Feng Zhi, Yang Ying, Liu Xiang-Zhuo, Sun Hui-Jiao, Wen Bo-Ya, Chen Zhi, Wei Bo
Institute of Translational Medicine, School of Basic Medical, Hengyang Medical College, University of South China, Hengyang, Hunan 42100l, China.
Department of Specialty Medicine, School of Public Health, Hengyang Medical College, University of South China, Hengyang, Hunan 421001, China.
Int Immunopharmacol. 2025 Feb 6;147:114017. doi: 10.1016/j.intimp.2025.114017. Epub 2025 Jan 7.
Rheumatoid arthritis (RA) is a common chronic autoimmune disease that primarily affects the joints, leading to synovial inflammation and hyperplasia, which subsequently causes joint pain, swelling, and damage. The microenvironment of RA is characterized by hypoxia, high reactive oxygen species (ROS), low pH, and levels of high inflammatory factors. Traditional treatments only partially alleviate symptoms and often cause various adverse reactions with long-term use. Therefore, there is an urgent need for safer and more effective treatments. In recent years, mesenchymal stem cells (MSCs) have shown significant potential in treating RA due to their diverse immunomodulatory mechanisms. MSCs paracrine a variety of soluble factors to improve the inflammatory microenvironment in RA patients by inhibiting T cell proliferation or inducing T cell differentiation to regulatory T cells (Tregs), inhibiting B cell proliferation and differentiation and immunoglobulin production, prompting macrophage polarization toward an anti-inflammatory phenotype, and inhibiting neutrophil recruitment and preventing the maturation of dendritic cells (DCs). This review summarizes the immunomodulatory effects of MSCs in RA and their application in animal models and clinical trials. Although the immunomodulatory mechanisms of MSCs are not yet fully elucidated, their significant potential in RA treatment has been widely recognized. Future research should further explore the immunomodulatory mechanisms of MSCs and optimize their functions in different pathological microenvironments to develop more effective and safer therapeutic strategies.
类风湿性关节炎（RA）是一种常见的慢性自身免疫性疾病，主要影响关节，导致滑膜炎症和增生，进而引起关节疼痛、肿胀和损伤。RA的微环境特征为缺氧、高活性氧（ROS）、低pH值以及高炎症因子水平。传统治疗只能部分缓解症状，长期使用往往会引起各种不良反应。因此，迫切需要更安全、更有效的治疗方法。近年来，间充质干细胞（MSCs）因其多样的免疫调节机制在治疗RA方面显示出巨大潜力。MSCs通过抑制T细胞增殖或诱导T细胞分化为调节性T细胞（Tregs）、抑制B细胞增殖和分化以及免疫球蛋白产生、促使巨噬细胞极化为抗炎表型、抑制中性粒细胞募集以及阻止树突状细胞（DCs）成熟，分泌多种可溶性因子来改善RA患者的炎症微环境。本文综述了MSCs在RA中的免疫调节作用及其在动物模型和临床试验中的应用。尽管MSCs的免疫调节机制尚未完全阐明，但其在RA治疗中的巨大潜力已得到广泛认可。未来的研究应进一步探索MSCs的免疫调节机制，并在不同病理微环境中优化其功能，以制定更有效、更安全的治疗策略。
