Stem Cell-based Therapies for Rheumatoid Arthritis (RA):
More than just another symptom treating medicine
Rheumatoid Arthritis (RA) and Juvenile Idiopathic Arthritis are chronic inflammatory autoimmune diseases that attack the body's own tissues. Most frequently they start by affecting the joints.
Several medications exist in the world that offer temporary pain relief or slightly alter the progression of Rheumatoid Arthritis (RA). As with most medications, they have many side effects and offer no real cure for RA.
Stem Cell-based therapies for Rheumatoid Arthritis are a new paradigm in the repertoire for treating RA, and offer more than just a simple reduction of the associated pain, i.e. inflammation.
Stem Cell-based therapies have been shown to downregulate the inflammation, alter immune responses and stimulate increased regeneration for longer periods of time, thus bringing Regenerative Medicine much closer than ever before to finding a viable treatment for RA.
Rheumatoid Arthritis (RA):
An autoimmune disease with no cure available so far
Rheumatoid Arthritis is an autoimmune disorder where the body mistakenly starts attacking its own tissues. The body begins to assume that the tissues are no longer its own, marks them as foreign objects (like bacteria or viruses), and initiates (immune) programs to completely remove them from the body. This causes the known chronic inflammation, characteristic of RA.
It is a never-ending battle between the body and its tissues, that with time the body's conditions deteriorate. In most cases the joints are primarily affected. Usually, the fingers are the first victims in the early stages of RA. However, RA is not entirely limited to affecting the joints.
In about 40% of the cases, structures like blood vessels, nerve tissue, bone marrow, heart, lungs, skin, eyes and others can suffer permanent damage from Rheumatoid Arthritis. About 70% of RA patients are women with a distinct age range between 35-50 years.
In addition to Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) for treating rheuma, new type of medication classified as Disease-Modifying Antirheumatic Drugs (DMARDs) were shown to significantly reduce symptoms.
The latest generation of DMARDs are known as biological and immunological DMARDs. They are designed to specifically target and alter the immune system pathways that RA affects.
However, more than 50% of the patients have to discontinue their use after 2 years due to declining efficacy or adverse side effects. In any case, RA is a severe disease that often leads to disabilities and life span reduction with no known cure.
Stem Cell-based therapies for Rheumatoid Arthritis (RA)
and other forms of Arthritis
Stem Cell-based therapies work on several pathways: Anti-inflammatory, immunomodulation and tissue regeneration. With these benefits, stem cell-based therapies can be more than just a temporary pain relief of the standard medications.
The latest generation of biological DMARDs drugs focuses on blocking the function of aberrant immune cells. This class of drugs considerably improved the treatment options for RA. Nevertheless, these treatments are limited by incomplete treatment response and severe side effects, often leading to drug withdrawal and refectory cases. The research of Stem Cell-based treatments for Rheumatoid Arthritis, however, is focused on different aspects of RA, mainly:
- Balancing of immune responses
- Stimulation of tissue (joint) repair
- Reduction of acute inflammation
Research showed that, in addition to the tissue repair and regeneration abilities of Mesenchymal Stem Cells (MSCs), they maintain anti-inflammatory and immunomodulatory powers. This wide range of natural healing effects from Mesenchymal Stem Cells (MSCs) is mainly responsible because of the soluble paracrine (messaging) factors the MSCs secrete, which are also known as the Stem Cell Secretome .
MSCs have the capacity to regulate immunity-induced peripheral tolerance which is essential for a sustained and effective treatment for RA. Several clinical trials have already been conducted with positive results. Administration of MSCs to patients with RA showed to be safe, well tolerated and induced significant remission. The serum levels of inflammatory factors were decreased as well. Other forms of Arthritis which have different manifestations but somewhat similar mechanisms, appear to be treatable with Stem Cell-based therapies as well. These forms include but are not limited to:
- Psoriatic Arthritis
- Juvenile Idiopathic Arthritis
We at ANOVA have harnessed the essence of stem cells (the paracrine "messaging" factors from Mesenchymal Stem Cells) and "packaged" it into what we call the ANOVA Stem Cell Secretome. The ANOVA Stem Cell Secretome is an optimized method that utilizes the knowledge gained from latest stem cell research to make treatments safer, easier and repeatable. Our secretome has a high concentration of paracrine factors, making it a potent individualized medication.
