EP330 - A Bibliometric And Visualization Analysis Of Mesenchymal Stromal Cell Therapy For Perianal Fistulas In Crohn's Disease

Purpose/Background: Crohn's disease is a chronic, relapsing inflammatory bowel disorder with complex etiology and a high burden of complications. Approximately 25%-35% of patients develop perianal complications, particularly perianal fistulas, for which durable clinical and radiologic remission remains suboptimal with immunosuppression and surgery alone. As an emerging cell-based therapy, mesenchymal stromal cell (MSC) treatment has gained traction in perianal fistulizing Crohn's disease (PFCD). We therefore conducted a bibliometric and visualization analysis to delineate the research landscape, hotspots, and frontiers of MSC therapy for PFCD, and to further explore heterogeneity in cell preparation and injection strategies, with the goal of informing optimization and integration with existing modalities.

Methods/Interventions: Literature on MSC therapy for PFCD published from January 1, 2000 to September 1, 2025 was retrieved from the Web of Science Core Collection. VOSviewer, CiteSpace, and Scimago Graphica were used to perform co-authorship, co-citation, and keyword co-occurrence analyses, generate timeline (timezone) views and thematic clusters, and construct knowledge-graph visualizations. Publications were categorized by country/region, institution, author, journal, keywords, and highly cited papers. Comparative impact metrics (citation count, citation impact, H-index, journal impact factor) were calculated and interpreted alongside the maps; duplicates and records not focused on MSC therapy for PFCD were excluded. Keyword burst detection was applied to identify emerging topics and research shifts.

Results/Outcomes: A total of 241 papers from 224 institutions across 40 countries/regions were included. Over the past decade, annual output has remained robust, with the United States as the most prolific contributor, followed by Italy, Spain, and China. Cleveland Clinic Foundation produced the highest international output, followed by Mayo Clinic and Hospital Clínic de Barcelona. The journal with the most articles was Journal of Crohn's & Colitis. Amy L. Lightner (United States) was identified as the most prolific author. High-frequency and frontier keywords included "mesenchymal stem cells," "crohns disease," and "inflammatory bowel disease" Thematic clustering and burst detection suggested a transition from early feasibility and safety studies to strategy refinement (e.g., cell source and dose, carrier matrices, local delivery techniques) and combination approaches with established medical/surgical therapies, with growing emphasis on standardized healing endpoints and durability.

Conclusion/Discussion: MSC therapy for PFCD is a rapidly maturing field with expanding translational momentum. This bibliometric synthesis provides a comprehensive map of contributing countries, institutions, authors, journals, and influential publications and highlights methodologic and strategic heterogeneity in current practice. Priorities include optimization and standardization of cell preparation and injection protocols, integration with multidisciplinary care pathways, and rigorous comparative effectiveness trials using harmonized outcomes (clinical remission, combined clinical/MRI healing, time to closure, recurrence, adverse events, quality of life, and cost-effectiveness) with adequate follow-up. Frameworks for phenotype-guided patient selection and sequencing with immunotherapy/surgery may also facilitate extension of MSC-based strategies to other CD-associated fistulas.