There are about 200 million patients with rheumatism in my country, talking about the clinical application of metamorite stem cells in rheumatism

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There are about 200 million patients with rheumatism in my country, talking about the clinical application of metamorite stem cells in rheumatism

2021-11-27 06:06:45 62 ℃

The data shows that there are about 200 million patients in my country's rheumatoid diseases. As the diagnosis rate of rheumatism is increased year by year, the problems faced in clinical practice are also more significant. In many people's impressions, "rheumatism" seems to be in the wind and rainy days, the body produces discomfort. It is clinically, rheumatism is a large class containing more than 200 diseases, such as rheumatoid arthritis, lupus erythematitis, lupus sore, dry syndrome, gout, osteoarthritis, ankylosing spondylitis, etc.

In recent years, the treatment of rheumatoid diseases has been continuously developed, and stem cells have also made progress in this field. For example, there is a new drug clinical trial for rheumatoid diseases such as rheumatoid arthritis and osteoarthritis in my country. Batch.

At the same time, the research breakthrough in this area has also been released. Recently, domestic scholars published "Stem Cell Research" (STEM CELL RESEARCH & THERPY), "The application of mesenchymal stem cells in rheumatism", further summarizing the development overview of this area.

Research history of mesenchymal stem cells

Mesenchymal Stem Cells, MSC is a pluripotent stem cell, which has all common nature of stem cells, ie self-renewal and multi-directional differentiation. Methylactic stem cells are present in many tissues, such as bone marrow, skeletal muscle, bone mildew, and bone girle, etc.

In 1867, German pathologist Julius Friedrich Cohnheim confirmed that inflammation was caused by leukocytes into tissue through the capillary wall, and the pus was mainly composed of the fragments of these leukocyte decomposition, and the viewpoint of non-excited cells in the bone marrow was first proposed. It is believed that fibroblasts may originate from bone marrow [1].

In the 1970s, Julius Friedrich Cohnheim et al. Successfully separated a fibrior cell from the bone marrow by adhesion, and proved that it can be amplified in vitro and have a characteristic of directional differentiation. Subsequently, Prockop, D.j. and Pittenger, M.f proved that this fibrous adhesive cell contains mesenchymal stem cells, with the ability to secrete a variety of interstitial tissues [2, 3].

In 1991, Caplan, A.I. Professor Professor made the concept of MSCS for the first time, and he was also called "the father of mesenchymal stem cells". Caplan, A.I. The bone marrow can be adhered to the surface of the plastic petri dish, and the cell population named MSCs can be amplified in vitro energy and have multi-differentiated potential.

Thereafter, MSCs entered the rapid development phase. After decades of long development, a large number of in vitro and animal experiments have shown that mesenchymal stem cells have potential therapeutic effects on many diseases [4, 5].

Metachate Treatment of Rheumatoid Arthritis

Rheumatoid Arthritis, RA) is a common systematic autoimmune disease that is characterized by synovial hyperplasia and joint injury, resulting in clinically significant functional damage. Conventional drugs for rheumatoid arthritis include anti-inflammatory drugs, corticosteroids and synthetic diseases modified anticogenic drugs. However, these therapies are still limited by some patients with low efficacy and severe complications, including infection and malignant tumors. Therefore, it is necessary to determine the rheumatoid arthritis of a new treatment solution.

Studies have shown that mesenchymal stem cells can regulate their local environment, activate endogenous progenitor cells through cell interactions and various factors, and play a role in tissue damage repair. MSCs can also produce a variety of growth factors and cytokines, play an important role in tissue repair and removal. These characteristics make the mesenchymal stem cells into ideal drugs for treating rheumatoid arthritis [6, 7, 8].

The researchers of the Army Military Medical University were published in the research results of the rheumatism immunization period "rheumatism school year". Compared with conventional mesenchymal stem cell transplantation, the effective rate of mesenchymal stem cell therapy rheumatoid arthritis has increased by 40%, which is important advancement in the field of rheumatoid arthritis in mesenchymal stem cells [17].

Metacchard stem cells for ankylosing spondylitis

Ankylosing Spondylitis (AS) is a chronic carnival inflammatory arthritis. TGF-β, PGE2 and HLA-G5 are effective immunomodulatory molecules generated by MSCs to inhibit the immune system by inhibiting dendritic cells and inducing TREG cell production. In addition, MSCs can inhibit the proliferation and activity of E effects T cells, such as Th1, Th17 and cytotoxic T lymphocytes (CTL), these cells participate in the pathogenesis of AS. In addition, indolaamine, IDO and PGE2-induced macrophage phenotype produced by MSCs were converted from anti-inflammatory (m1) to anti-inflammatory (M2). Therefore, MSC treatment can be used as one of the methods of improving Cell therapeutic methods for AS [9, 10].

A clinical study charges 40 patients with ankylosing spondylitis, 20 cases of control group using immunization and biological agents, and 20 cases were infused using UC-MSCS intravenous infusion. The results showed that patients with UC-MSCs were more efficient than immunization and biological preparations, and the immune indicators were significantly reduced, and the patient's pain was obviously alleviated, and the activity index score was significantly decreased. [18,19]. Meijie stem cells therapy systemic lupus erythematosus

Systemic Lupus Erythematosus, SLE is a heterogeneous chronic autoimmune disease. The pathogenesis of the SLE includes the activation of B cells, the production of autoantibodies, and the formation of immune complexes. MSC transplantation combined immunosuppressive treatment can significantly improve the condition. Moreover, its efficacy is dose-dependent, repeated injection can delay the progress of the disease, reducing recurrence; however, in order to determine the appropriate dosage and multiplex intervals, large-scale experiments are required [11].

