Multi-function of adipose-derived stem cells on gut disorder: from bench to bedside

Adipose-derived stem cells (ADSCs) are a specific type of mesenchymal stem cells (MSCs) obtained easily from adipose tissue (AT). Compared with MSCs, ADSCs are easier to obtain, have fewer ethical issues, and have a higher proliferative capacity, which makes them a promising type of stem cell in regenerative medicine. ADSCs possess impressive capabilities in cell regeneration as well as differentiation, making them promising candidates for injury repair, tissue regeneration and alleviation of inflamed tissues. At present, most clinical studies on ADSCs focus on the treatment of wounds, multiple sclerosis, soft tissue trauma, aging, diabetes, Parkinson's disease, bone and cartilage regeneration, stroke, and spinal cord injury, while its clinical applications in the gastrointestinal tract are relatively few. Therefore, this review summarizes the findings of preclinical experiments, clinical trials, and areas that may require further development of ADSCs in the treatment of digestive disorders, including inflammatory bowel disease (IBD), colorectal cancer (CRC), colorectal fibrosis, hepatocellular carcinoma, hepatic fibrosis, gastric cancer (GC), gastrostomy closure and radiation-induced proctitis. The review is concluded by discussing the goals for improvement and future directions for ADSCs before large-scale clinical application. ADSCs are simple to isolate and access, and they have few ethical issues for their application. ADSCs can differentiate into various cell types, supporting their use in regenerative medicine. ADSCs hold great promise for treating gastrointestinal diseases through modulation of immune response, anti-inflammation and tissue repair. ADSCs effectively treat gastrointestinal diseases like IBD and colorectal cancer, and show potential for liver fibrosis and gastric cancer. ADSC-derived extracellular vesicles (EVs) mimic parental cells' bioactivity and mitigate safety issues of live stem cell delivery, crucial for their application.