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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Stem Cells. Aug 26, 2026; 18(8): 121648
Published online Aug 26, 2026. doi: 10.4252/wjsc.121648
From mesenchymal stem cells to myoblast cell sheets: A next-generation regenerative concept for fistulizing Crohn’s disease
Bo-Lin Zhang, Shinichiro Kobayashi, Lu-Yang Li, Tian-Yang Li, Shinichiro Ogawa, Daisuke Miyamoto, Kayo Hasegawa, Shun Yamaguchi, Tomohiko Adachi, Susumu Eguchi, Kengo Kanetaka
Bo-Lin Zhang, Shinichiro Kobayashi, Lu-Yang Li, Tian-Yang Li, Shinichiro Ogawa, Daisuke Miyamoto, Kayo Hasegawa, Shun Yamaguchi, Tomohiko Adachi, Susumu Eguchi, Kengo Kanetaka, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
Co-corresponding authors: Shinichiro Kobayashi and Kengo Kanetaka.
Author contributions: Zhang BL and Kobayashi S drafted and edited the manuscript and approved the final version; Ogawa S and Adachi T edited the section on “Pathogenesis of Crohn’s disease”; Ogawa S and Miyamoto D edited the section on “Structural and myogenic limitations of mesenchymal stem cells”; Li LY and Li TY edited the section on “Myoblasts”; Kobayashi S and Hasegawa K contributed to writing and revising the section on “Cell sheet technology”; Yamaguchi S and Adachi T contributed to editing of the section on “Fibrosis and structural remodeling”; Eguchi S and Kanetaka K conceived the study, supervised its overall design, and approved the final manuscript. Kobayashi S and Kanetaka K served as co-corresponding authors and contributed equally to the overall supervision, conceptual development, critical revision, and final approval of the manuscript. Kobayashi S is designated as the corresponding author responsible for communication with the journal during the submission, peer-review, and publication processes.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by the Japan Society for the Promotion of Science Grant-in-Aid for Scientific Research C, No. 24K11935; Japan Agency for Medical Research and Development, No. 25ym0126811j0004.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Shinichiro Kobayashi, MD, PhD, FACS, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. skobayashi1980@gmail.com
Received: March 31, 2026
Revised: May 19, 2026
Accepted: June 15, 2026
Published online: August 26, 2026
Processing time: 143 Days and 3.4 Hours
Core Tip

Core Tip: Crohn’s disease fistulas remain a clinical challenge because current therapies mainly suppress inflammation without restoring the damaged tissue’s architecture. This review highlights cell sheet technology as a scaffold-free regenerative platform with superior cell retention, extracellular matrix preservation, and sustained paracrine activity. While mesenchymal stem cell therapies mainly provide regulatory repair, myoblast cell sheets add intrinsic myogenic potential, enabling reconstruction of the disrupted muscle layer and functional tissue recovery. By shifting the therapeutic goal from inflammation control to structural regeneration, myoblast cell sheets may offer a next-generation strategy for the durable repair of complex Crohn’s disease fistulas.

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