Mesenchymal Stem Cells and MSCs-Derived Extracellular Vesicles Immunomodulatory Effects in Systemic Lupus Erythematosus

Mesenchymal Stem Cells and MSCs-Derived Extracellular Vesicles Immunomodulatory Effects in Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a common multisystemic autoimmune disease that often results in multi-organ damage when left untreated. Currently affecting over 1.5 million Americans, the etiology and pathogenesis of SLE continue to remain unclear. 

At present, glucocorticoids and immunosuppressants are the most prescribed course of therapeutic treatment and mostly as a way to manage and treat symptoms of SLE, not the cause itself. 

Considering that the etiology and pathogenesis of SLE are accompanied by immune disorders including abnormal proliferation, differentiation, and activation and dysfunction of T cells, and that mesenchymal stem cells (MSC) and MSC-derived extracellular vesicles (EVs) play important roles in the immunity process, researchers are increasingly turning their attention to MSCs and EVs as potential therapeutic treatment options for SLE.  

In this review, Yang et al. examine the immunomodulatory effects and related mechanisms of MSCs and EVs in SLE with hopes of better understanding SLE pathogenesis and guiding biological therapy. 

Examining the potential use of MSC and MSC-EVs in SLE treatment the authors found some studies have established that MSCs reduce adverse effects of immunosuppressive drugs and when combined have demonstrated distinct effects on T cell activation and bias.  

Additionally, Yang et al. report that MSCs are able to participate in the immune response in two distinct ways: paracrine effect and directly through cell-to-cell interaction. Since reconstruction of immune tolerance and tissue regeneration and repair are required parts of SLE treatment and since MSCs possess high self-renewal ability, rapid expansion in vitro and in vitro, and low immunogenicity, allogeneic MSC transplantation has demonstrated strong evidence for the therapeutic potential of MSC in SLE. 

Besides the ability to repair and regenerate tissue, MSCs, and MSC-EVs have strong anti-inflammatory and immunomodulatory effects, making them a potentially ideal treatment option as part of a therapeutic strategy for SLE. Considering that MSC-EVs have similar biological functions with MSCs, but are also considered cell-free, the authors point out that MSC-EVs could be the better choice for SLE treatment in the future.

Despite the potential of MSC and MSC-EVs, Yang et al. point out that genetic modification, metabolic recombination, and other priming of MSCs in vitro should be considered before MSC/MSC-EVs application for SLE treatment. The authors also recommend further clinical evaluation of the time of infusion, appropriate dosage, interval of treatment, and long-term safety of MSC/MSC-EVs in the treatment of SLE before any form of the combination is used as a treatment option.


Source: “Immunomodulatory Effect of MSCs and MSCs-Derived Extracellular ….” 16 Sep. 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481702/.

Mesenchymal Stem Cells for Systemic Lupus Erythematosus

Mesenchymal Stem Cells for Systemic Lupus Erythematosus

Systemic Lupus Erythematosus (SLE) is an autoimmune disease that causes inflammation to affect many different body systems including the joints, skin, kidneys, blood cells, brain, heart, and lungs.

Affecting over 5 million people worldwide, and associated with a wide range of symptoms, SLE is difficult to diagnose. Currently, there is no treatment to prevent or cure lupus and current therapeutic treatment options are only designed to treat and minimize the symptoms of the disease.

Considering their strong protective and immunomodulatory abilities, mesenchymal stem cells (MSCs) have been recognized as a potential treatment for various autoimmune diseases and inflammatory disorders, including SLE.

In this research article, Zhou et al. conducted a meta-analysis with the goal of assessing if MSCs are able to become a new treatment for SLE with good efficacy and safety.  

Specifically, using predetermined criteria, the authors conducted a bibliographical search and statistical analysis to assess the efficacy and safety of MSCs for SLE. This search and analysis resulted in 10 studies comprising of 8 prospective or retrospective case series, including 231 SLE patients, and four randomized control trials (RCTs) with 47 patients with SLE in the case group and 37 patients with SLE in the control group, that fulfilled the inclusion criteria for this meta-analysis. 

