What is Rheumatoid Arthritis?
Rheumatoid Arthritis (RA) is an autoimmune disease in which the patient’s immune system generates cellular and antibody responses to various components of the joint such as type I collagen. As a result of this immune response, not only does joint destruction occur, but also other secondary complications such as pulmonary fibrosis, renal damage, and even heart damage.
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Can stem cells help treat rheumatoid arthritis?
Newly diagnosed rheumatoid arthritis is currently treated with immune suppressive agents such as steroids, methothrexate, cyclosporine, gold, and more recently infliximab (Remicade). Despite inducing temporary improvement, these approaches possess long-term adverse effects due to non-specific inhibition of immune responses. When disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate are not effective, biologics like abatacept (Orencia), adalimumab (Humira) or etanercept (Enbrel) may be recommended. None of these treatments address the issue of damage that has already occurred to the joints or extra-articular tissues.
Even though advancements in rheumatoid arthritis (RA) treatment protocols and introduction of targeted biological therapies have markedly improved patient outcomes, up to 50% of patients still fail to achieve a significant clinical response.
Stem cell therapy has been demonstrated to induce profound healing activity in animals with various forms of arthritis. For example, the company Vet-Stem routinely utilizes stem cells in horses with various joint deformities to accelerate healing. Besides healing of damaged tissues, stem cells have the unique ability to modulate the immune system so as to shut off pathological responses while preserving ability to fight off disease.
Stem cells and specifically, mesenchymal stem cells (MSCs) home to inflamed tissue and start producing anti-inflammatory agents. These mediators act locally and do not suppress the immune response of the patient’s whole body. Additionally, MSCs induce the production of T regulatory cells, a type of immune cell whose function is to protect the body against immunological self-attack.
A recent study on MSCs for rheumatoid arthritis (Human Umbilical Cord Mesenchymal Stem Cell Therapy for Patients with Active Rheumatoid Arthritis: Safety and Efficacy) showed that MSCs produced a significant decrease in pro-inflammatory cytokines IL-6 and TNF-α, both of which are temporarily targeted by many current RA treatments. – without the long-term side effects. These decreases are shown in Figure 5 from the original publication.
Through administration of umbilical cord tissue-derived mesenchymal stem cells, we have observed improvements in rheumatoid arthritis patients treated at our facilities.