Most importantly, all our Stem Cell-based therapies, especially our Stem Cell Secretome therapy, do not interfere with your current medication. All the processes that the Stem Cell Secretome employs are completely natural to your body, since the stem cells come from your body.
Treating Rheumatoid Arthritis with next generation Stem Cell-based therapies and our services at ANOVA
We focus on offering our patients the best treatment options possible from the latest trends in regenerative medicine; but not by means of excluding already proven and effective therapies. We define our goals of making you better, by considering all possible solutions and combinations of all our available treatments, to provide you with the best and most optimized treatment for your specific condition. Just as importantly, a diagnostic work up with state-of-the-art technology combined with evidence-based effective therapies make our treatments so special.
It is our passion to provide you with the best possible treatments in the world.
Frequently Asked Questions
Usually the symptoms of Rheumatoid Arthritis include but are not limited to:
- Swollen and warm joints
- Fever and weight loss
- Tender Joints
that are usually much worse in the mornings or after prolonged inactivity.
Early Rheumatoid Arthritis usually starts with the joints of the fingers or toes. As the disease progresses, symptoms often spread to the ankles, elbows, wrists, knees, hips or shoulders. In about 40% of the cases other structures like: blood vessels, nerve tissue, bone marrow, heart, lungs, skin, eyes and others can suffer permanent damage from Rheumatoid Arthritis (RA) effects. The symptoms of RA may vary in severity, and may even come and go (known as flare-ups and remission periods). Over time, RA can cause joints to deform.
The causes of RA are not fully understood. It is known that an abnormal response of the immune system plays a major role in the inflammation and joint degeneration.
There is evidence that genes, hormones and environmental factors are involved. As such RA ranks among the multifactorial autoimmune chronic inflammatory diseases.
A specific genetic marker, HLA (Human Leukocyte Antigen) - a gene that controls immune responses, was shown to be responsible for a five-fold prevalence in causing Rheumatoid Arthritis. However, this gene alone is not the only cause for the development of the disease. Other genes connected to RA such as STAT4, C5, TRAF1 and PTPN22 are also influencing the prevalence or the progression of RA.
Additionally, bacteria or viruses are under investigation, as they may trigger the disease outbreak in people with genetic predisposition.
Female hormones appear to be an important factor, as 70% of all RA patients are women.
Moreover, obesity, physical or emotional trauma can trigger the disease as well. There have been additional reports about air pollution, cigarette smoke and insecticides to be correlated to RA.
- Age: 80% of the RA patients are between 35 and 50.
- Sex: 70% of RA patients are women.
- Family History: As described above, genes play a role. Hence, if a direct relative has RA, you may have an increased risk of the disease.
- Environment: Exposure to asbestos or silica may increase the risk for developing Rheumatoid Arthritis.
- • Smoking: Associated both with higher risk for developing RA symptoms (if the Genes are present) as well as a worse disease progress.
- Obesity: Appears to increase the risk for RA.
NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce inflammation and pain. Side effects may include but are not limited to stomach irritation, heart problems, and liver and kidney damage.
Steroids: Corticosteroid medications temporarily but highly effective reduce inflammation and pain and slow joint damage. The treatment cannot be repeated indefinitely due to side effects like the thinning of bones. Other Side effects may include weight gain and diabetes.
DMARDs: Disease-Modifying Antirheumatic Drugs. They treat the symptoms and change the progression of RA.
Most common DMARDs are: Methotrexate, Leflunomide, Hydroxychloroquine and Sulfasalazine.
Sadly, they come with a wide range of side effects, such as: Immunosuppression, Bone Marrow suppression, liver damage, and severe lung infections which often lead to death.