The authors found that all of the studies included as part of the meta-analysis of RCT and self-controlled studies with the exception of one indicated that MSC treatment of SLE can achieve better efficacy. Specific results of the RCT meta-analysis supporting this conclusion included lower proteinuria, increased serum albumin, and increased serum C3 at 3 months, lower SLEDAI values at 3 months and 6 months, and a lower rate of adverse events in the MSC group when compared to the control group. 

Similar results were observed and reported from the meta-analysis of self-controlled studies. These results included MSC treatment significantly reducing proteinuria and the value of SLEDAI at 1 month, 2 months, 3 months, 4 months, 6 months, and 12 months. Further supporting evidence reported included improved values of SCR, BUN, C3, and C4.  


While the results of this meta-analysis were overwhelmingly supportive of MSCs as a potential treatment option for SLE, the authors also noticed several limitations associated with their findings. These limitations included the small sample sizes of the included studies and the inconsistency of the severity of the patient’s disease.

Although more studies with larger sample sizes should be conducted to confirm these findings, Zhou et at. concluded that MSCs might be a good treatment agent for SLE in the clinic. 


Source: “Immunomodulatory Effect of MSCs and MSCs-Derived Extracellular ….” 16 Sep. 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481702/.

Regenerative Medicine for Lupus

Regenerative Medicine for Lupus

Lupus can be unpredictable, with symptoms that physicians frequently mistake for other illnesses. Since the condition causes the immune system to attack its organs and tissues, it can affect any area in the body, including the skin, kidneys, blood cells, brain, heart, joints, and lungs. While some patients are more likely to develop lupus, the cause is unknown in most cases. However, regardless of the cause, treatments can help to manage symptoms. Here we will discuss what you need to know about Regenerative Medicine for Lupus!

What Is Lupus?

Lupus is a chronic or long-term autoimmune disease that can affect any body area. The signs and symptoms of lupus vary widely, depending on the organs or tissues that the immune system attacks. Most patients with lupus experience some of the disease’s most common indications, which include:

  • Fatigue
  • Joint pain, swelling, or stiffness
  • Fever
  • A butterfly-shaped rash on the face 
  • Skin lesions
  • Shortness of breath
  • Dry eyes
  • Headaches

Since each case of lupus presents differently, patients often struggle to receive a diagnosis. In addition, lupus often causes flare-ups, where the symptoms worsen for some time before improving or disappearing.

The severity of lupus and the health conditions resulting from the disease depends on the system attacked during a flare-up.

What Is Regenerative Medicine?

Regenerative medicine aims to manage a condition’s root cause rather than manage its symptoms. By combining biology and engineering principles, regenerative medicine develops new treatments focusing on replacing and repairing damaged cells, tissues, and organs. 

How Can Regenerative Medicine Treat Lupus?

Lupus and other autoimmune diseases may benefit from stem cells that can help boost the body’s ability to fight inflammation and regulate the immune system. 

The Lupus Foundation of America (LFA) has funded a Phase II trial with the National Institute of Allergy and Infectious Diseases to study adult stromal cells for treating moderate to severe lupus.

The study hopes to identify if stem cell therapy can lessen the long-term effects associated with lupus, reduce the need for medications, and stop the condition from damaging vital organs. 

In the study’s Phase I trial, participants experienced significantly decreased lupus disease activity and sustained that reduction for 52 weeks. In addition, patients were able to reduce or maintain lower levels of steroids to manage their symptoms.

The Phase II trial will work with a much larger pool of patients in hopes of producing consistent results. As stem cell therapies and other regenerative medicine treatments continue to offer safe and effective results, those struggling with chronic conditions like lupus may finally find relief in this new blend of biology and engineering.

Tips for Learning to Live with Lupus

Tips for Learning to Live with Lupus

Lupus is a systemic autoimmune disease in which the body’s immune system attacks healthy tissue and organs. It’s characterized by widespread inflammation which can appear in different areas of the body, including the skin, joints, blood cells, kidneys, brain, heart, and lungs. Oftentimes, lupus is challenging to diagnose, as its symptoms can vary widely and mimic other conditions. Receiving a diagnosis can bring relief in some ways, as it puts a name to an array of frustrating symptoms. Yet, it also means you’ll have to adapt to living with a chronic illness. Here are some tips for learning to live with Lupus. 

