O Uso de Células Tronco Hematopoéticas para o Tratamento da Doença de Crohn em Pacientes Refratários: Uma revisão da literatua
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2023-12
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Artigo Científico
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Acesso aberto
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SILVA, Gabrielly Cruz da
Orientador
MORAES, Chaiane Mara Oliveira
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Resumo
A Doença de Crohn é caracterizada por lesões intestinais omitidas, podendo estar presente em qualquer parte do trato gastrointestinal, levando à inflamação transmural da parede do intestino, podendo causar dor abdominal crônica, diarreia e fístulas perianais. Atualmente, a cicatrização da mucosa é o alvo de tratamento preferencial, sendo muito utilizado medicamentos como anti-inflamatórios e terapias com anti-fator de necrose tumoral. Infelizmente, alguns pacientes tendem a se tornar refratários a estas terapias, o que força a medicina a buscar novas opções de tratamento para melhorar a qualidade de vida, tornando o transplante de células tronco hematopoéticas uma destas opções. O principal objetivo que se busca atingir através do uso de células-tronco hematopoéticas é a renovação de células do epitélio intestinal, como as células dendríticas, que apresentam os antígenos T e B, responsáveis pelas respostas inflamatórias hiperestimuladas. Por não se tratar de uma terapia comum no meio médico, neste trabalho abordou-se o método de transplante, assim como seus efeitos e resultados, buscando, através das bases de dados, como: MEDLINE, Google Acadêmico e Scielo, artigos que elucidassem tais métodos. Para isso, a pesquisa buscou artigos entre os anos de 1993 a 2022 através das palavras-chaves consultadas no DeCS/MeSH. Através das pesquisas realizadas, concluiu-se que, embora a recidiva ocorra na maioria dos pacientes dentro de 5 a 8 anos após o transplante, a capacidade de resposta ao medicamento é recuperada e a remissão clínica é alcançada em 80% dos casos.
Crohn's disease is characterized by omitted intestinal lesions, which can bepresent in any part of the gastrointestinal tract, leading to transmural inflammationof theintestinal wall, which can cause chronic abdominal pain, diarrhea andperianal fistulas. Currently, mucosal healing is the preferred treatment target, with medicationssuch as anti-inflammatories and anti-tumor necrosis factor therapies beingwidelyused. Unfortunately, some patients tend to become refractory to these therapies, which forces medicine to seek new treatment options to improve qualityof life, making hematopoietic stem cell transplantation one of these options. Themainobjective sought to be achieved through the use of hematopoietic stemcellsistherenewal of intestinal epithelial cells, such as dendritic cells, which present TandBantigens, responsible for hyperstimulated inflammatory responses. As it isnot acommon therapy in the medical world, this work addressed the transplant method, aswell as its effects and results, searching, through databases such as: MEDLINE, Google Scholar and Scielo, articles that elucidated such methods. To dothis, theresearch searched for articles between the years 1993 and 2022 using thekeywordsconsulted in DeCS/MeSH. Through research carried out, it was concludedthat, although relapse occurs in the majority of patients within 5 to 8 yearsaftertransplantation, the ability to respond to medication is recovered andclinical remission is achieved in 80% of cases.
Crohn's disease is characterized by omitted intestinal lesions, which can bepresent in any part of the gastrointestinal tract, leading to transmural inflammationof theintestinal wall, which can cause chronic abdominal pain, diarrhea andperianal fistulas. Currently, mucosal healing is the preferred treatment target, with medicationssuch as anti-inflammatories and anti-tumor necrosis factor therapies beingwidelyused. Unfortunately, some patients tend to become refractory to these therapies, which forces medicine to seek new treatment options to improve qualityof life, making hematopoietic stem cell transplantation one of these options. Themainobjective sought to be achieved through the use of hematopoietic stemcellsistherenewal of intestinal epithelial cells, such as dendritic cells, which present TandBantigens, responsible for hyperstimulated inflammatory responses. As it isnot acommon therapy in the medical world, this work addressed the transplant method, aswell as its effects and results, searching, through databases such as: MEDLINE, Google Scholar and Scielo, articles that elucidated such methods. To dothis, theresearch searched for articles between the years 1993 and 2022 using thekeywordsconsulted in DeCS/MeSH. Through research carried out, it was concludedthat, although relapse occurs in the majority of patients within 5 to 8 yearsaftertransplantation, the ability to respond to medication is recovered andclinical remission is achieved in 80% of cases.
Palavras-chave
Doença de Crohn, Colite ulcerativa, Transplante de células-tronco hematopoéticas