Arthritis is defined by the experts as a disease which involves pain, inflammation and stiffness of different joints in the body. Joints affected by arthritis suffer an important limitation in the range of movement, which can be explained by the fact that these joints can hurt a lot when the person moves them, so unconsciously, the person moves them less.
Other experts say that arthritis is not a disease but a group of diseases that share the symptoms mentioned above. In fact, this is the main reason why arthritis is so common. Among the most common diseases that can be included, osteoarthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia, can be mentioned.
According to the CDC (Centers for Disease Control and Prevention) statistics, from 2013 to 2015, around 54.4 million US adults (22.7% of all adults) were diagnosed of a type of arthritis every year.
Current treatments available for these diseases only help to control or reduce the symptoms, but they do not treat the cause. For example, the biologic drugs used in the last years attack a molecule called TNF-alpha (tumor necrosis factor-alpha) which is not only present in the inflamed joints, but in other systems of the body (such as the immune system). So, the secondary effects of this kind of drugs are many, including predisposing the patient to develop severe infections.
Therefore, experts in this area have been studying new options for treatment, especially the regenerative ones, such as the therapies based on the use of stem cells.
Also, there is a new option which consists in using the gene-editing technology to create stem cells able to fight arthritis. The experts call this new treatment the SMART cells technique (Stem cells Modified for Autonomous Regenerative Therapy). The SMART cells treatment consists in artificially inducing the stem cells to differentiate themselves into mature cartilage cells, so the new cells will be able to produce natural substances that can act as anti-inflammatory agents and reduce the joint swelling in both the short and the long-term.
Likewise, these anti-inflammatory substances can help to protect the joints and the surrounding tissues from chronic inflammation damages. The new cartilage cells can also be able to replace the cells which have been damaged by arthritis, so the patient feels an immediate pain relief and can also recover an adequate range of motion and a proper function of the joint.
This innovative treatment was developed by researchers from the Washington University School of Medicine, Duke University and Cytex Therapeutics Inc. The first stages of the study consisted of converting skin cells from mice’s tails into stem cells, which is a very complicated process.
After that, they took the obtained stem cells and kept them in specific crops to modify their genes by the CRISPR genetic technique. With these genetic tools, they were able to change the genes which are related to the inflammatory process by genes that allow them to release the biologic anti-inflammatories. After that, the new cells are ready to combat inflammation.
In other terms, the stem cells tech to fight arthritis consists in re-coding the stem cells genes by gene-editing technology to change the inflammation genes in the stem cells by genes able to produce biologic drugs which fight against the inflammation.
The new stem cells also demonstrated that cartilage cells derived from the re-coded stem cells had a natural resistance to the effects of the inflammatory substances produced by the body.
The researchers said that their main objective was using the new stem cells in groups and creating a treatment, a kind of “vaccine”, for arthritis. However, this new development is very difficult to reproduce because they must create a lot of “smart” cells in the laboratory.
They also say that creating a stem cell therapy to fight arthritis is a very good way to focus the treatment to the joints that need it, opposed to current treatments which can alter the inflammatory response in the entire body. This fact is very important because it allows to avoid unnecessary side effects, such as developing severe and disseminated infections.
Likewise, the genetically modified stem cells do not only act in the affected area but also release the anti-inflammatory substances when they are needed, for example, during an arthritic flare or an intense blow in the joint. This is possible because these modified stem cells recognize the TNF-alpha signals and, instead of activating the inflammatory response, they release a biologic TNF-alpha inhibitor, protecting the joint from inflammation and chronic damage.
Another important benefit of this new development is the fact that, in order to perform the study, the researchers used pluripotent stem cells, so they affirm that these re-coded stem cells can be induced to differentiate themselves in any type of specialized cell.
This discovery is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Institute on Aging of the National Institutes of Health (NIH).
Finally, it is very important to highlight that, although this therapy seems to be an excellent option, more studies are needed to approve and generalize its use in the daily clinical practice because, until now, the stem cells tech to fight arthritis have been only proved in mice and in vitro.
The researchers also concluded that the findings about this treatment are very promising for treating other chronic conditions (especially diseases from the systems which depend on a feedback loop), such as Diabetes.