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Mesenchymal stromal cells and rheumatic disorders.
Journal article

Mesenchymal stromal cells and rheumatic disorders.

  • Tyndall A Dept of Rheumatology, University Hospital, Basel, Petersgraben 4, 4031 Basel, Switzerland. Electronic address: alan.tyndall@usb.ch.
  • 2015-07-06
Published in:
  • Immunology letters. - 2015
Arthritis
Lupus
Mesenchymal stromal cells
Rheumatic diseases
Stem
Arthritis, Rheumatoid
Cell Communication
Clinical Trials as Topic
Humans
Immune System
Lupus Erythematosus, Systemic
Mesenchymal Stem Cell Transplantation
Mesenchymal Stem Cells
Models, Immunological
Osteoarthritis
Treatment Outcome
English Mesenchymal stromal cells (MSC), often incorrectly called stem cells, have been the intense focus of in vitro studies and animal models of rheumatic and other diseases over more than a decade. Despite multiple plausible mechanisms of action and a plethora of positive in vivo animal studies, few randomised controlled clinical trials have demonstrated meaningful clinical benefit in any condition so far. This could be due to confusion in cell product terminology, complexity of clinical study design and execution or agreement on meaningful outcome measures. It could also indicate that MSC as currently employed are ineffective. Within the rheumatic diseases, SLE, rheumatoid arthritis (RA) and osteoarthritis (OA) have received most attention. Uncontrolled multiple trial data from over 300 SLE patients have been published from one centre suggesting a positive outcome; one single centre comparative study in 172 RA was positive and no human studies have compared intra-articular MSC therapy to non-MSC techniques for osteoarthritis in the absence of surgery. Two randomised studies suggested benefit from the addition of bone marrow derived MSC and peripheral blood mononuclear cells added to surgical "standard of care" in knee OA and knee focal cartilage defects, respectively. The possible reasons for this apparent mismatch between expectation and clinical reality will be discussed.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/299108
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