Geboes in the 1-st group was 4,2 ± 0,2 points in the 2-nd - 4,1 ± 0,3 points (p=0.107).
After 2 months, the level of CRP in patients in group 1 was 10,6 ± 1,1 mg/l, in the 2-nd - 11,0 ± 1,1 mg/l (p=0.139). The level of the FCP in patients in the 1st group was 110 ± 12,0 mcg/g, in the 2-nd - 120 ± 12,0 mcg/g (p=0.001). Index Geboes in 1-st group was 0,9 ± 0,1 points, in the 2-nd - 1,1 ± 0,1 points (p<0.001).
After 6 months, the level of CRP in patients in 1-st group was 6,5 ± 0,6 mg/l, in the 2-nd - 8,9 ± 0,1 mg/l (p<0.001). The level of the FCP in patients of 1-st group was 80 ± 5,0 mcg/g, in the 2-nd - 95 ± 0,5mcg/g (p<0.001). Index Geboes in 1-st group was 0,9 ± 0,1 points, in the 2-nd - 1,0 ± 0,1 points (p<0.001).
After 12 months, the level of CRP in patients in 1-st group was 8,6 ± 1,2 mg/l, in the 2-nd - 9,4 ± 1,0 mg/l (p=0.004). The level of the FCP in patients of 1-st group was 75 ± 5 mcg/g, in the 2-nd - 80 ± 5 mcg/g (p<0.001). Index Geboes in 1-st group was 0,6 ± 0,1 points, in the 2-nd - 1,0 ± 0,1 points (p<0.001).
Inclusion of MSCs in a comprehensive anti-inflammatory therapy UC contributes to a deeper immunobiological and histological remission UC.