Learn About Lupus 

Everyone experiences lupus differently, which can make learning about lupus challenging. With that being said, there are helpful resources such as The Lupus Foundation of America to help you find out more about the condition.

You may have been experiencing an array of strange and uncomfortable symptoms that come and go. During lupus flares, symptoms such as rash, swollen joints, sores or ulcers, and fever can intensify. You’ll want to start tracking conditions leading up to flares to see if they occur in a pattern and an identifiable trigger brings them on. For instance, flares often arise after emotional or physical stress, as well as exhaustion, injury, and viral illnesses.

Find the Right Doctor

Since lupus is fairly rare, most general practitioners don’t see patients with the condition very often. To ensure you have access to the right treatment, you’ll want to see a specialist. Most people with lupus visit a rheumatologist, who specializes in systemic autoimmune diseases. 

Once you’ve found a reputable doctor, you’ll want to discuss wellness strategies and treatment options. Your treatment approach may evolve, so know that you don’t have to explore all options right away. You might also consider adopting lifestyle strategies to help control symptoms, such as beginning a meditation practice to limit emotional stress.

Seek Support

Online support groups are rich with resources and firsthand accounts. Within these groups, you might be able to connect with someone whose symptoms are similar to yours and discuss treatment options that worked for them. You can also discuss the emotional and mental challenges that come with living with a chronic illness and turn to people who are ready to lend an ear. Lupus Warriors on Facebook, LupusConnect, and Lupus Research Alliance are a few options to consider.

Maintain Ongoing Care

You’ll want to visit your rheumatologist regularly, even if you aren’t having frequent flare-ups. With blood work and regular conversations, the doctor may be able to help you pinpoint which treatments and lifestyle modifications are working effectively to control flares. They might also help you explore complementary and alternative treatments to manage symptoms. 

Many have begun to seek regenerative medicine, also known as stem cell therapy, as an alternative option for managing symptoms. Stem cells are considered the building blocks of life since they have the ability to self-renew and differentiate into specialized cell types. Mesenchymal stem cells (MSCs) can be sourced from autologous or allogeneic tissues and act as immunomodulators that suppress the activity of T regulatory cells.

Since lupus impacts your immune system, you’ll also want to take care to minimize your risk for other illnesses. This includes staying up-to-date with vaccines and exams. If you live with lupus it will require some adjustments, most patients can live fulfilling, happy lives after their diagnosis. By learning more and finding the right care providers, you can begin taking control of your lupus and your overall health. Contact a Care Coordinator today for a free assessment!

A Look into Stem Cell Therapy for Lupus

A Look into Stem Cell Therapy for Lupus

Lupus is a long-term illness which can lead to inflammation and pain in any part of the body. As an autoimmune condition, lupus is characterized by an immune response in which the body mistakenly attacks healthy tissue. Oftentimes, the condition affects the skin and joints. In serious cases, it can also affect the internal organs, such as the kidneys and heart. Common symptoms include rash, fatigue, and swollen lymph nodes. 

There is currently no cure for lupus, though medications such as anti-inflammatory drugs and immune-suppressants are used to control symptoms. In severe cases, cytotoxic drugs may be prescribed. These medications target and destroy cells that grow at a rapid rate. In the case of autoimmune conditions, the hyperactive immune system produces autoantibodies too rapidly, and the medications may help to control this response. 

Unfortunately, drugs such as cytotoxic medicines have a number of unfavorable side effects, including toxic effects on the blood and immune systems. Patients become more vulnerable to infections such as pneumonia, and hair loss is a common side effect. 

Frustratingly, lupus can be a painful and debilitating illness, and patients are left with few treatment options. Moreover, not all patients respond to medications as desired. 

Stem Cell Therapy for Lupus 

Any successful therapy for lupus should help to control the flare of symptoms and balance the body’s immune response. While achieving this harmony has proven difficult with traditional therapies, recent research suggests stem cell treatment could hold the potential in helping to manage the symptoms of this autoimmune condition. 

