Rheumatoid Arthritis


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Stem Cell Therapy for Rheumatoid Arthritis


Rheumatoid arthritis is a known autoimmune disease that results in inflammation in the smaller joints of the body, such as the hands and feet. The inflammation leads to swelling and pain, which is typically worse in the mornings. While no exact cause is known, researchers have found a genetic factor associated with developing rheumatoid arthritis. Rheumatoid arthritis affects 1% of the general population worldwide. For many people with this painful, disabling disease, current medical treatment is not effective.

With rheumatoid arthritis, the autoimmune condition causes attach of the body’s health tissues. This starts with the lining of the joints (synovial membrane). The autoimmune condition results in inflammation and this contributes to shifting of the joints (deviation of the fingers or toes). Because stem cells have anti-inflammatory effects, scientists believe they are useful in the treatment of rheumatoid arthritis. They have helped produce and regenerate cartilage and accelerate the body’s natural healing process.

  • Indications for Stem Cell Transplantation

    Stem cell therapy has been proven effective for rheumatoid arthritis in many clinical studies. When cartilage is restored/preserved, pain improved, and inflammation reduced, the patient enjoys improved quality of life. The indications for transplantation of stem cells are:

    • The state of the disease is resistant to standard treatment.
    • Ineffective anti-inflammatory drug therapy.
    • Decreased functional capacity of the joints.
    • Trophic disturbances of the musculoskeletal system.
    • Deviations of hemopoetic and immunologic parameters.

    Within three months after stem cell transplantation, the inflammatory process activity decreases, swelling goes away, and joint tenderness diminishes. Researchers also have found that c-reactive protein levels decline (indicate inflammation). For most patients, treatment with stem cells can facilitate remission.

  • Research Studies involving Stem Cells

    Adult mesenchymal stem cells (MSCs) are proven to suppress effector T cell and inflammatory responses, and this has emerged as curative for immune disorders. A group of researchers studied the effects of stem cells on patients with the disease. They found the stem cells suppressed the antigen-specific response of T cells from people with rheumatoid arthritis, and the cells inhibited production of inflammatory cytokines.

    MSCs reside in the joint tissues and synovium. In normal conditions, these cells contribute to the repair and maintenance of joint tissues. However, with RA, the interaction of fibroblast-like cells and infiltrating immune cells results in inflammation and thickening of the synovium. MSCs, derived from the bone marrow, can inhibit inflammation and produce growth factors, which allow for synovium healing. In one study, MSC transplantation resulted in reduction of T cell subsets, which decreased secretion of inflammatory cytokines. In addition, stem cell therapy protected against bone loss by inhibiting receptor activity and osteoclastogenesis.

    In a large clinical trial involving 136 patients who were unresponsive to RA standard therapies, researchers used intravenous stem cell therapy as an option. The procedure proved safe, with no side effects or adverse events. There was remission achieved in many patients. The researchers also noted improvement at 3- to 6-month follow-up in laboratory values and decreased expression of cytokines.

    In a large randomized placebo trial, researchers administered MSCs intravenously to 48 people with active rheumatoid arthritis. After six months, clinical efficacy was observed. Anti-HLA-I antibodies against the disease were detected in a few participants, and no adverse clinical effects were observed. The scientists speculated that stem cell therapy was a safe, alternative therapy.

  • Resources

    Ansboro S, Roelofs AJ, De Bari C. Mesenchymal stem cells for the management of rheumatoid arthritis. Curr Opin Rheumatol 2017; 29: 201–207. De Bari C. Are mesenchymal stem cells in rheumatoid arthritis the good or bad guys? Arthritis Res Ther 2015; 17: 113.

    Gonzalez-Rey E, Gonzalez MA, O’Valle F, et al. (2010). Human adipose-derived mesenchymal stem cells reduce inflammatory and T cell responses and induce regulatory T cells in vitro in rheumatoid arthritis. Ann Rheum Dis, 69(1), 241-248.

    Gu Y, Shi S. Transplantation of gingiva-derived mesenchymal stem cells ameliorates collagen-induced arthritis. Arthritis Res Ther 2016; 18: 262Liu R, Li X, Zhang Z, et al. Allogeneic mesenchymal stem cells inhibited T follicular helper cell generation in rheumatoid arthritis. Sci Rep 2015; 5: 12777.

    Lopez-Santalla M, Mancheño-Corvo P, Menta R, et al. Human adipose-derived mesenchymal stem cells modulate experimental autoimmune arthritis by modifying early adaptive T cell responses. Stem Cells2015; 33: 3493–3503.

    Yan X, Cen Y, Wang Q. Mesenchymal stem cells alleviate experimental rheumatoid arthritis through microRNA-regulated IκB expression. Sci Rep 2016; 6: 28915.

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