A comprehensive review on the role of mesenchymal stromal/stem cells in the management of rheumatoid arthritis.

IF 3.9 3区医学 Q2 IMMUNOLOGY

Expert Review of Clinical Immunology Pub Date : 2024-05-01 Epub Date: 2024-01-01 DOI:10.1080/1744666X.2023.2299729

Elisa Pignatti, Monia Maccaferri, Alessandra Pisciotta, Gianluca Carnevale, Carlo Salvarani

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引用次数: 0

Abstract

Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease with systemic manifestations. Although the success of immune modulatory drug therapy is considerable, about 40% of patients do not respond to treatment. Mesenchymal stromal/stem cells (MSCs) have been demonstrated to have therapeutic potential for inflammatory diseases.

Areas covered: This review provides an update on RA disease and on pre-clinical and clinical studies using MSCs from bone marrow, umbilical cord, adipose tissue, and dental pulp, to regulate the immune response. Moreover, the clinical use, safety, limitations, and future perspective of MSCs in RA are discussed. Using the PubMed database and ClincalTrials.gov, peer-reviewed full-text papers, abstracts and clinical trials were identified from 1985 through to April 2023.

Expert opinion: MSCs demonstrated a satisfactory safety profile and potential for clinical efficacy. However, it is mandatory to deepen the investigations on how MSCs affect the proinflammatory deregulated RA patients' cells. MSCs are potentially good candidates for severe RA patients not responding to conventional therapies but a long-term follow-up after stem cells treatment and standardized protocols are needed. Future research should focus on well-designed multicenter randomized clinical trials with adequate sample sizes and properly selected patients satisfying RA criteria for a valid efficacy evaluation.

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间充质基质/干细胞在类风湿关节炎治疗中的作用综述。

导言类风湿性关节炎（RA）是一种具有全身表现的慢性自身免疫性炎症疾病。尽管免疫调节药物治疗取得了巨大成功，但仍有约40%的患者对治疗无效。间充质基质/干细胞（MSCs）已被证明具有治疗炎症性疾病的潜力：本综述介绍了有关 RA 疾病的最新情况，以及利用骨髓、脐带、脂肪组织和牙髓中的间充质干细胞调节免疫反应的临床前和临床研究。此外，还讨论了间充质干细胞在 RA 中的临床应用、安全性、局限性和未来展望。通过PubMed数据库和ClincalTrials.gov，我们找到了从1985年到2023年4月的同行评审全文论文、摘要和临床试验：间充质干细胞具有令人满意的安全性和临床疗效潜力。专家观点：间充质干细胞具有令人满意的安全性和潜在的临床疗效，但仍需深入研究间充质干细胞如何影响RA患者的促炎性失调细胞。对于传统疗法无效的严重RA患者，间充质干细胞可能是很好的选择，但需要在干细胞治疗后进行长期随访，并制定标准化方案。未来的研究应集中在设计良好的多中心随机临床试验上，要有足够的样本量，并适当选择符合RA标准的患者，以进行有效的疗效评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Immunology IMMUNOLOGY-

CiteScore

7.60

自引率

2.30%

发文量

221

审稿时长

6-12 weeks

期刊介绍： Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology. Articles focus on the following key areas: • Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines • Performance and benefits of newly approved therapeutic agents • New diagnostic approaches • Screening and patient stratification • Pharmacoeconomic studies • New therapeutic indications for existing therapies • Adverse effects, occurrence and reduction • Prospects for medicines in late-stage trials approaching regulatory approval • Novel treatment strategies • Epidemiological studies • Commentary and comparison of treatment guidelines Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.