In particular, the intravenous administration of a patient’s own stem cells could help to regulate the body’s immune response, restoring function in the organs affected by the illness while simultaneously minimizing or eliminating the need for certain medications. 

Stem cells can give rise to virtually any cell tissue within the body. They also have the ability to repair damaged tissue because they have the ability to multiply. Within recent years, studies involving stem cell therapy have been performed, offering immense promise to patients with autoimmune conditions seeking alternative treatment options. Contact a Care Coordinator today for a free assessment!

Mesenchymal Stem Cells Help Patients with Severe Systemic Lupus Erythematosus

Mesenchymal Stem Cells Help Patients with Severe Systemic Lupus Erythematosus

Systemic lupus erythematosus, also known as SLE or lupus, is a chronic inflammatory condition that can affect almost every organ in the body. Commonly, patients with lupus suffer from fatigue, fever, muscle pains, and fluctuations in weight. Perhaps the most noticeable feature of lupus is a butterfly rash that affects the nose and cheeks. In its most severe form, lupus can be life-threatening. As many as half of all patients with systemic lupus erythematosus experience some sort of kidney involvement. One feared manifestation of lupus is an inflammation of the kidney called lupus nephritis. Patients can also experience blood clots in the arteries and veins, and serious inflammation of the gastrointestinal tract, lungs, and/or heart.

There is no cure for lupus. The goals of treatment are to reduce the severity of lupus symptoms, prevent damage to organs, and improve patient quality of life. Many treatments for lupus are merely preventive. For example, patients with lupus know that staying out of the sun or using sunscreen can help prevent skin rashes that often occur during the disease. Unfortunately, the treatments that are commonly used for SLE cause serious side effects. For example, steroids can help control flares, but they are not suitable for long-term use. Immunosuppressants are sometimes helpful, but they can increase a patient’s risk of infection. Newer biologics such as belimumab and rituximab are more selective treatments, but are not helpful for most patients and remain relatively expensive.

Not surprisingly, many patients with systemic lupus erythematosus are unsatisfied with their current treatments. This is frustrating for patients, families, and doctors. Thus, researchers have started testing stem cell therapy to determine if this novel treatment could be effective for treating lupus.

In one such clinical study, scientists collected mesenchymal stem cells from umbilical cord tissue (the substance that usually gets thrown away as medical waste after a baby is born). They then infused the purified stem cells into patients with SLE who had a difficult-to-treat disease (i.e., patients had failed to find relief of SLE symptoms from standard treatments or had life-threatening complications from the condition). The scientists then followed the patients for about eight months on average, though some patients were followed for as many as 28 months after stem cell treatment.

Patients treated with mesenchymal stem cells showed dramatic improvements in a measure of lupus disease activity called the SLEDAI. In fact, patients enjoyed significant improvements in as little as one month after mesenchymal stem cell treatment. This effect lasted for up to two years in some patients. Moreover, patients treated with umbilical cord-derived stem cells had improvements in kidney function and lost less protein in their urine. Impressively, patients treated with stem cells showed improvements in various markers associated with active lupus including serum antinuclear antibody (ANA), anti-double-stranded DNA (anti‐dsDNA) antibody, serum complement C3 and C4, and albumin levels. Patients with lupus know that these blood markers are used to track the severity of the condition.

While one person had severe nausea during stem cell infusion, this passed quickly, and no other treatment-related side effects occurred. In fact, stem cell treatment was well tolerated by all patients in the study. These remarkable results will, of course, need to be repeated and verified in larger clinical trials. Nevertheless, the dramatic improvements seen with umbilical cord mesenchymal stem cells in patients with difficult-to-treat lupus are impressive. While more work needs to be done, patients and doctors are now looking toward stem cell treatments in the hope that this terrible disease can finally be treated effectively.

 

Reference: Lingyun, S. et al. (2010). Umbilical cord mesenchymal stem cell transplantation in severe and refractory systemic lupus erythematosus. Wiley Online Library. 2010 https://doi.org/10.1002/art.27548.

 

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