Rheumatoid arthritis (RA) is a chronic inflammatory disorder affecting the joints. Antirheumatic drugs include nonsteroidal anti-inflammatory agents (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs). 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.
Stem cells are specialized cells with the ability to build every type of tissue in the human body. Because they can 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 specialized cells and tissues.
Stem cell therapy is a type of regenerative medicine that’s aimed at repairing and reconstructing damaged tissues. It 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 U.S. Food and Drug Administration (FDA). The only stem cell therapies approved by the FDA are hematopoietic progenitor cells (blood-forming stem cells) sourced from umbilical cord blood. These stem cells are approved for limited use in people with medical conditions that affect the hematopoietic system (body’s blood production).
One type of multipotent stem cell, mesenchymal stem cells (MSCs), are of great interest for stem cell therapy. Human MSCs 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. MSCs can also suppress the immune system and are being studied in autoimmune diseases.
Stem cell therapy is not currently FDA approved as a treatment option for RA. However, as published in the journal 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 RA, the immune response attacks the synovium — the tissue that produces joint-lubricating fluid. Damage to the synovium 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 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, 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.
You may be wondering — does stem cell therapy work for RA? Early studies show that it might. Laboratory studies published in the journal Cells show that MSCs 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 from the journal PeerJ Life & Environment using a mouse model of RA found that MSC treatment improved RA symptoms, including bone erosions and synovitis (inflammation of the synovium). 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.
In 2022, the journal Stem Cell Research & Therapy published the results from a phase 1/2a clinical trial studying MSCs in people with RA. In this study, the researchers performed a one-time infusion of MSCs isolated from fat tissue to determine whether the treatment improved RA symptoms. Overall, the participants saw an improvement in joint pain and swelling at follow-up after one year of treatment.
The specific methods of stem cell therapy used in this study were shown to be safe in people with RA. However, larger clinical trials that use placebo (“fake”) treatments to compare against stem cell therapy are needed to confirm these findings in more participants.
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 own cells. The FDA states that 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.
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.
If you’re interested in stem cell therapy for treating your RA, you may consider joining a clinical trial. Several studies have been submitted to ClinicalTrials.gov that are active but not yet recruiting participants. These include:
If you’re interested in joining a clinical trial, talk to your rheumatologist. They can recommend studies that may be a good fit for you and help you get in contact with the study organizers. Every clinical trial has inclusion criteria — requirements you need to meet to join a study. These may include your age, having a certain disease activity level, and having certain markers of inflammation. They usually have exclusion criteria, or certain conditions that disqualify you from participation in the study. These can include taking certain types of medication or having other underlying health conditions.
The study organizers will discuss these with you before joining a study. These requirements help make sure you’re healthy enough to participate and make it less likely that you would become sick due to treatment.
Some myRAteam members have asked about stem cell therapy, and others have shared their experiences and advice. If you’re interested in learning more about the therapy and how you may benefit from it, talk to your rheumatologist or another specialist.
One member asked, “I’ve been contacted by a company that does stem cell therapy and they wanted me to go in and talk to them about doing stem cell therapy to regrow damaged cartilage. Has anyone tried it and what were the results?” Another member replied, “I’m currently saving up for this procedure, it’s about $16K. I’ve read some personal stories of complete remission after one treatment.” “My ortho and I were talking about this a few weeks ago. She thinks it’s worth a try for my damaged Achilles tendons,” said another member.
On myRAteam, you’ll have access to the social network for people living with RA and their loved ones. Here, more than 197,000 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.