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Allogeneic bone marrow-derived mesenchymal stem cells (MSCs) are a cellular therapy being investigated for the treatment of refractory perianal fistulizing Crohn's disease, particularly in pediatric and adolescent populations. Developed under the leadership of Dr. Amy Lightner at the Cleveland Clinic, this therapy involves the direct injection of 75 million adult donor-derived MSCs into the fistula tracts. The mechanism of action relies on the innate immunomodulatory properties of MSCs, which secrete a variety of anti-inflammatory cytokines and growth factors (paracrine signaling) to suppress local inflammation and promote tissue regeneration and fistula closure. Unlike autologous therapies, these allogeneic cells are "off-the-shelf," derived from healthy adult bone marrow, and do not require a prior harvest from the patient.
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