Mesenchymal Stem Cell Secretome Improves Bone Quality in Autoimmune Rheumatic Patients (AIIRD): A Case Report

Yulyani Werdiningsih; Arief Nurudhin; indrayana sunarso

doi:10.11594/ibehs.vol13iss1pp11-15

Authors

Yulyani Werdiningsih Divisi Rheumatology Ilmu Penyakit Dalam RSUD Dr Moewardi
Arief Nurudhin Divisi Reumatologi Ilmu Penyakit Dalam RSUD Dr Moewardi
indrayana sunarso Divisi Reumatologi Ilmu Penyakit Dalam RSUD Dr Moewardi

DOI:

https://doi.org/10.11594/ibehs.vol13iss1pp11-15

Keywords:

Autoimun, Steroid, GIOP, Sekretom, AIIRD

Abstract

ABSTRAK

Autoimmune Inflammatory Rheumatic Disease (AIIRD) is a group of different disorders, which have similar clinical, laboratory and immunological manifestations. In East Asia, the top 3 diseases included in AIIRD are Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Sjogren's Syndrome. Glucocorticoids are still one of the therapeutic modalities for AIIIRD with their antiinflammatory and immunosuppressive effects. However, glucocorticoids have some side effects. One side effect of concern is decreased bone density. The condition of glucocorticoid induced osteoporosis (GIOP) is reported with increasing prevalence. The main effect of the use of glucocorticoids on bones is the presence of impaired bone formation regardless of the role of inflammation. Secretome stem cells contain bioactives that exhibit diverse physiological functions such as immunomodulation, anti-inflammatory, angiogenesis, anti-apoptotic and anti-oxidation. Secretome can modulate cell differentiation by promoting osteogenesis and inhibiting adipogenesis. In this case report, it showed improvements in markers of bone damage, inflamation, and vitamin D levels after stem cell secretome administration in AIIRD patients with long-term corticosteroid use.

References

Briot and Roux. 2015. Glucocorticoid-induced osteoporosis. RMD Open, 1(1).

Chen J, Cai W, Liu T, Zhou Y, Jin Y, Yang Y, Chen S, Tang K, Li C. 2022. The COVID-19 vaccine: Attitudes and vaccination in patients with autoimmune inflammatory rheumatic diseases. Rheumatol Autoimmun. 2(2):82-91.

Chotiyarnwong and McCloskey. 2020. Pathogenesis of glucocorticoid-induced osteoporosis and options for treatment. Nature Reviews Endocrinology. 2020;16(8):437–47.

Compston J. 2018. Glucocorticoid-induced osteoporosis: an update. Endocrine, 61; pp:7–16.

Dantas JR, Araujo DB, Silva KR, Souto DL, Pereira MFC et al. 2022. Adipose Tissue-Derived Stromal/Stem Cells Transplantation with Cholecalciferol Supplementation in Recent-Onset Type 1 Diabetes Patients: Twelve Months Follow-Up. Horm Metab Res. 2023 Aug;55(8):536-545.

Firestein and Mcinnes. 2017. Review Immunopathogenesis of rheumatoid arthritis. immunity.46(2); pp:183–96.

Hua C., et al. 2020. Glucocorticoids in rheumatoid arthritis: Current status and future studies. RMD Open, 6(1).

Jiang Y., et al. 2021. Advances in mesenchymal stem cell transplantation for the treatment of osteoporosis. Cell Proliferation, 54(1).

Joseph L., editors. 2018. Harrison’s Principles of internal medicine. 20th ed. New York: McGraw-Hill, pp: 2527–40.

Kim H, Cho SK, Kim JW, Jung SY, Jang EJ, Bae SC, Yoo DH, Sung YK. 2020. An increased disease burden of autoimmune inflammatory rheumatic diseases in Korea. Semin Arthritis Rheum. 50(3):526-533.

Kuo T.R. and Chen C.H. 2019. Bone Biomarker for the clinical assessment of osteoporosis: recent developments and future perspectives. Biomarker Research, 5(1).

Liang M., et al. 2019. The therapeutic effect of secretome from human umbilical cord-derived mesenchymal stem cells in age-related osteoporosis. Artificial Cells, Nanomedicine, and Biotechnology, 47(1); pp:1357–66.

Ocarino Nde M., et al. 2010. Intra-bone marrow injection of mesenchymal stem cells improves the femur bone mass of osteoporotic female rats. Connect Tissue Res, 51(6); pp:426-433.

Shang F., et al. 2021. Advancing application of mesenchymal stem cell-based bone tissue regeneration. Bioactive Materials. 6(3); pp: 666–83.

Singh J.A., et al. 2016 American college of rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol, 68;pp:1–26.

Smolen J.S., et al. 2010 Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis, 69(4); pp:631–7.