Treatment of refractory ulcers of the rectum by autologous stem-cell transplantation
S. F. Bagnenko,
V. P. Morozov,
A. S. Nemkov,
A. A. Kamanin,
A. Yu. Korolkov,
O. B. Shchukina,
A. A. Vinichenko https://doi.org/10.24884/0042-4625-2024-183-4-15-20
Abstract
The OBJECTIVE was to improve the quality of diagnosis and the effectiveness of treatment of refractory ulcers of the rectum. METHODS AND MATERIALS. We analyzed clinical and biochemical parameters in 39 patients with previously diagnosed solitary ulcers of the rectum. It was proved that in 18 patients, ulceration in the rectum was caused by an autoimmune process, according to the type of Crohn’s disease. The obtained data made it possible to substantiate and apply a new method of treating rectal ulcers – local bone marrow stem cell transplantation. RESULTS. All patients had pain, stool returned to normal, and ulcerative defects were noted to heal. CONCLUSION. Bone marrow stem cell transplantation differs fundamentally in its mechanism of action from known methods of treating rectal ulcers. The method has shown high efficiency and a good safety profile.
About the Authors
S. F. Bagnenko
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Bagnenko Sergey F., Dr. of Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Rector
6-8, L’va Tolstogo str., Saint Petersburg,197022
Competing Interests:
The authors declare no conflict of interest.
V. P. Morozov
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Morozov Victor P., Dr. of Sci. (Med.), Professor, Head of the Department of General Surgery with the Clinic
6-8, L’va Tolstogo str., Saint Petersburg,197022
Competing Interests:
The authors declare no conflict of interest.
A. S. Nemkov
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Nemkov Alexandr S., Dr. of Sci. (Med.), Professor of the Department of Faculty Surgery with Courses of Laparoscopic and Cardiovascular Surgery with the Clinic
6-8, L’va Tolstogo str., Saint Petersburg,197022
Competing Interests:
The authors declare no conflict of interest.
A. A. Kamanin
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Kamanin Alexey A., Cand. of Sci. (Med.), Associate Professor of the Department of General Surgery with the Clinic
6-8, L’va Tolstogo str., Saint Petersburg,197022
Competing Interests:
The authors declare no conflict of interest.
A. Yu. Korolkov
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Korolkov Andrey Yu., Dr. of Sci. (Med.), Professor, Head of the Department of Hospital Surgery № 2 with the Clinic named after Academician F. G. Uglov, Head of the Department of General and Emergency Surgery of the Research Institute of Surgery and Emergency Medicine
6-8, L’va Tolstogo str., Saint Petersburg,197022
Competing Interests:
The authors declare no conflict of interest.
O. B. Shchukina
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Shchukina Оksana B., Dr. of Sci. (Med.), Professor of the Department of General Medical Practice (Family Medicine), Head of the Office of Inflammatory Bowel Diseases of the Polyclinic with Consultative and Diagnostic Center
6-8, L’va Tolstogo str., Saint Petersburg,197022
Competing Interests:
The authors declare no conflict of interest.
A. A. Vinichenko
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Vinichenko Anastasya A., Doctor of the Surgical Department № 3 of the Research Institute of Surgery and Emergency Medicine
6-8, L’va Tolstogo str., Saint Petersburg,197022
Competing Interests:
The authors declare no conflict of interest.
References
1. Tjandra J. J., Fazio V. W., Petras R. E. et al. Clinical and pathologic factors associated with delayed diagnosis in solitary rectal ulcer syndrome. Dis Colon Rectum. 1993;36(2):146‒53. DOI: 10.1007/BF02051170.
2. Powell C. R., Lawson J. A., Lindholm P. C. Solitary Rectal ulcer syndrome mimicking perianal Crohn’s disease. Cureus. 2022;14(4):e23733. DOI: 10.7759/cureus.23733.
