Regenerative therapy: cell dust to absorb digestive fistulas

Stem cells open up new medical perspectives, but their use is not without risk, in particular because these cells retain their ability to differentiate and divide, which can generate undesirable lines and possibly tumors. In this context, the use of vesicles produced by these cells offers an interesting alternative. Released in the extracellular medium, these vesicles, long regarded as uninteresting “cell dust”, are in fact endowed with therapeutic properties similar to those of mother cells, without presenting the same drawbacks. They have already been used successfully to treat kidney, heart and liver damage. A French research team has just demonstrated for the first time, in pigs, their interest in the treatment of digestive fistulas. These pathologies, consecutive for example to a surgical operation or to certain autoimmune pathologies like Crohn’s disease, create an abnormal communication of the organs of the digestive tract between them or with the skin. The treatments currently available are struggling to absorb them satisfactorily. Gabriel Rhami, of the AP-HP department of gastroenterology and endoscopy, and his colleagues incorporated extracellular vesicles from mesenchymal stem cells into a biocompatible polymer. Injected locally into the digestive fistula at low temperature (4 ° C), this mixture gels with body heat and fills the lesion. The results are spectacular, with a 100% success rate in animals. Researchers are now planning to test the effectiveness of this treatment in the management of perineal fistulas and to perform the first trials in humans.

A.K.A Silva et al. (2018) ACS Nano, 12 (10), 9800-14