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Medically reviewed by Dr. Shani S. Saks, D.O. on August 23, 2023

In this study of perianal fistulizing Crohn’s disease patients and controls, the cellular composition of subcutaneous lipoaspirate was comparable; however, the platelet-rich plasma products in Crohn’s disease patients exhibited a greater number of myeloid cells of the regular phenotype.

The combination of autologous stromal vascular fraction and platelet-rich stroma (PRS) is a novel treatment modality for perianal fistula in Crohn’s disease (CD) patients; however, the effect of CD on adipose-derived stromal therapy is unknown. 

This study investigated the cellular composition of PRS products and subcutaneous lipoaspirate in controls and perianal fistulizing Crohn’s disease (pCD) patients. The findings, published in the journal Stem Cell Research, indicate similar cellular composition and inter-donor variation in subcutaneous lipoaspirate from pCD patients and controls. However, more myeloid cells of the regular phenotype were observed in PRS products from pCD patients.  

Study Characteristics

A total of 23 patients were included, comprising 12 controls and 11 CD patients. The median age was 37.8 (IQR 30.7–45.0) years, and the median duration of pCD was 2.4 (IQR 1.6–4.4) years.

Subcutaneous Lipoaspirate Contents

The cellular composition of lipoaspirate among pCD patients and controls was similar, with no significant differences in the stromal cells, endothelial cells, immune cells, live cells, or the ratio between regulatory and pro-inflammatory macrophages.

Cellular Composition of Platelet-Rich Stromal Fractions

The PRS products contained immune cells and stromal cells, with a greater number of cells in CD patients compared to controls. Among these cells, a higher quantity of stromal cells was present; however, this was insignificant. The endothelial cells were in lower concentrations but similar across the pCD patients and healthy controls. The myeloid cells were significantly abundant in PRS products in pCD patients. There was a higher ratio of regulatory macrophages in PRS products in pCD patients compared to healthy controls.

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Combination Product Platelet-Rich Stroma

The adipocytes in platelet-rich plasma and the autologous stromal vascular fraction persisted despite mechanical fractionation of PRS. H&E staining demonstrated a high number of nucleated non-adipocyte cells in PRS products from CD patients when compared to controls.

Source

Arkenbosch, J., Becker, M. J., Buskens, C. J., Witjes, C., De Vries, A. C., Van Der Woude, C. J., Fuhler, G. M., Wildenberg, M. E., & Van Ruler, O. (2023). Platelet-Rich stroma from Crohn’s disease patients for treatment of perianal fistula shows a higher myeloid cell profile compared to non-IBD controls. Stem Cell Research, 67, 103039. https://doi.org/10.1016/j.scr.2023.103039