Stem Cell Arthritis Update
Arthritis treatment has gone through a revolution in the last twenty years.
And it appears, that a second revolution may be on the horizon with new research involving stem cells.
While much attention has been focused on the role of mesenchymal stem cell (MSCs) in treating osteoarthritis, there has also been a great deal of research in other areas of arthritis.
An example would be rheumatoid arthritis (RA).
A tremendous amount of progress has been made in the treatment of RA.
It has been established that RA is perpetuated by a complex array of protein messengers, called cytokines, as well as many pro-inflammatory antibodies.
In addition, certain rogue populations of cells such as abnormal B-cells and T-cells also play a significant role in perpetuating disease.
The thrust of research has been aimed at creating selective biologic "bullets" that can neutralize these offenders.
Examples of anti-cytokine and anti-antibody drugs are the TNF-inhibitor and the interleukin-6 blocking drugs.
There have also been biologic treatments developed against T-cells and B cells.
Mesenchymal stem cells have been shown to have healing capabilities for damage occurring in connective tissue such as cartilage, tendon, and bone.
They also have anti-inflammatory and immunomodulatory effects.
And, because they are precursor cells (meaning they are infant-like cells), they don't have protein antigens that could potentially trigger rejection or a graft versus host reaction.
What this means is that they can be used therapeutically without resorting to immunosuppressive treatments.
What is truly interesting is that MSCs can block the multiplication of B cells, T cells, natural killer cells, and other cells that have potentially destructive capabilities.
Secondarily, they can also block the production of inflammatory cytokines by these cells as well.
So then...
at least theoretically, mesenchymal stem cells could be used to restore the abnormal regulation seen in autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus.
Multiple animal models of inflammatory arthritis have demonstrated that MSCs can reset the immune "thermostat" and correct the imbalance among cells that leads to conditions such as rheumatoid arthritis.
Similar studies have been conducted in systemic lupus erythematosus.
The downside is that there have been other studies showing conflicting evidence.
The verdict to date? The jury is still out on a final decision.
Questions still remain as to the actual protocols that should be used such as optimal dosing, timing, etc.
An elegant scientific discussion which I have attempted to review and summarize here has been published (MacDonald GIA, Augello A, De Bari C.
Role of mesenchymal stem cells in reestablishing immunologic tolerance in autoimmune rheumatoic diseases.
Arthritis Rheum.
2011; 63: 2547-2557.
And it appears, that a second revolution may be on the horizon with new research involving stem cells.
While much attention has been focused on the role of mesenchymal stem cell (MSCs) in treating osteoarthritis, there has also been a great deal of research in other areas of arthritis.
An example would be rheumatoid arthritis (RA).
A tremendous amount of progress has been made in the treatment of RA.
It has been established that RA is perpetuated by a complex array of protein messengers, called cytokines, as well as many pro-inflammatory antibodies.
In addition, certain rogue populations of cells such as abnormal B-cells and T-cells also play a significant role in perpetuating disease.
The thrust of research has been aimed at creating selective biologic "bullets" that can neutralize these offenders.
Examples of anti-cytokine and anti-antibody drugs are the TNF-inhibitor and the interleukin-6 blocking drugs.
There have also been biologic treatments developed against T-cells and B cells.
Mesenchymal stem cells have been shown to have healing capabilities for damage occurring in connective tissue such as cartilage, tendon, and bone.
They also have anti-inflammatory and immunomodulatory effects.
And, because they are precursor cells (meaning they are infant-like cells), they don't have protein antigens that could potentially trigger rejection or a graft versus host reaction.
What this means is that they can be used therapeutically without resorting to immunosuppressive treatments.
What is truly interesting is that MSCs can block the multiplication of B cells, T cells, natural killer cells, and other cells that have potentially destructive capabilities.
Secondarily, they can also block the production of inflammatory cytokines by these cells as well.
So then...
at least theoretically, mesenchymal stem cells could be used to restore the abnormal regulation seen in autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus.
Multiple animal models of inflammatory arthritis have demonstrated that MSCs can reset the immune "thermostat" and correct the imbalance among cells that leads to conditions such as rheumatoid arthritis.
Similar studies have been conducted in systemic lupus erythematosus.
The downside is that there have been other studies showing conflicting evidence.
The verdict to date? The jury is still out on a final decision.
Questions still remain as to the actual protocols that should be used such as optimal dosing, timing, etc.
An elegant scientific discussion which I have attempted to review and summarize here has been published (MacDonald GIA, Augello A, De Bari C.
Role of mesenchymal stem cells in reestablishing immunologic tolerance in autoimmune rheumatoic diseases.
Arthritis Rheum.
2011; 63: 2547-2557.
Source...