Crohn’s Disease (CD) is the category of IBD (Inflammatory Bowel Disease) that causes digestive tract inflammation, abdominal pain, diarrhea, weight loss, malnutrition, fatigue, and inflammation. All of these problems may occur due to Crohn’s Disease, which may involve several areas of the digestive tract in different patients. In severe or advanced cases, inflammation tends to spread to the deeper layers of the organs and bowel.

CD can be debilitating (causing weakness) and painful, which can lead to life-threatening complications and risks. In terms of interventions, Crohn’s Disease isn’t curable. However, therapies and medications can help reduce the signs and symptoms of the disease instead of focusing on the root cause of the problem. CD can be a chronic or long-term condition that may cause remission of the disease and remitting inflammation. 

The most common causes of CD are:

• Immunity: a few species of bacteria and viruses can trigger Crohn’s disease, causing abnormal immune responses in the digestive tract.

• Genetics: Crohn’s disease is more common among people who have a family history of the disease. Genes may play a vital role in making people more susceptible to the disease.

• Age and gender: people in their youth (before 30 years) have more chances of developing the disease. However, the black population of the United Kingdom and North America are at the highest risk of the disease.

The most prevalent symptoms of this disease are:

• Cramping and abdominal pain

• Fatigue, fever, and diarrhea

• Bloody stools and mouth sores

• Weight loss and loss of appetite

• Drainage or pain around the area of the anus due to inflammation in the tunnel-like space deep inside the fistula (skin)

In Crohn’s Disease, part of the large or small intestine can be involved at different levels. In most patients, the disease ranges to the large intestine and colon, causing mild-severe intensity symptoms of the disease. Crohn’s Disease symptoms tend to develop slowly, but in some cases, they can appear spontaneously.

Treatment for CD consists of medications as:

• Anti-inflammatory disease

• Corticosteroids

• Oral 5-aminosalicylates

• Immune system suppressor drugs

• Vedolizumab

• Natalizumab

• Azathioprine

• Mercaptopurine

• Methotrexate

• Infliximab

• Ustekinumab

• Adalimumab

• Certolizumab

• Antibiotics, vitamins, supplements, pain relievers, and antidiarrheal drugs

• Surgery and nutritional therapy are the other options of treatments for Crohn’s Disease.

According to recent studies, Stem Cell Therapy (SCT) with bone marrow-derived MSCs (Cesenchymal Stem Cells) can significantly lower CD’s activity for improving the life quality and prognosis of chronic patients. Most of the time, Crohn’s Disease causes fistulas (abnormal connection of body parts causing pain and irritation). 

Clinical data suggests that 75% of patients with fistulas had complete closure of the fistulas after the therapy with Stem Cell Therapy. Furthermore, data also suggests that this therapy can sustain its effects and can last as long as more than four years after one session. 

Research studies conclude that Stem Cell Therapy is the new and promising treatment for Inflammatory bowel disease and Crohn’s Disease. Mesenchymal Stem Cells are the source of the most innovative and reliable cells for regeneration and repair in patients with chronic digestive tract damage and inflammation. Along with decreasing the disease-related problems, this therapy also has been evidenced in lowering the chances of flare-ups and recurrences. MSCs have potent immunomodulatory effects, preventing the immune system from abnormally responding to inappropriate threats in the body. Along with reducing negative immune responses in patients, Stem Cell Therapy also helps in providing a safe treatment for the disease with minor side effects. 

Other than Mesenchymal Stem Cells, Hematopoietic Stem Cells (HSCs) also show relief from CD and restoration of immune tolerance in the patients. 

In CD (Crohn’s Disease), Stem Cells can help with:

• Inhibiting the intestinal inflammation

• Promoting long-term healing of intestinal mucosa

• Significantly improving the life quality of a patient

• Improving Crohn’s disease-related perianal fistulation and IBD (inflammatory bowel disease)

According to the clinical literature, Exosomes combined with MSCs help in autoimmune diseases by regulating the inflammatory cytokines, microenvironment, and immune cells. These processes have a potent relation with both adaptive and innate immune cells. In these cells, macrophages, Treg cells, Th17, immunoregulatory miRNAs, and CD4+Th1 are the most crucial ones. 

Exosomes-combined-MSCs help in the regulation of T-Cell subsets in cases of autoimmune diseases. Moreover, the MSCs-Exosomes also aid in reducing the levels and concentration of pro-inflammatory Th17 and TH1 cytokines as IL-17AF, IL-12p70, and IL-6. However, the same MSCs-Exosomes help in increasing the concentration of anti-inflammatory Treg. 

Therefore, MSCs-Exosomes increase the concentration of Treg cells and the related products without changing the concentration index of the lymphocytes to maintain immunoregulation in the body. Similar effects of these cells are seen in the cases of RA (rheumatoid arthritis) and GVHD (graft-versus-host disease). MSCs-Exosomes help improve the GVHD by suppressing the differentiation of populations of the naïve T-cells. Macrophages constitute a crucial and major portion of the innate immunity of the human body, which can be regulated through the administration of MSCs-Exosomes. According to the different microenvironments, Mo (naïve macrophages) can be polarized into anti-inflammatory (M2) or pro-inflammatory (M1) to play different roles in different conditions. Along with the autoimmune conditions, this combination therapy can also help facilitate metabolic hemostasis to attenuate obesity and adipose inflammation. Moreover, MSCs-Exosomes can also promote the M1-M2 macrophage conversion to reduce the pro-inflammatory factors or effects of the macrophage M1.

Stem Cell Therapy is the most dependable procedure for Crohn’s Disease now. Generally, Stem Cell Therapy has a satisfactory safety profile, good prognosis, and effectiveness. 

However, no medical procedure is 100% safe; so, the most frequent or common risk factors of SCT can be:

• Allergic reactions

• Bleeding from the site of injection

• Fever

• Painful injection area /site

• Lethargy and fatigue

Pre-treatment education can help with awareness of slight side effects of the therapy. Allergic reactions are preventable through pre-injection history and care. Bleeding and swelling of the injured site are manageable via proper technique. Fever, lethargy, and pain are managed through the appropriate drugs along with the treatment.