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Mesenchymal Stem Cell Transplantation in Rheumatoid Arthritis

  • Kendrick To
  • Wasim KhanEmail author
Chapter
Part of the Stem Cells in Clinical Applications book series (SCCA)

Abstract

Rheumatoid arthritis represents a destructive cascade of both innate and adaptive immunity. In recent times, the use of stem cell transplantation in immune reeducation has been gaining an audience. There is a growing number of in vitro studies and several randomized controlled trials in human subjects. In this chapter we review the mechanism of inflammation in rheumatoid arthritis by looking at the different cells and mechanisms involved in innate and adaptive immunity. Mesenchymal stem cells appear to influence a multitude of inflammatory pathways involved in the pathogenesis of rheumatoid arthritis. We discuss the use of autologous and allogeneic mesenchymal stem cells in rheumatoid arthritis. We consider the different routes of administration of these cells including the intravenous and intra-articular route, and the role of priming mesenchymal stem cells. We also look at clinical trials, pitfalls, and limitations. Evidence suggests that mesenchymal stem cells seem to play a role in joint repair in pathological joints. The transplantation of these cells into the peripheral blood and joints of patients with rheumatoid arthritis who are refractory to conventional treatments have been shown to be both safe and effective. The main trials and tribulations that we face include the need for technological advancement in tissue engineering, and the task of discovering the correct target audience with a responsive phenotype for stem cell transplantation, as well as developing a standard method for the delivery of these cells.

Keywords

Rheumatoid arthritis Mesenchymal stem cells Stem cell transplantation Stem cell therapy Stem cell treatment 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Trauma and Orthopaedic SurgeryUniversity of Cambridge, Addenbrooke’s HospitalCambridgeUK

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