Cellular therapy with stem cells is revolutionising the focus of treatment of many serious diseases. Replacing the cells of damaged tissue with other new cells from the same patient is already a reality. This is the basis of cellular therapy and regenerative medicine, the latest great advance in biomedicine. In this line, Hospital Clínic, Barcelona is leading the world in the application of an innovative cellular therapy that uses stem cells to treat Crohn's disease, a chronic genetic disease that affects 1% of the population in Spain and which has considerable impact on the quality of life of the patients. The procedure is based on an autologous bone-marrow transplant (when patients receive a transplant of their own stem cells) and now constitutes a treatment option to cure an intestinal disease that sometimes does not successfully respond to drugs and requires highly complex surgery that does not provide a cure.
Hospital Clínic, Barcelona is one of the few hospitals in the world to apply this new therapeutic option for patients with Crohn's disease, and it does so with the guarantee of success experienced in the US and Italy, where the technique has been tested with excellent results: in an average follow-up period of 6 years, 80% of transplant patients are in a phase of total remission of the disease and the remaining 20% have shown considerable improvement following the transplant, and are now responding favorably to drugs. Dr. Julián Panés and Dr. Elena Ricart over the Gastroenterology Department of Hospital Clínic, Barcelona are the driving force behind this therapy in Spain and began to implement regenerative cellular therapy in patients with Crohn's disease in August 2008. To date, a total of 6 patients are benefiting from this new treatment, of whom 3 I've already completed the process and are in the follow-up face, and a further 3 are at different stages of therapy. The transplant requires several weeks of admission to hospital before patients receive their own cells.
The success of autologous stem-cell transplants in Crohn's disease is possible thanks to the joint collaboration of the gastroenterology and haematology departments and of the haemotherapy and haemostasis department, as the procedure is the same as that carried out in bone-morrow transplants to cure leukaemia or myeloma. Thus, when a case is detected, the professionals from the different departments of Hospital Clinic, Barcelona supervise each of the phases of the process to autologous Transplant. In this case, Dr. Panés and Dr. Ricart from the gastroenterology department work together with Dr. Montserrat Rovira from the haematology department of the Catalan hospital and with Dr. Enric Carreras, the head of this department, to provide joint monitoring of the patients. Dr. Pedro Marín of the haemotherapy and haemostasis department of Hospital Clínic, together with Dr. Miquel Lozano, are responsible for guiding the patients through the process of cryopreservation and collection of stem cells before the final transplant.
Crohn's disease, together with ulcerative colitis, is included in what is called irritable bowel disease. It is a chronic genetic disease that occurs when the immune system loses tolerance to the patient's own intestinal flora, leading to an abnormal inflammatory response that continues over time. The results are inflammation and ulceration in different areas of the digestive tract, leading to the symptoms. The disease progresses in the form of unpredictable and variable outbreaks throughout the patient's life and the severity of the symptoms varies according to the level of involvement of the intestines and the patient's response to the assigned treatment. It is a disease that usually affects young people between the ages of 18 and 40 years, and approximately 2000 new cases are diagnosed in Spain every year. Diagnosis is often difficult because it presents symptoms similar to those of other diseases of the digestive tract: abdominal pain, diarrhea, vomiting, nausea, fever, general malaise, etc. Patients' quality of life is conditioned by the severity of the disease and, in the most severe cases, prevents them from leading a normal life, with a very high level of suffering due to the acuteness and frequency of the intestinal symptoms.
Institut d'Investigacions Biomèdiques
