MESENCHYMAL STEM CELLS: THERAPEUTIC TOOL FOR RHEUMATOID ARTHRITIS. Mrs. SREEWARDHINI SIVAPALAN*, Dr. D. SANKARI Department of Biotechnology, Faculty of Science and Humanities SRM Institute of Science and Technology,Kattankulathur, Chengalpattu District, Tamil Nadu - 603203.
ABSTRACT Rheumatoid arthritis (RA) is an autoimmune disease that occurs more frequently in females than males. Disease primarily affects the lining of the synovial joints. This is associated with progressive disability, premature death, and socioeconomic burdens. The human leukocyte antigen (HLA)–DRB1 locus has been confirmed in patients who are positive for rheumatoid factor or anti-citrullinated protein antibodies (ACPA). The overall worldwide prevalence of RA is 0.8% - 1% and in India it has been estimated to be 0.7%. Better understanding of disease progress will help to develop therapies. Synthetic disease-modifying anti-rheumatic drug and biologic DMARD targeting TNF has revolutionized treatment of RA. Adverse effects or inadequate efficacy leads, failure with DMARDs in RA by suppressing overactive immune systems. Management of DMARD for RA lies in safe monitoring. Therefore, a novel treatment strategy aimed. Mesenchymal stem cells (MSC) possess multipotent capacity and immunoregulatory properties, prompting us to consider MSC as a new therapeutic agent for RA.
Rheumatoid Arthritis: RA is a Chronic systemic autoimmune disease. It affects Primarily affect small diarthrodial joints. Generally Middle age and women are affected 2.5 times as frequently as men. Human leukocyte antigen ( HLA- DRB1) locus has been confirmed in the patients who has positive Rheumatoid factor or ACPA.This alleles contain a common amino acid motif (QKRAA) in HLA-DRB1 region. It’s called as ‘Shared epitope’, which plays major risk factor in RA.
MSC in the treatment of RA :
Current treatment: DRUGS FOR RA
NON BIOLOGIC DMARDs
Methotrexate Leflunomide Hydroxychloroquine Sulfasalazine Cyclophosphamide Cyclosporine
Drawback of Current treatment
BIOLOGIC DMARDS
Anti-TNF agents Etanercept Certolizumab pegol Adalimumab Infliximab
Nonbiologic DMARDs : Can cause Liver effects, hair loss, oral ulcers
Bone marrow and placenta, umbilical cord synovial derived mesenchymal stem have the potency to prevent tissue damage in Collagen-Induced Arthritis. Human Umbilical cord Wharton's Jelly–Derived and Placenta derived mesenchymal stem cells are abundant source of MSC that have increasingly gained attention in Cell therapy.These MSCs have the ability to suppress various inflammatory effects of FLSs and T cells of RA in vitro.
MSC as a novel drug : Mesenchymal stem cells (MSCs) can be easily isolated from various organs. possess multipotent capacity. Exhibit immunoregulatory properties which Plays a role in tissue repair.
Biologic DMARDs Anti-TNF agents , can cause TB, opportunistic infection
CONCLUSION Mesenchymal stem cells (MSCs) exhibits its potential role in cell therapy and functional repair of tissues and organs.The dual function of immune regulation as well as tissue repair that lead MSC as a new treatment tool for RA.Therapeutic potential of MSC for RA has been investigated in various clinical rodent models. Better understanding of the interaction between the MSC and other immune cells involved in RA will help to improve the targeted drug discovery and therapeutic application of MSC in RA.
Bibliography ➢ Alhadlaq, Adel, and Jeremy J. Mao. 2004. “Mesenchymal Stem Cells: Isolation and Therapeutics.” Stem Cells and Development 13 (4): 436–48. ➢ Beeravolu, Naimisha, Christina McKee, Ali Alamri, Sasha Mikhael, Christina Brown, Mick Perez-Cruet, and G. Rasul Chaudhry. 2017. “Isolation and Characterization of Mesenchymal Stromal Cells from Human Umbilical Cord and Fetal Placenta.” Journal of Visualized Experiments: JoVE, no. 122 (April). https://doi.org/10.3791/55224.