Rheumatoid arthritis (RA) leads to joint inflammation, pain, and progressive damage. While conventional treatments—such as disease-modifying antirheumatic drugs (DMARDs) and biologics—help control symptoms, their long-term use can result in adverse effects. This has led researchers to explore alternative approaches, including the use of mesenchymal stem cells (MSCs) due to their immunomodulatory properties.
MSCs influence the RA inflammatory environment by interacting with key immune cells:
- T cells: MSCs inhibit T cell proliferation and promote regulatory T cell (Treg) differentiation.
- B cells: They suppress B cell proliferation, differentiation, and immunoglobulin production.
- Macrophages: MSCs encourage a shift toward an anti-inflammatory phenotype.
- Neutrophils and dendritic cells: MSCs help regulate their activity to reduce immune overactivation.
Despite their potential, RA’s hostile microenvironment—characterized by high reactive oxygen species (ROS), low pH, and persistent inflammation—can reduce the efficacy of MSC therapy. Researchers suggest that preconditioning MSCs before administration may enhance their resilience and therapeutic effects.
