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Biomed Pharmacother. 2019 Jan;109:1196-1205. doi: 10.1016/j.biopha.2018.10.137. Epub 2018 Nov 6.

Ankylosing spondylitis and mesenchymal stromal/stem cell therapy: a new therapeutic approach.

Author information

1
Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Stem Cell Biology, Stem Cell Technology Research Center, Tehran, Iran.
2
Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
3
Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
4
Department of Pharmaceutical Nanotechnology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
5
Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Stem Cell Biology, Stem Cell Technology Research Center, Tehran, Iran; Department of Immunology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.
6
Department of Immunology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
7
Department of Stem Cell Biology, Stem Cell Technology Research Center, Tehran, Iran; Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
8
Marquette University School of Dentistry, Milwaukee, WI 53233, USA.
9
Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: mhnicknam@sina.tums.ac.ir.

Abstract

Ankylosing spondylitis (AS) is an inflammatory rheumatoid disease categorized within spondyloarthropathies (SpA) and manifested by chronic spinal arthritis. Several innate and adaptive immune cells and secreted-mediators have been indicated to play a role in AS pathogenesis. Considering the limitations of current therapeutic approaches (NSAIDs, glucocorticoids, DMARDs and biologic drugs), finding new treatments with fewer side effects and high therapeutic potentials are required in AS. Mesenchymal stem cells (MSCs) with considerable immunomodulatory and regenerative properties could be able to attenuate the inflammatory responses and help tissue repair by cell-to-cell contact and secretion of soluble factors. Moreover, MSCs do not express HLA-DR, which renders them a favorable therapeutic choice for transplantation in immune-mediated disorders. In the present review, we describe immunopathogenesis and current treatments restrictions of AS. Afterwards, immunomodulatory properties and applications of MSCs in immune-mediated disorders, as well as recent findings of clinical trials involving mesenchymal stem cell therapy (MSCT) in ankylosing spondylitis, will be discussed in detail. Additional studies are required to investigate several features of MSCT such as cell origin, dosage, administration route and, specifically, the most suitable stage of disease for ideal intervention.

KEYWORDS:

Ankylosing spondylitis; Immunopathogenesis; Inflammation; Mesenchymal stem cells; Therapeutic approach

PMID:
30551369
DOI:
10.1016/j.biopha.2018.10.137
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