Rheumatoid arthritis (RA) is a chronic, autoimmune disease affecting multiple joints symmetrically. The main symptoms at the early stage of the disease are joint pain and swelling; at the late stage, arthritis leads to joint stiffness, malformation, loss of function, and even disability.
Current therapies include medications with limited efficacy, such as non-steroidal antiinflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), and immunosuppressants.
The Use of Mesenchymal Stem Cells
Mesenchymal stem cells (MSCs) are characterized by their regenerative property to repair parenchymal tissue and organs through differentiating into lineages of mesenchymal tissues, as well as immunomodulation.
When injected they can migrate to injured tissues and facilitate the recovery of damaged cells. Several studies have demonstrated the clinical benefits of MSCs in RA therapy.
MSCs can express various receptors for pro-inflammatory cytokines to reduce inflammation in RA patients.
Clinical Trial Using Umbilical Cord-derived MSCs
Liming Wang and colleagues assessed the long-term efficacy and safety of umbilical cord-derived MSCs along with DMARDs for the treatment of RA.
The study included a total of 64 patients with RA aged 18 to 64. The inclusion criteria were patients with swelling present in at least one joint, and three or more joint swelling, morning stiffness for 3 hours on average which did not have another cause, and symptoms present for at least 6 weeks. Patients were excluded if they were pregnant, aged under 12 or over 70 years, and if had received any RA treatment before.
The patients received 40 mL umbilical cord-derived MSCs suspension or 20 million cells/20 mL via an intravenous injection immediately after the infusion of 100 mL of saline solution.
All patients’ blood samples were collected before treatment, 1 year, and 3 years after UC-MSC treatment.
The patients showed a decreased level of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR), which are markers of acute inflammation, rheumatoid factor, and anti-CCP levels 1 and 3 years after treatment. Health index (HAQ) and joint function index (DAS28), which are used in clinical practice to evaluate clinical disease activity of RA, were also decreased 1 and 3 years after the procedure.
The study showed evidence of long-term safety and efficacy in the use of UC-MSC therapy for RA for up to 3 years.
Wang L, Huang S, Li S, Li M, Shi J, Bai W, Wang Q, Zheng L, Liu Y. Efficacy and Safety of Umbilical Cord Mesenchymal Stem Cell Therapy for Rheumatoid Arthritis Patients: A Prospective Phase I/II Study. Drug Des Devel Ther. 2019 Dec 19;13:4331-4340. doi: 10.2147/DDDT.S225613. PMID: 31908418; PMCID: PMC6930836.