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.
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.
Cellular 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) are programed to receive signals from damaged tissue and specifically target inflamed tissue, where they lock-on and begin producing powerful anti-inflammatory agents that stops the pain and heals the damaged tissue. These anti-inflammatory mediators act locally and do not suppress the natural immune response of the rest of the patient’s 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 human study on MSCs for rheumatoid arthritis (Human Umbilical Cord Mesenchymal Cellular Therapy for Patients with Active Rheumatoid Arthritis: Safety and Efficacy) showed that MSCs produced a significant decrease in the pro-inflammatory cytokines IL-6 and TNF-α, both of which are temporarily targeted by many current RA treatments, but without the typical long-term side effects. These decreased inflammatory levels are shown in Figure 5 from the original publication.
Which types of stem cells are used to treat rheumatoid arthritis and how are they collected?
The adult stem cells used to treat RA at the Stem Cell Institute come from human umbilical cord tissue (allogeneic mesenchymal).
The mesenchymal stem cells we use are recovered from donated umbilical cords following normal, healthy births. Each mother has her medical history screened and is tested for infectious diseases. Proper consent is received from each family prior to donation.
All umbilical cord-derived stem cells are screened for infectious diseases to International Blood Bank Standards before they are cleared for use in patients.
What are the advantages of treating rheumatoid arthritis with allogeneic umbilical cord tissue-derived stem cells?
- Since HUCT mesenchymal stem cells are immune system privileged, cell rejection is not an issue and Human Leukocyte Antigen (HLA) matching is not necessary.
- High levels of MSCs can be harvested to provide a high level of anti-inflammatory activity, immune modulating capacity, and ability to stimulate regeneration of damaged tissue.
- Stem Cells can be administered in high doses typically in the range of 60-90 million Stem Cells via IV infusion.
- Umbilical cord tissue provides an abundant supply of mesenchymal stem cells.
- No need to collect stem cells from the patient’s hip bone or fat under anesthesia, which especially for small children and their parents, can be an unpleasant ordeal.
- There is a growing body of evidence showing that umbilical cord-derived mesenchymal stem cells are more robust than mesenchymal stem cells from Bone Marrow Concentrate or Adipose Tissue.
- Umbilical cord-derived mesenchymal stem cells also proliferate/differentiate more efficiently than “older” cells, such as those found in the fat and therefore, they are considered to be more “potent”.
- No need to administer chemotherapy drugs like Granulocyte-colony stimulating factor (G-CSF or GCSF) to stimulate the bone marrow to produce granulocytes and stem cells and release them into the bloodstream.
Are mesenchymal stem cells approved by the US FDA?
Human umbilical cord tissue-derived mesenchymal stem cells (MSCs) were approved by the United States FDA with the first regulation/guidelines given in November 2017. FDA Commissioner, Scott Gottlieb, MD, has said, “We’re at the beginning of a paradigm change in medicine with the promise of being able to facilitate regeneration of parts of the human body and adult stem cells can generate replacements for cells that are lost to injury or disease. This is no longer the stuff of science fiction. This is the practical promise of modern applications of regenerative medicine.”
How are the stem cells administered for rheumatoid arthritis treatment?
Stem Cells are given by intravenous (IV) infusion over a period of 15 to 30 minutes. Typically each patient receives 60-90 Million Cells per infusion.
For More Information about Cellular Therapy
For more detailed information about Cellular Therapy for Rheumatoid Arthritis, we encourage you to read/download the entire chapter on cellular therapy for arthritis from Dr. Niel Riordan’s new book, Cellular Therapy: A Rising Tide – How Stem Cells are Disrupting Medicine and Transforming Lives.