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AT mesenchymal stem cells (AT-MSCs) mediate the healing process, but the relationship between molecular characteristics of AT-MSCs of the injected AT and fistula healing has not been adequately studied. Thus we aimed to characterize the molecular and functional properties of AT-MSCs isolated from autologous AT injected as a treatment of cryptogenic high transsphincteric perianal fistulas and correlate these findings to the healing process.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>27 patients (age 45\u2009\u00b1\u20092\u00a0years) diagnosed with perianal fistula were enrolled in the study and treated with autologous AT injected around the anal fistula tract. AT-MSCs were isolated for cellular and molecular analyses. The fistula healing was evaluated by MRI scanning after 6\u00a0months of treatment. AT-MSC phenotype was compared between responders and non-responders with respect to fistula healing.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>52% of all patients exhibited clinical healing of the fistulas as evaluated 6\u00a0months after last injection. Cultured AT-MSCs in the responder group had a lower short-term proliferation rate and higher osteoblast differentiation potential compared to non-responder AT-MSCs. On the other hand, adipocyte differentiation potential of AT-MSCs was higher in non-responder group<jats:italic>.<\/jats:italic> Interestingly, AT-MSCs of responders exhibited lower expression of inflammatory and senescence associated genes such as <jats:italic>IL1B, NFKB, CDKN2A, TPB3,TGFB1<\/jats:italic>.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our data suggest that cellular quality of the injected AT-MSCs including cell proliferation, differentiation capacity and secretion of proinflammatory molecules may provide a possible mechanism underlying fistula healing. Furthermore, these biomarkers may be useful to predict a positive fistula healing outcome.<\/jats:p>\n                <jats:p><jats:italic>Trial registration<\/jats:italic>: NTC04834609, Registered 6 April 2021. <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04834609\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04834609<\/jats:ext-link><\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13287-021-02644-8","type":"journal-article","created":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T11:02:59Z","timestamp":1637751779000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Molecular differences of adipose-derived mesenchymal stem cells between non-responders and responders in treatment of\u00a0 transphincteric perianal fistulas"],"prefix":"10.1186","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8670-425X","authenticated-orcid":false,"given":"Michaela","family":"Tencerova","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilli","family":"Lundby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steen","family":"Buntzen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stig","family":"Norderval","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helene Tarri","family":"Hougaard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bodil Ginnerup","family":"Pedersen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moustapha","family":"Kassem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,11,24]]},"reference":[{"key":"2644_CR1","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1007\/s00384-007-0334-7","volume":"22","author":"C Zanotti","year":"2007","unstructured":"Zanotti C, et al. 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