Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara 903-0215, Japan.
Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara 903-0215, Japan.
Cells. 2023 Jul 21;12(14):1905. doi: 10.3390/cells12141905.
Rheumatoid arthritis (RA) is a highly prevalent, chronic, and progressive autoimmune disorder primarily affecting joints and muscles. The associated inflammation, pain, and motor restriction negatively impact patient quality of life (QOL) and can even contribute to premature mortality. Further, conventional treatments such as antiinflammatory drugs are only symptomatic. Substantial progress has been made on elucidating the etiopathology of overt RA, in particular the contributions of innate and adaptive immune system dysfunction to chronic inflammation. Although the precise mechanisms underlying onset and progression remain elusive, the discovery of new drug targets, early diagnosis, and new targeted treatments have greatly improved the prognosis and QOL of patients with RA. However, a sizable proportion of patients develop severe adverse effects, exhibit poor responses, or cannot tolerate long-term use of these drugs, necessitating more effective and safer therapeutic alternatives. Mounting preclinical and clinical evidence suggests that the transplantation of multipotent adult stem cells such as mesenchymal stromal/stem cells is a safe and effective treatment strategy for controlling chronic inflammation and promoting tissue regeneration in patients with intractable diseases, including RA. This review describes the current status of MSC-based therapies for RA as well as the opportunities and challenges to broader clinical application.
类风湿关节炎（RA）是一种高发、慢性、进行性的自身免疫性疾病，主要影响关节和肌肉。相关的炎症、疼痛和运动受限会降低患者的生活质量（QOL），甚至导致过早死亡。此外，抗炎药物等传统治疗方法只是对症治疗。在阐明明显 RA 的病因发病机制方面已经取得了重大进展，特别是先天和适应性免疫系统功能障碍对慢性炎症的影响。尽管发病和进展的具体机制仍不清楚，但新的药物靶点的发现、早期诊断和新的靶向治疗方法极大地改善了 RA 患者的预后和 QOL。然而，相当一部分患者出现严重的不良反应、反应不佳或不能耐受这些药物的长期使用，因此需要更有效和更安全的治疗选择。越来越多的临床前和临床证据表明，移植间充质基质/干细胞等多能成体干细胞是一种安全有效的治疗策略，可控制慢性炎症并促进包括 RA 在内的难治性疾病的组织再生。本综述描述了基于 MSC 的 RA 治疗的现状，以及更广泛临床应用的机遇和挑战。