A newer generation of DMARDs are known as biological and immunological DMARDs. They include: Abatacept, Adalimumab, Anakinra, Certolizumab, Etanercept, Golimumab, Infliximab, Rituximab, Tocilizumab and Tofacitinib. They target immune system pathways, and very frequently cause problems to the immune system, as they partly block the natural way of how the immune system works. Usually these immunological DMARDs are paired with Methotrexate.
Physical and Occupational Therapy for Rheumatoid Arthritis are an important part for any Rheumatoid Arthritis treatment. They are aimed to maintain muscle mass and keep joints flexible for as long as possible.
Surgery for Rheumatoid Arthritis is required when medications or Stem Cell-based therapies fail to bring relief. There are different surgical methods with different aims. They are never meant to cure the disease, as they are only able to relief pain, bring back some flexibility or are used for cosmetic purposes. Tendon repair, Joint fusion, total joint replacement and Synovectomy are the most usual surgeries performed for Rheumatoid Arthritis.
Alternative medicine for Rheumatoid Arthritis, and the most commonly recommended methods are:
- Tai Chi: Gentle movement exercise to reduce stress, increase flexibility of joints and muscle. It has been found to reduce pain for many RA patients.
- Omega 3 Fish Oil (either fresh or as supplements): Fish oils have been found to reduce both pain and stiffness from RA.
- Plant Oil: Black currant, Borage and Evening Primrose contain a fatty acid which also reduces pain and stiffness from RA, similar to how fish oils work.
Enough sleep: About 8 hours of sleep is recommended for RA patients.
Enough exercise: Exercise is very important for RA patients for a variety of biological reasons. Gentle stretching, Tai Chi, walking, swimming and water aerobics are good low-impact choices.
Creams, gels and lotions: Topical creams can ease the pain and increase blood flow. Typical active ingredients are capsaicin, salicylates, camphor and menthol.
Fish Oil supplements: Studies have shown that fish oil supplements can reduce pain. Take care however, as their intake can interfere with some medications.
Aspirin and NSAIDs: The common medications, but not without side effects. See us or your local RA specialist for prescriptions.
Assistive devices: Customized shoes, canes and crutches are common tools to assist with the daily life of RA patients.
Plant oil: Though not scientifically proven, some plant oil containing a fatty acid called gamma-linoleic acid may be effective to reduce pain and morning stiffness.
Heat and cold: Use this common method to numb the pain and increase blood flow.
Methotrexate is a Disease-Modifying Antirheumatic Drug (DMARD). It acts as an immune-suppressor. This means that it controls the immune system, that is affected by RA, to reduce pain and inflammation. This drug was shown to help with preventing permanent joint damage and disability.
Psoriatic Arthritis is also a chronic disease that is characterized by a form of inflammation of the skin (psoriasis) and joints (inflammatory arthritis). Psoriatic Arthritis can cause painful inflammations around joints just as RA, and it is often associated with a scaly skin condition (psoriasis). Sometimes the arthritis develops before the psoriasis, therefore proper diagnostics are vital.
Both RA and Psoriatic Arthritis appear to be treatable with Stem Cell-based treatments. A diagnostic examination with state-of-the-art technology and careful planning is important before starting treatments with Stem Cell-based methods.
We recommend you contact us to receive a full diagnostic work-up and suggested treatment plan.
- Tyndall A, van Laar JM. Stem cells in the treatment of inflammatory arthritis. Best Pract Res Clin Rheumatol 2010;24:565–574.
- Liang J, Li X, Zhang H, Wang D, Feng X, Wang H, et al. Allogeneic mesenchymal stem cells transplantation in patients with refractory RA. Clin Rheumatol 2012;31:157–161.
- Wang L, Wang L, Cong X, Liu G, Zhou J, Bai B, et al. Human umbilical cord mesenchymal stem cell therapy for patients with active rheumatoid arthritis: safety and efficacy. Stem Cells Dev 2013;22:3192–3202.