Studies have shown that MSC can regulate the release of inflammatory factors, induce an immune tolerance, inhibit autoimmune response through a variety of ways. The MSC transplantation treatment SLE has the following advantages: 1 of the absence of rejection, the transplant success rate is high and safe; 2 eliminating the need for collections, no infection, death and other complications before transplantation; 3 treatment effect, MSC can be long Play role [12].

Methylactic stem cell therapy systemic hardening

Systemic Sclerosis, SSC is a chronic autoimmune disease. There is currently no safe and effective treatment for SS. MSCs have the potential to differentiate into bone or muscle cells as well as endothelial cells. Compared with the Health Control Group, SSC patients show abnormal functional activities, such as TGF-β, vascular endothelial growth factor (VEGF), endothelial cell differentiation disorder, etc., which may play an important role in the development of SSC fibrosis effect. Based on these findings, allogeneic MSCs transplantation is a very promising SSC treatment method [13, 14].

Researchers gave umbilical cord serum-permeated stem cell transplantation for 5 patients with systemic stems, and all patients have no transplanted adverse reactions. After mixed stem cell transplantation, the skin thickness score (MRSS) has a significant decrease, and the skin ulcer has improved after transplantation of vasculitis and refractory skin ulcers, and the level of serum anti-nuclear antibody is lowered, and the quality of life (HAQ-DI) improve. In summary, scientists believe that mesenchymal stem cell therapy can improve system sclerosis symptoms, after preliminary clinical evaluation, and effective [15].

Meijie stem cell for dry syndrome

Sjogren's Syndrome (SS) is a chronic systemic autoimmune disease, characterized in that lymphocytes infiltrate the extent of extent, such as lacrimal gland and salivary gland. The clinical manifestations of SS are complex, the most common symptoms are mouth, dry eye, often accompanied by organ damage. A malignant lymphoma in some SS patients. Since MSCs have high proliferation, immunomodulatory and multi-directional differentiation capabilities, the proliferation of various immune cells can inhibit proliferation, inflammatory factors secretion and antibody production, and promote the repair of damaged tissues. Therefore, MSC administration has become a new method for treating SS.

The clinical study of MSCS transplantation for SS has found that almost all patients in transplantation can improve [16]. Platelet reduction, hemolytic poverty, autoimmune liver disease, enteritis and other complications, improved symptoms after transplantation. At the same time, the nutritional state is improved, weakness is reduced, and the weight increases before. All patients' clinical medicinal doses are reduced, and immunosuppressors and corticosteroids are displaced. Examination revealed. Plasma anti-SSA and anti-SSB antibody concentration decreased after transplantation [20].

summary

In summary, the effectiveness of mesenchymal stem cells in rheumatoid disease has been widely confirmed. As a cellotherapy, mesenchymal stem cell transplantation may result in blockage bed blocking, ectopic bone, cartilage formation, etc., to some extent, to a certain extent, its clinical application process. However, with the gradual understanding of the biological characteristics and clinical application of mesenchymal stem cells, it will have a broader application. In addition, further study of autologous transplantation mesenchymal stem cells will provide new strategies for their applications in autoimmune disease treatment.

references:

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10. Xu J, WANG D, Liu D, Fan Z, Zhang H, Liu O, ET Al. Allogeneic Mesenchymal Stem Cell Treatment Alleviates Experimental and Clinical Sjogren Syndrome. Blood. 2012; 120: 3142-51.11. Gu f, wang d .......................................................................... ...

12. WANG D, Niu L, FENG X, YUAN X, ZHAO S, ZHANG H, ET Al. Long-Term Safety of Umbilical Cord Mesenchymal Stem Cells Transplantation for System Lupus Erythemativity for System Lupus Erythematosus: a 6-Year FOLLOW-UP Study. Clin Exp MED. 2017; 17: 333-40.

.. 13. Wang D, Li J, Zhang Y, Zhang M, Chen J, Li X, et al Umbilical cord mesenchymal stem cell transplantation in active and refractory systemic lupus erythematosus: a multicenter clinical study Arthritis Res Ther 2014; 16.: R79.

. 14. Wang D, Zhang H, Liang J, Li X, Feng X, Wang H, et al Allogeneic mesenchymal stem cell transplantation in severe and refractory systemic lupus erythematosus: 4 years of experience Cell Transplant 2013; 22:.. 2267- 77.

15. Sun L, WANG D, Liang J, ZHANG H, FENG X, WANG H, ET Al. Umbilical Cord Mesenchymal Stem Cell Transplantation In Severe and Refractory System Lupus ErytHematosus. Arthritis Rheum. 2010; 62: 2467-75.

. 16. Carrion F, Nova E, Ruiz C, Diaz F, Inostroza C, Rojo D, et al Autologous mesenchymal stem cell treatment increased T regulatory cells with no effect on disease activity in two systemic lupus erythematosus patients Lupus 2010;.. 19 : 317-22.

17. ZHAO C, ZHANG L, KONG W, LIANG J, XU XY, WANHY, FENG XB, Hua Bz, WANG H Rheumatoid Arthritis. J Immunol RES 2015.

18. Flint J, Panchal S, Hurrell A, et al BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding-Part II:. Analgesics and other drugs used in rheumatology practice [J] Rheumatology (Oxford), 2016, 55 (.9):. 1698-1702.19 Flint J, Panchal S, Hurrell A, et al BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding-Part ⅰ:. standard and biologic disease modifying anti-rheumatic drugs and corticosteroids [J] Rheumatology.(Oxford), 2016, 55 (9): 1693-1697.

20. Mesenchymal Stem Cell Transplantation Ameliorates Sjögren's Syndrome Via Suppressing IL-12 Production by dendritic Cells.Stem Cell RES THER.2018, 9 (1): 308