Systemic lupus erythematosus (SLE) is a diffuse connective tissue disease that often affects multiple organs and systems, such as the kidneys, blood system, and nervous system.
The disease is more common in women, and patients that have the condition need to take long-term glucocorticoids and immunosuppressants such as cyclophosphamide, mycophenolate mofetil, and other drugs in order to control the disease activity.
Current therapies do not always work for all patients and even with multiple immunosuppressive therapies, the patients are refractory to treatment.
A new therapy that has been under investigation for many years now is the use of stem cell therapy. The use of mesenchymal stem cells (MSCs) that have multi-directional differentiation potential and can differentiate into mesoderm tissue cells such as bone, cartilage, and fat, while also having a strong paracrine effect that can modulate the immune response.
MSCs can be extracted from the placenta, umbilical cord, fat, dental pulp cells, and other tissues, especially the umbilical cord, which has become a widely used MSC source due to its easy access and good cell proliferation potential.
Clinical Trials Using MSCs for SLE
In a meta-analysis published in 2018, researchers evaluated multiple studies using MSCs for the treatment of systemic lupus, which included a total of 8 published studies that had a total of 213 patients from 12 to 55 years of age, with an average age of 32.6 years, 193 were female and 20 males.
Only mild adverse events were reported during the studies, including fever, diarrhea, vomiting, headache, and pruritus that improved after symptomatic treatment.
The study showed that there are MSC abnormalities in systemic lupus compared with normal controls the bone marrows of patients with SLE grow slowly, are more prone to apoptosis and senescence, secrete cytokine levels are also reduced, and the function of inhibiting the proliferation and differentiation of T cells and B cells is also defective. That is why some studies have suggested that SLE is a disease mediated by MSCs and that MSCs can improve the clinical symptoms and survival rates of these patients.
The studies evaluated by the researchers showed improved disease activity, proteinuria, and complement levels in SLE patients, which is consistent with what animal studies have also found.
Liu S, Guo YL, Yang JY, Wang W, Xu J. [Efficacy of mesenchymal stem cells on systemic lupus erythematosus:a meta-analysis]. Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Dec 18;50(6):1014-1021. Chinese. PMID: 30562774.