Rheumatoid arthritis (RA) is a chronic inflammatory disorder affecting the joints. Antirheumatic drugs include nonsteroidal anti-inflammatory agents (NSAIDs), corticosteroids, and disease-modifying biologics. However, some people with RA do not respond to these therapies or cannot use them due to potential side effects. In recent years, stem cell therapy has been proposed as a potentially effective treatment option for RA.

What Are Stem Cells?

Stem cells are specialized cells with the ability to build every type of tissue in the human body. Due to their ability to repair, replace, and regenerate cells and organs, stem cells potentially have many different therapeutic uses. Researchers hope that one day, stem cells can be used to treat many medical conditions and diseases.

There are different types of stem cells, including pluripotent and multipotent stem cells. Pluripotent stem cells can develop into all cell types in the body, including bone, heart, muscle, nerve, and blood cells. During development, pluripotent stem cells are only present for a very short time before turning into more specialized cells called multipotent stem cells. Multipotent stem cells then turn into particular cells and tissues.

What Is Stem Cell Therapy?

Stem cell therapy involves sourcing stem cells from body tissue, isolating them in a lab, manipulating them to produce specific functions, and then injecting them into a person. Adult stem cells, or embryonic stem cells, can be used for therapy.

Two types of stem cell transfer are possible: allogeneic (allo means other) and autologous (auto means self). In allogeneic stem cell therapy, stem cells are collected from a donor and injected into the person receiving therapy. In autologous stem cell therapy, stem cells are collected from the person receiving treatment.

Stem cell therapy is being studied for many different diseases and is regulated by the Food and Drug Administration (FDA). The only stem cell therapies approved by the FDA are blood-forming stem cells (hematopoietic progenitor cells) sourced from umbilical cord blood. These stem cells are approved for limited use in people with medical conditions that affect the body’s blood production (the hematopoietic system).

One type of multipotent stem cell, mesenchymal stem cells (MSCs), are of great interest for stem cell therapy. Human MSCs (hMSCs) are isolated from many different sources, including bone marrow, fat (adipose) tissue, umbilical cord blood, umbilical cord, placenta, and dental (tooth) pulp. MSCs can turn into different tissues such as bone and cartilage. Mesenchymal stem cells can also suppress the immune system and are being studied in autoimmune diseases.

Stem Cell Therapy for RA

Stem cell therapy is not currently FDA-approved as a treatment option for RA. However, mesenchymal stem cells (MSCs) are now being studied in people with RA.

In autoimmune diseases like RA, the immune system mistakes the body’s cells for foreign materials and produces cells that attack healthy tissue. In rheumatoid arthritis, the immune response attacks the synovium, tissue that produces joint-lubricating fluid. Damaged tissue is linked to inflammation, joint pain, stiffness, and swelling.

MSCs have immunomodulatory properties, meaning they can change immune function. By turning down or suppressing the immune system, MSCs may decrease inflammation within affected joints. MSCs dampen down the immune response by reducing the numbers or activity of immune cells and the specialized inflammatory chemicals they produce.

MSCs isolated from the synovium, called synovial MSCs (S-MSCs), are also being studied for their anti-inflammatory properties in RA. However, additional research and clinical trials are needed to determine the safety and effectiveness of stem cell therapy for RA.

Research on Stem Cell Therapy for RA

Laboratory studies demonstrate that mesenchymal stem cells can suppress the activity of immune cells isolated from people with RA. The MSCs also decreased the production of proinflammatory chemicals (called cytokines) and increased the production of anti-inflammatory cytokines.

Studies using a mouse model of rheumatoid arthritis found that MSC treatment improved RA symptoms, including bone erosions and synovitis (inflammation of the synovial membrane). The researchers also found lower levels of proinflammatory cytokines.

Two initial clinical studies tested the safety and potential of umbilical cord blood-derived MSCs in people with RA. Researchers found no negative side effects, and participants treated with MSCs showed lower levels of inflammatory cytokines. One study found a significant decrease in RA disease severity and pain intensity in individuals treated with MSCs, indicating a higher quality of life.

What Should People With RA Know About Stem Cell Therapy?

Although stem cells show promise in treating autoimmune conditions, further research is needed to study their safety and effectiveness. People with RA should seek medical advice from their rheumatologist regarding stem cell therapy options.

Those considering stem cell therapy should only use FDA-approved or studied therapies. It is essential to understand your rights and any potential side effects, even if the treatment uses your cells. Unproven stem cell therapies can be unsafe, leading to dangerous side effects such as cancer or infection.

The FDA recommends only using stem cell treatments that are either FDA-approved or are being studied in clinical trials under an Investigational New Drug Application (IND).

Many people in the United States are interested in stem cell treatments offered in other countries. However, the FDA does not control or test therapies in other countries. Those considering international treatment should learn about that country’s regulations. It may be hard to know if the treatment is safe.

Talk With Others Who Understand

On myRAteam, you’ll have access to the social network for people living with RA and their loved ones. Here, more than 147,000 members come together to ask questions, give advice, and share their stories with others who understand life with RA.

Have you undergone stem cell therapy to manage your RA? Share your experience in a comment below, or start a conversation by posting on myRAteam.

References

1. Introduction to Stem Cell Therapy — Journal of Cardiovascular Nursing
2. Mesenchymal Stem Cells Improve Rheumatoid Arthritis Progression by Controlling Memory T Cell Response — Frontiers in Immunology
3. FDA Warns About Stem Cell Therapies — U.S. Food & Drug Administration
4. Rheumatoid Arthritis: Causes, Symptoms, Treatments and More — Arthritis Foundation
5. Mesenchymal Stem Cells, Autoimmunity and Rheumatoid Arthritis — QJM: An International Journal of Medicine
6. Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis — Cells
7. Amelioration of Clinical Symptoms of Patients With Refractory Rheumatoid Arthritis Following Treatment With Autologous Bone Marrow-Derived Mesenchymal Stem Cells: A Successful Clinical Trial in Iran — Biomedicine & Pharmacology