Stem Cell Therapy in Rheumatoid Arthritis: This Is HYPE.
The writer is confused and confusing the different types of “stem” cells, from the truly pluripotent embryonic stem cells (ESC) and induced pluripotent stem cells (iPSC), to the multipotent haemopoietic (HSC) and mesenchymal (MSC) stem cells, to non-stem cells like autologous chondrocyte transplants (ACT) and platelet-rich plasma (PRP).
This article premised on ESC and iPSC showing promise in regenerating old/damaged/malfunctioning tissue and organs, but this has consistently failed abysmally.
Stem Cell Therapy in Osteoarthritis: This Is REALITY.
What has worked and in increasing clinical usage is in using autologous MSC and ACT in repairing focal defects of cartilage in Osteoarthritis, and perhaps early Avascular Necrosis (AVN) of bone.
Stem Cell Therapy in Multiple Sclerosis: This Is RISKY.
What has been used in desperate but risky situations is HSC transplant as haemopoietic rescue and immunological reconstitution after ablative chemotherapy for refractory autoimmune diseases.
Rituximab: Don’t Count It Out as MS Treatment
Despite advances through the years, HSCT remains a risky procedure, fraught with complications like life-threatening infections and graft-versus-host disease.
Rituximab would be tried first in most refractory autoimmune diseases these days before undergoing HSCT.
Stem Cell Therapy in Lupus & Scleroderma: This Is PROMISING!
Beyond HSCT for refractory autoimmune diseases, what is promising and exciting is allogeneic MSC as immunomodulatory therapy for autoimmune diseases.
Treatment of severe autoimmune disease by stem-cell transplantation
Perhaps non-myeloablative allogeneic haploidentical HSCT is the way to go, with lower infection and GvHD risk, yet with Graft-vs-Autoimmunity effect for prolonged disease remission. The difficulty appears to be in achieving stable mixed chimerism.
