What is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a systemic, inflammatory autoimmune disease that mainly involves peripheral facet joint disease, which is the main pathological feature as well as joint synovial cell proliferation, inflammatory cell infiltration and pannus.
It is a chronic inflammatory disorder that can affect more than just the joints. In some people, the condition can damage a wide variety of body systems including the skin, eyes, lungs, heart and blood vessels.
Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.
The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.
What Causes RA?
Normally your immune system helps protect your body from infection and disease. In rheumatoid arthritis your immune system attacks healthy tissue in your joints and other parts of the body like the lungs, heart, nerves, eyes and skin.
Although genetic components appear to contribute, researchers believe that environmental factors are more likely to be the cause, such as infections with certain viruses and bacteria that may trigger the disease. Some known risk factors are:
- Sex. Women are more likely than men to develop RA.
- Age. RA can occur at any age, but it most commonly begins in the middle age.
- Family history. If a family member has RA, you may have an increased risk.
- Smoking. Cigarette smoking increases the risk of developing RA, particularly if you have a genetic predisposition and is also associated with greater disease severity.
- Excess weight. People who are overweight appear to be at a somewhat higher risk of developing RA.
What are the Most Common Signs and Symptoms?
Signs and symptoms of rheumatoid arthritis may include:
- Tender, warm, swollen joints.
- Joint stiffness that is usually worse in the mornings and after inactivity.
- Fatigue, fever and loss of appetite.
Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet.
As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.
About 40% of people who have rheumatoid arthritis also experience signs and symptoms that don’t involve the joints. Areas that may be affected include:
- Salivary glands.
- Nerve tissue.
- Bone marrow.
- Blood vessels.
Current Treatment Options
To date, traditional RA treatment mainly involves reducing the symptomatic inflammatory reaction and sequelae, conventional treatment cannot satisfy the clinical requirement of achieving a curative effect.
Current treatment options include:
- NSAIDs. Nonsteroidal antiinflammatory drugs can relieve pain and reduce inflammation.
- Steroids. Corticosteroids, such as prednisone, reduce inflammation and pain and slow joint damage. However they can cause multiple side effects that may include osteoporosis, weight gain and increased glucose levels.
- DMARDs. Disease-modifying antirheumatic drugs can slow the progression of RA and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate, leflunomide, hydroxychloroquine and sulfasalazine. They can also cause different side effects like liver damage and severe lung infections.
Stem Cell Therapy with Umbilical Cord Mesenchymal Stem Cells
Because conventional treatment has failed to achieve a curative effect and can cause multiple side effects, exploring more effective and safer treatment options is increasingly important.
Mesenchymal stem cells (MSCs) are derived from early-development mesoderm pluripotent stem cells and have a high degree of self-renewal and multidirectional differentiation potential; MSCs widely exist in a variety of human tissues and can be cultured in vitro.
They can differentiate into osteoblasts, nerve cells, adipose cells, muscle cells and cardiomyocytes. These cells have great application value in tissue engineering repair and in cell replacement therapy.
Umbilical cord MSCs (UC-MSCs) are derived from human umbilical cord blood and have MSC characteristics and functions. Therefore, UC-MSCs offer the hope of a new treatment option for RA.
In recent years, MSCs have been widely used in the treatment of various diseases including spinal cord injury, cerebral palsy, amyotrophic lateral sclerosis, systemic lupus erythematosus, systemic sclerosis, Crohn’s disease, stroke, diabetes, among other conditions. In clinical research, the main types of MSCs are bone marrow-derived MSCs (BM-MSCs), adipose-derived mesenchymal stromal cells (AD-MSCs) and UC-MSCs.
Compared to BM-MSCs and AD-MSCs, umbilical cord mesenchymal stem cells have the advantages of having lower expression of major histocompatibility complex I (MHC I), MHC II is not expressed, so they do not cause rejection. Also, the growth environment is more pure and they have stronger abilities to proliferate and differentiate, and are easy to culture in vitro.
UC-MSCs have shown good efficacy and tolerability in RA patients and have emerged as a promising alternative in the management of RA. The pathogenesis of RA is related to disorders of immune mechanisms and cytokines, which UC-MSCs have shown to reduce cytokines and chemokines. They have also shown to have a very good immune regulation and ability to repair tissue damage.
As they have achieved a certain efficacy and few side effects in clinical practice, they are worthy of further large-sample clinical trials for future evaluation.
Stem Cell Therapy at Zignagenix
At our clinic we utilize MSCs derived from the Warthon’s jelly umbilical cord. We use high doses of stem cells infused intravenously (IV) combined with exosomes to increase the effectiveness of the therapy.
We also combine the IV therapy with localized injections in joints affected by the disease, which normally can include the joints of the hands, wrists, shoulders, elbows and knees. By injecting stem cells directly into the joint space the MSCs can modulate the immune response locally to decrease the inflammation and can also help regenerate some of the damaged tissue. By doing so patients can decrease the degree of pain and joint edema that RA normally causes.
Lv X, Wang L, Zou X, Huang S. Umbilical Cord Mesenchymal Stem Cell Therapy for Regenerative Treatment of Rheumatoid Arthritis: Opportunities and Challenges. Drug Des Devel Ther. 2021;15:3927-3936