3. Tandon R. K., Atmakuri S. P., Mehra N. K. et al. Is solitary rectal ulcer a manifestation of a systemic disease? J Clin Gastroenterol. 1990; 12(3):286‒90. DOI: 10.1097/00004836-199006000-00010.
4. Sadeghi A., Biglari M., Forootan M., Adibi P. Solitary rectal ulcer syndrome: a narrative review. Middle East J Dig Dis. 2019. Vol. 11(3): 129‒134. DOI: 10.15171/mejdd.2019.138
5. Shelygin Yu. A., Ivashkin V. T., Achkasov S. I. et al. Clinical guidelines Crohn’s disease (K50), adults. Koloproktologia. 2023;22(3):10‒49. (In Russ.).
6. Eglinton T. W., Barclay M. L., Gearry R. B., Frizelle F. A. The spectrum of perianal Crohn’s disease in a population-based cohort. Dis Colon Rectum. 2012;55(7):773‒7. DOI: 10.1097/DCR.0b013e31825228b0.
7. Danese S., Fiorino G., Mary J. Y. et al. Development of red flags index for early referral of adults with symptoms and signs suggestive of Crohn’s disease: an IOIBD initiative. J Crohns Colitis. 2015;9(8):601‒6. DOI: 10.1093/ecco-jcc/jjv067.
8. Belousova E. A., Shelygin Yu. A., Achkasov S. I. et al. Clinical and demographic features and treatment approaches for inflammatory bowel diseases (crohn’s disease, ulcerative colitis) in the russia. The primery resultsof the analysis of the national register. Koloproktologia. 2023; 22(1):65‒82. (In Russ.).
9. Raghuram A. C., Yu R. P., Lo A. Y. et al. Role of stem cell therapies in treating chronic wounds: A systematic review. World J Stem Cells. 2020;12(7):659‒675. DOI: 10.4252/wjsc.v12.i7.659.
10. Colombo F., Cammarata F., Baldi C. et al. Stem cell injection for complex refractory perianal fistulas in Crohn’s disease: A single center initial experience. Front Surg. 2022;9:834870. DOI: 10.3389/fsurg.2022.834870.
11. Krainyukov P. E., Artsimovich I. V., Zinoviev E. V. et al. Using cell technologies in treatment of different etiology wounds: literature review. Bulletin of Pirogov National Medical & Surgical Center. 2021;2(16):131‒137. (In Russ.).
12. Shchukina O. B., Kharitonov A. G., Botina A. V. et al. Diagnostic and prognostic value of some typical morphological changes in crohn’s disease. Doctor.ru. 2013;9(87):82‒88. (In Russ.).
13. Roggenbuck D., Reinhold D., Schierack P. et al. Crohn’s disease specific pancreatic antibodies: clinical and pathophysiological challenges. Clin Chem Lab Med. 2014;52(4):483‒94. DOI: 10.1515/cclm-2013-0801.
14. Vermeire S., Pierik M., Hlavaty T. et al. Association of organic cation transporter risk haplotype with perianal penetrating Crohn’s disease but not with susceptibility to IBD. Gastroenterology. 2005;129(6):1845‒53. DOI: 10.1053/j.gastro.2005.10.006.
15. Sedov V. M., Nemkov A. S., Afanasiev B. V. et al. Long-term results of clinical application of autologous mono nuclear bone marrow fraction for regeneration therapy of ischemic heart disease patients. Grekov’s Bulletin of Surgery. 2012;5(171):11‒19. (In Russ.)
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For citations:
Bagnenko S.F., Morozov V.P., Nemkov A.S., Kamanin A.A., Korolkov A.Yu., Shchukina O.B., Vinichenko A.A. Treatment of refractory ulcers of the rectum by autologous stem-cell transplantation. Grekov's Bulletin of Surgery. 2024;183(4):15-20. (In Russ.) https://doi.org/10.24884/0042-4625-2024-183-4-15-20
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