The debilitating condition known as rheumatoid arthritis (RA) is one that no one should be forced to live with on a day-to-day basis. Macquarie Stem Cells provides locals in Sydney with rheumatoid arthritis treatment that uses stem cell therapy in order to provide pain relief and alleviate symptoms. Learn more about rheumatoid arthritis and how it can be treated.
What is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune disease that typically results in the sufferer experiencing inflammation in the smaller joints of the body, particularly the hands and the feet. This inflammation presents itself as swelling and pain in the joints – usually in the morning. A definitive cause of the condition has not yet been found; continued research in the field will hopefully bring more conclusive findings in the near future, though it is believed at this stage that some people might be more susceptible to developing the condition due to genetic factors.
Being an autoimmune disease, rheumatoid arthritis will attack the body’s healthy tissue rather than fight off any infection. It begins by working its way through the lining of the joints, which is known as the synovial membrane. This direct targeting of the joint lining results in inflammation which displays itself as rheumatoid arthritis in the hands, the feet and other areas of the body. The appearance of swelling tends to occur when the joints produce too much synovial fluid in order to counteract the inflammation.
Risk Factors of Developing RA
Research so far has indicated that these are the most common risk factors for developing rheumatoid arthritis:
- Sex – Women are more likely to develop RA than men are.
- Age – People between the ages of 40 and 60 are more likely to develop rheumatoid arthritis
- Heredity factors – If people in your family have suffered from the condition, your risk might increase.
- Smoking – This not only increases your risk of developing RA, especially if you’re genetically predisposed to it, but it can also increase the severity of symptoms.
- Obesity – People who are overweight or obese are more likely to be at risk of developing rheumatoid arthritis
The Symptoms of Rheumatoid Arthritis
In addition to the already mentioned inflammation and pain in the joints of the hands and the feet, there are numerous other rheumatoid arthritis symptoms that could manifest. These can include:
- Joint stiffness, particularly first thing in the morning
- Constant fatigue
- Interrupted sleeping patterns as a result of the pain
- Muscle weakness
- Symptoms reminiscent of the flu (e.g. temperature, sweats)
- Lack of full range of motion
It’s entirely possible to have different symptoms of rheumatoid arthritis present themselves on different days, and the severity can vary from person to person. If you think you’re presenting any signs or symptoms of rheumatoid arthritis, please make an appointment with your doctor.
The link between Stem Cells & Rheumatoid Arthritis Treatment
The cells used in treating Rheumatoid Arthritis can work as follows;
- Place the immune system in a state of remission (alternatively known as tolerogenesis)
- Target and fight off inflammation (reduce the pain you have)
- Repair damaged tissue (cartilage & blood vessels)
- Differentiate to the matching tissue type (eg: muscle, tendon, ligament & cartilage)
- Increase the productivity of synovial fluid (increase lubrication of your joints)
(Paz Rodriguez et al., 2012) (Wu et al., 2013) (Gibbs et al., 2015) (Jo et al., 2014) (Michalek, 2015)
Tolerogenesis – What is it?
The word tolerogenesis is derived from the concept of tolerance. An example is the body’s ability to tolerate a very large foreign body when pregnant. If the mother loses her tolerance she will immediately abort the baby. With auto-immune disorders such as Rheumatoid Arthritis and Multiple Sclerosis the body thinks that some cells are foreign and attempts to destroy them. At this time the body is not tolerating these cells. (P.Nancy, 2012)
Stromal cells appear to have a strong ability to stop the attack and restore a state of tolerogenesis. During this time the stromal cells will then repair (cartilage) cells that are damaged, target the inflammation in the joints causing issues such as pain and loss of function. (Paz Rodriguez et al., 2012)
Similarly to osteoarthritis cases we have seen these cells increase the productivity and effectiveness of the synovial fluid with in the joints thus allowing for better lubrication.
In combination this will give a reduction in pain and stiffness, therefore allowing increased function. (Michalek, 2015)
RESULTS POST TREATMENT
Every patient will have a different response to the rheumatoid arthritis treatment; keeping in mind a very small number of patients will not have any response to their own cells. Responding patients are expected to notice significant improvements to the items listed below;
- Reduction of pain & inflammation throughout the body and joints.
- Increase in mobility of the joints
- Deformation of joints should decrease or stop their progression
- Improvements to quality of life and fatigue
Reduction to your body’s C-reactive proteins
(can be monitored via blood tests)
Reduction to your body’s rheumatoid factors
(can be monitored via blood tests)
Improvements to your immune function
(Treg Cell Modulation)
Improvements via RA Qualify of Life and Function Questionnaires
* Multiple injections provide for greater results, specifically applies in the case of broken immune remission.
All graphs referenced to previous studies by Wang et al., 2013.
Key Points from R.A. Research & Stem Cells
“MSCs can express various receptors for inflammatory factors, which might combine with the corresponding inflammatory factors to reduce inflammation in RA patients. Immunoregulatory role of MSCs may associate with the occurrence of inflammatory mediators. In this study, the serum levels of TNF-a and IL-6 significantly decreased in parallel with the deduction of serum C-reactive protein.”
“After treatment, indicating that anti-inflammation was one of the major mechanisms of MSCs. Furthermore, MSCs were recently reported to suppress effector T cells and inflammatory responses and have emerged as attractive therapeutic candidates for immune disorders.”
(Wang et al., 2013)
“The weight of evidence for protective mechanisms of exogenously administered MSCs is on immunomodulatory effects, including inhibition of dendritic cell maturation, polarization of macrophages to an anti-inflammatory phenotype, and activation of regulatory T cells, thereby dampening inflammation and preventing joint damage. Evidence for direct effects on tissue repair is scant. Recent studies have identified MSC subsets in vivo and an important question is whether MSCs in their native tissues have similar immunoregulatory functions. Recent proof-of-concept clinical studies have shown a satisfactory safety profile of allogeneic MSC therapy in RA patients with promising trends for clinical efficacy.”
(Ansboro, Roelofs and De Bari, 2017)
“During preclinical RA, when autoreactive T cells expand and immunological tolerance is broken, the main sites of disease are the secondary lymphoid tissues. Naive CD4 T cells from patients with RA have a distinct metabolic signature, characterized by dampened glycolysis, low ATP levels and enhanced shunting of glucose into the pentose phosphate pathway. Equipped with high levels of NADPH and depleted of intracellular reactive oxygen species, such T cells hyperproliferate and acquire proinflammatory effector functions. During clinical RA, immune cells coexist with stromal cells in the acidic milieu of the inflamed joint. This microenvironment is rich in metabolic intermediates that are released into the extracellular space to shape cell-cell communication and the functional activity of tissue-resident cells.”
(Weyand and Goronzy, 2017)
“We show that cell therapy with ASCs, among other effects, modulate the inflammatory innate cell responses with a concomitant delay in the progression of the arthritis. Modulation of innate immune responses in RA is of critical importance in the clinic since a growing body of evidence has shown the key contribution of dysregulated innate responses during the progression of the disease. The fact that the effect of the ASCs was transient was somewhat expected. The majority of the in vivo studies with ASCs for preventing collagen‐induced arthritis used multiple doses of MSCs before the onset of the disease. Gonzalez MA and collaborators demonstrated that three doses of eASCs can have a sustained beneficial effect when used in a therapeutic protocol”
(Lopez-Santalla et al., 2016)
Immune Remission & Stem Cells
This is a very good article that will explain the full cellular mix, their abilities and the relationships observered between different auto-immune conditions with the treatment of stem cells. Please click here to read it