Development of regenerative medicine for inflammatory bowel disease

Inflammatory Bowel Disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), is a chronic inflammatory condition of the gastrointestinal tract. In Japan, the incidence of IBD is on the rise, with approximately 300,000 individuals currently affected. The pathophysiology of IBD is multifactorial, involving immune dysregulation, gut microbiome imbalances, and various environmental factors. The implementation of treat-to-target (T2T) strategies has revolutionized IBD management, establishing new therapeutic goals, such as mucosal healing, which is a critical indicator of long-term remission. Although biologic therapies, particularly anti-TNF-α agents, have yielded significant success, a subset of patients still experience refractory disease with ongoing mucosal damage, highlighting the need for novel treatment approaches that facilitate tissue repair. Recent advances in intestinal stem cell (ISC) research have led to the development of organoids derived from murine ISCs, human patient biopsies, and induced pluripotent stem cells (iPSCs). These organoids represent a promising platform for regenerative therapies and have demonstrated potential for treating refractory IBD ulcers or intestinal failure, with promising results from animal models. This presentation will review a clinical study investigating the use of organoid-based regenerative therapy for UC and explore the emerging role of regenerative medicine in IBD management, offering new possibilities for achieving long-term remission in patients with treatment-resistant disease.