Ankylosing spondylitis (AS) is a progressive, inflammatory rheumatoid disease that, over time, can result in chronic spinal arthritis and can cause the vertebrae to fuse together. Affecting an estimated 300,000 people in the U.S., AS causes the spine to become less flexible and can result in a hunched posture.
There is no current treatment for AS and current drug therapy options are focused on reducing inflammation, stiffness, and back pain. While current treatments assist in reducing inflammation, many patients with AS continue to experience unresponsive or painful side effects from these drugs.
In the search for a cure for AS, stem cells – and specifically, mesenchymal stem cells (MSCs) have emerged as a potentially promising treatment option. Specifically, researchers believe the immunomodulatory and regenerative properties demonstrated by MSCs could reduce inflammatory responses and help tissue repair through cell-to-cell contact and secretion of soluble factors.
In this review, Abdolmohammadi et al. describe immunopathogenesis and current treatment restrictions of AS and discuss the recent findings of clinical trials involving MSC therapy in AS.
The safety and therapeutic potency of MSC therapy have been shown in many types of research. While there are currently a number of in-process clinical trials exploring MSC transplantation in related disorders, the transplantation of MSCs is a therapeutic option for AS patients who cannot tolerate the anti-inflammatory drugs.
Previous studies have demonstrated MSC infusion in AS patients to be a safe and beneficial choice with no severe side effects and is effective in decreasing related clinical symptoms and severity of the disease. There are also a number of clinical trials for curing AS patients currently in progress. These trials include phase 1 exploring the application of human umbilical cord-derived MSCs (hUC-MSCs) and IV infusion of MSCs plus NSAIDs in AS patients, phase 2 of a clinical trial evaluating human bone marrow-derived MSCs application in AS patients, and clinical trial phase I/II for the safety of MSC transplantation in patients with AS.
Although there have been notable achievements in the treatment of AS using NSAIDs, glucocorticoids, and other drugs, a therapeutic option without side effects has yet to be discovered. MSCs offer a favorable treatment option for the treatment of immune-mediated disorders, including AS.
While findings of previous studies demonstrate that MSC injection might be beneficial in alleviating AS signs and symptoms, the authors point out that further study is required to determine several important features of MSC therapy, including cell origin, dosage, administration route, and the most ideal stage of disease for intervention, before it can be accepted as a clinical option for treating AS.
Source: “Ankylosing spondylitis and mesenchymal stromal/stem cell therapy.” https://www.sciencedirect.com/science/article/pii/S0753332218356762.