Stem cell therapy for IBD

Stem cell therapy for IBD

Our current project focuses on the treatment of both perianal Crohn’s disease and luminal disease with mesenchymal stem cells (MSCs). Mesenchymal stem cells are known for their immunomodulating and tissue regenerative capacities and are thereby a promising therapeutic agent for IBD. We use in vitro and in vivo models to gain more insight in the effects and working mechanism of MSCs. Furthermore, our research has a strong translational character. So far we performed to clinical trials in which we showed that MSCs can be safely given to patients with IBD and have a promising effect in the treatment of perianal fistulas. 

Inflammatory bowel disease (IBD) is a chronic inflammation of the intestines and is divided into Crohn's disease (CD) and Ulcerative colitis (UC). In recent years, many developments have taken place within IBD in the area of new medicines and therapies. However, research is still needed to improve the quality of patient care in other areas, for example by dealing with "unmet needs" of patients, setting up better shared decision making, and providing more efficient and better care by better understanding  what patients and their partners find important in their current therapy. Also, finding new ways to administer care to patients is an area which can be improved and can lead to a better patient satisfaction. 

In the IBD patient care there are still many "unmet needs". This can involve complaints such as joint pains and fatigue, where doctors sometimes can not do much to improve the complaints. These complaints regularly do not appear to be associated with disease activity. But "unmet needs" are also the conversations that patients find difficult to perform, such as not being able to stop smoking, or experiencing intimacy problems in their relationship as a result of illness. If we can better deal with these "unmet needs", this will hopefully lead to an improvement in the quality of life for our patients.  Also we acknowledge  the fact that treatment goals can differ between patients, partners of patients, and physicians. By understanding these differences, a better dialogue can be had between patients and partners and a better personal treatment plan can be made.

Shared decision making is also becoming increasingly important at the clinic. It is precisely patients with a chronic disorder who can think along with their doctor about their options and condition when making important decisions. To be able to do this properly as a patient, it is essential to be well informed about your condition and therapeutic options. From studies conducted in the oncological care we know that stimulating patients at the outpatient clinic to ask more questions and to make themselves aware of the possibility to think along, leads to them also going to do more. The impact of these types of interventions has never been studied in IBD 


As such we have developed studies on 

1.Ask 3 questions: a study which analyzes if creating patient awareness regarding their options on possible treatments prior to their out-patient visits and stimulating them to decide what is important to them in their       treatment, leads to the asking of more questions and a better shared decision making 

2.A study in which treatment goals of physicians were compared to the treatment goals of  patients and patients’ partners, and to see if these preferences changed after a lecture explaining the treatment goals in IBD     from a physicians perspective

3. A study comparing home based infusions of vedolizumab to hospital infusions of vedolizumab and the effects this had on costs and on patient satisfaction

4. Question prompt list: a study to analyse the effects of a question prompt list prior to a out patient consultation on self efficacy

5. To study what the preferences are regarding self management in IBD from the views from patients, nurses and physicians and whether these views are different from each other

6. To evaluate how we record patient health care records of IBD patients in the Netherlands


PhD students ongoing:

Marieke Barnhoorn


PhD students completed:

Dr. Ilse Molendijk (2016)

Dr. Marjolijn Duijvestein (2012) 


Internships:

We always have research projects available for bachelor and master students with (bio-)medical and biopharmaceutical background. Please contact us via: M.C.Barnhoorn@LUMC.nl.


Selected publications:

Molendijk I, Bonsing BA, Roelofs H et al. Allogeneic bone marrow-derived mesenchymal stromal cells promote healing of refractory perianal fisutlas in patients with Crohn’s disease. Gastroenterology. 2015;149:918-27.

Molendijk I, Barnhoorn MC et al. Intraluminal injection of mesenchymal stromal cells in spheroids attenuates experimental colitis. Journal of Crohns Colitis. 2016;10:953-64.

Duijvestein M, Wildenberg ME et al. Pretreatment with interferon-y enhances the therapeutic activity of mesenchymal stromal cells in animal models of colitis. Stem Cells. 2011;29:1549-58.

Duijvestein M, Molendijk I, Roelofs H et al. Mesenchymal stromal cell function is not affected by drugs used in the treatment of inflammatory bowel disease. Cytotherapy. 2011;13:1066-73.

Duijvestein M, Vos AC, Roelofs H et al. Autologous bone marrow-derived mesenchymal stromal cell treatment for refractory luminal Crohn’s disease: results of a phase I study. Gut. 2010;59:1662-9.


Poster presentations and orals 

- N. Peek-Kuijt, M. de Jong, N. Srivastava, R. Veenendaal, P. Maljaars, L. van Bodegom- Vos, A. Linn, A. van der Meulen- de Jong. The Effect of Using a Question Prompt List in Outpatient Clinic Consultations in a Dutch IBD Population. Poster 505 ECCO congres, maart 2016.

- N.M.S. Peek-Kuijt, M.A. de Jong, N. Srivastava, P.W.J. Maljaars, L. van Bodegom- Vos, A.J. Linn, A.E. van der Meulen- de Jong.  The Effect of a Question Prompt List in Outpatient Consultations in a Dutch IBD Population.  Accepted as poster ARPH congres , februari 2017

- N.M.S. Peek-Kuijt, M. Aantjes, M. Verwey, A.E. van der Meulen- de Jong,  P.W.J. Maljaars. Treatment goals in IBD: a perspective from patients and their partners.  Accepted as oral presentation ARPH congres , februari 2017. 

- N. Peek-Kuijt, M. Aantjes, M. Verwey, A. van der Meulen- de Jong,  P. Maljaars. Treatment goals in IBD: a perspective from patients and their partners.  Accepted as poster 559 ECCO congres, februari 2017. 

- S.P. van den Burg, N.M.S. Peek-Kuijt, A.E. van der Meulen- de Jong,  P.W.J. Maljaars. Self Management in  IBD patients the view of nurses and phycisians.  Accepted as poster UEGW congres november 2017

- N.  Peek-Kuijt, S. van den Burg, A. van der Meulen- de Jong,  P. Maljaars. Self Management in  inflammatory bowel disease: A perspective of patients and caretakers.  GAccepted as poster 375 ECCO congres februari 2018

- N.  Peek-Kuijt, J. Nieuwstraten, L, van Ginkel, A. van der Meulen- de Jong. Home-based vedolizumab infusions: A suitble alternative to routine hospital infusions.  Accepted as poster 713 ECCO congres februari 2018