Until a few years ago, arthritis was treated either by administering drugs or performing a surgery in chronic cases. Many people had to undergo treatment for a long period, and for some, the outcome was not very promising. However with the discovery of stem cell therapy, the scenario of medical treatment and techniques has changed. Although an expensive treatment option, it is capable of curing arthritis almost completely from its roots.
There are several different forms of arthritis, amongst which rheumatoid arthritis has been extensively cured by stem cell therapy. The synovial membrane present in the lining of tendons and joints is inflamed, which further gives rise to pain, soreness, stiffness and swelling in joints. This is the typical condition of rheumatoid arthritis. With sheer advancement of research and medical science, this therapy can cure the inflammation. So how's this possible? We explain this in the subsequent paragraphs.
Stem Cells for Treatment of Arthritis
Arthritis is an autoimmune disease because the inflammation is caused when an immune response is triggered against the body itself. As a result of this, the antibodies present inside the body, start affecting the healthy cells and tissues, thereby causing severe inflammation to them. In case of rheumatoid arthritis, the auto-antibodies produced are Anti-MCV, Rheumatoid factor (anti-IgGFc) and ACPAs (Vimentin). The overactive immune response gives rise the symptoms explained above.
Use of Hematopoietic Stem Cells
The question here is how can stem cells
be used to counteract such a response. Let's assume that you are well aware of the unique property of stem cells, i.e., 'they have the potency to divide and give rise to specialized types of cells
'. Using the concept as the key to arthritis treatment, scientists propagated their research and experiments. We have listed the steps below.
- The healthy bone marrow cells (hematopoietic stem cell) of the patient are collected (preferably from the hip) in vitro and are then harvested under controlled conditions. The patient is given general anesthesia before making the incision.
- The method of collecting the stem cells is quite complicated as it depends on the requirement of the donor and treatment. Basically the stem cells are separated from the bone marrow by centrifugation.
- The isolated stem cells are then washed and concentrated by successive rounds of centrifugation. Concentration is done to step-up their efficiency to divide and grow.
- The stem cells are now ready for implanting in the patient. In case of arthritis, the stem cells are implanted in the affected joints. The inflamed cells are destroyed by chemotherapy before implanting the healthy cells.
The stem cells then regenerate and give rise to healthy cells. This was the basic technique of stem cell therapy. However, the process is not as simple as it seems under the list. This is because there are many factors to consider before performing it on an individual. We have explained them over below.
Research on Fetal Stem Cells
- The stems cells are taken from the patient himself in order to eliminate the complications of graft rejection by antibodies. This procedure in known as autologous transplantation.
- Although, hematopoietic stem cells can be collected from a healthy donor (allogeneic transplant) or an identical twin of the patient (syngeneic transplant), in such cases there are chances of rejection of the transplant. Thus, immunosuppressive drugs are administered to the patient.
- The process of collecting the stem cells in known as plasmapheresis. This step is highly crucial as the stem cells are mobilized from rest of the blood cells in conjunction with granulocyte colony-stimulating factor (G-CSF) and cyclophosphamide. These two elements aid in rapid multiplication of stem cells.
- The next step is selecting the stem cells having CD34+ (cluster of differentiation) molecule. This is a marker glycoprotein, that helps in adhesion of stem cells to the extracellular matrix formed by the bone marrow. Only the positively selected stem cells are transplanted into the joints.
A research conducted at the National Medical University of Ukraine, used fetal stem cells for the transplantation procedure. They observed that the test group affected with arthritis has certain symptoms in common, which included morning stiffness in joints, hyperthermia, synovitis, presence of C- reactive proteins and rapid erythrocyte sedimentation. When the graft was implanted in them, all these symptoms began disappearing approximately after two months. Apart from using hematopoietic stem cells and fetal stem cells, there's considerable research going on the use of adult stem cells, as an alternate treatment for arthritis. A report published in the journal 'Arthritis & Rheumatism', issued by American College of Rheumatology also states that a woman suffering from rheumatoid arthritis was cured by stem cell therapy. In her case, it was an allogeneic transplantation as the graft was donated by her sibling. She was completely cured of the disease within a year of the transplantation. The study also revealed that, being under immunosuppressive drugs she was absolutely out of the danger of graft vs host disease.
Treatment Benefits of Stem Cells
- It's indeed a great alternative for conventional surgeries, like joint replacement, etc., and the transplantation is performed with a very minor incision.
- Heavy dosage of steroids and anti-inflammatory drugs are stopped as healthy cells regenerate inside the body.
- The biggest advantage of the therapy is its assured results. Rheumatoid arthritis can be completely remitted in the long run with stem cell therapy.
Although several controversies are associated with stem cell therapy, its positive side is larger than the negative. Clinical trials are conducted on arthritis patients in order to find out the best possible method of this therapy. However, the success of a discovery depends much on the common man's response towards it. At this stage, undergoing this kind of therapy is indeed an expensive affair, but taking the advantages and operative benefits into consideration, it will be established uncontroversially in the future.