Stem cell therapy for arthritis | Overview including symptoms and causes

Arthritis is a disease in which inflammation occurs in the joints for some reason, causing persistent chronic swelling and pain. Various types of arthritis, including rheumatoid arthritis and osteoarthritis, can greatly affect daily activities when symptoms progress.
While conventional treatments are aimed at alleviating the symptoms, mainly with pain relief medications, injections, and physiotherapy, it is not easy to regenerate the joint itself.
In recent years, stem cell therapy has attracted attention as a type of regenerative medicine. Stem cells may be used to repair damaged tissues to fundamentally resolve joint pain, decreased range of motion, and other symptoms of arthritis.
In this article, we will reconfirm the causes and symptoms of arthritis and explain the mechanism and benefits of stem cell therapy, as well as the actual treatment process.

What is arthritis?

Arthritis is a disease associated with pain, swelling, and limited range of motion caused by inflammation occurring in the cartilage, synovium (the membrane that covers the joint), articular capsule, and other joint tissues.
In mild cases, the pain may subside temporarily, but when the condition becomes chronic, the risk of joint deformity greatly interfering with daily life increases. Types of arthritis include the following:

• Osteoarthritis: The cartilage wears away with age or because of trauma or other reasons, causing bone-on-bone contact leading to inflammation and deformity.
• Rheumatoid arthritis: Inflammation due to autoimmune reactions occurs in joints throughout the body. The condition is likely to become serious, causing deformation of fingers, etc.
• Gouty arthritis: When the uric acid level remains elevated, crystals deposit in joints, causing severe pain and swelling.
• Infectious arthritis: Bacterial and viral infections cause acute inflammation.

Although the site and mechanism of inflammation differ, in all cases, joint function may be greatly impaired if left untreated. *1

*1 Reference: Maniwa Orthopedic Clinic

Symptoms of arthritis

While symptoms of arthritis vary depending on the site of inflammation, the following features are common to all types of arthritis.

• Joint pain: Intense pain is felt during exercise and may even occur at rest when the disease progresses.
• Joint swelling and a feeling of warmth: Inflammation causes joint swelling and warmth to touch. Swelling is often visible.
• Stiffness and limited range of motion: Inflammation causes stiffness around the joint and difficulty in moving. It is typical to experience “morning stiffness” upon waking up in the morning.
• Deformation and loss of stability: If prolonged, the cartilage and bone get destroyed, and the joint becomes deformed, leading to a loss of support and stability.

Pain and swelling may persist chronically and often affect daily living activities (e.g., walking, holding objects). *2

*2 Reference: OMRON

Causes of arthritis

The causes of arthritis are mainly classified as follows:

• Aging and cartilage wear: As the cartilage wears away with age, its cushioning function is reduced, and bone-on-bone contact occurs, leading to inflammation (e.g., osteoarthritis).
• Traumatic injury and overwork: When the joint is overused in sports or work, or when the patient has an injury or a history of surgery, the risk of onset increases.
• Autoimmune disorder: A typical example is rheumatoid arthritis, where the immune system attacks one’s own tissues.
• Metabolic abnormality: As in the case of gout, disrupted metabolism in the body leads to deposition of crystals in the joints, causing inflammation.
• Infection: In infectious arthritis, bacteria/viruses enter the joint and causes inflammation.

Once inflammation begins, prompt treatment is necessary to prevent a chronic vicious cycle involving the swelling of the joint capsule and synovium among other symptoms. *3
*3 Reference: Alinamin Pharmaceutical Co., Ltd.

Stem cell therapy as a promising radical treatment for arthritis

Currently, expectations are focused on stem cells as a treatment approach for arthritis.

Here, we will explain the background of stem cells in relation to the treatment of arthritis and their specific advantages.

What is stem cell therapy?

Historically, it has been considered difficult to fundamentally regenerate damaged cartilage and bone tissue.
In recent years, stem cell therapy has attracted attention as a type of regenerative medicine that attempts to regenerate damaged cartilage and bone and suppress inflammation, thereby restoring their functions. It offers a new option for treating intractable arthritis, such as osteoarthritis and rheumatoid arthritis.

Advantages of stem cell therapy

Stem cell therapy for arthritis is expected to display the following advantages:

• Regeneration of cartilage and bone tissues: Stem cells differentiate into chondrocytes and osteocytes, which may directly reconstruct the damaged site.
• Inflammatory suppression: Cytokines secreted by stem cells suppress inflammation, thus reducing joint swelling and pain.
• Treatment with a low risk of side effects: When autologous stem cells are used, rejection and serious adverse reactions are less likely to occur.
• Combination with other therapies is possible: Drug therapy, exercise therapy, and stem cell therapy can be combined with the aim of achieving both symptom relief and fundamental regeneration simultaneously.

Reasons why stem cell therapy is effective

The ability to both self-renew and undergo multilineage differentiation allows stem cells to not only compensate for lost cells but also provide an appropriate regenerative environment in the damaged area through secretion of growth factors that activate surrounding tissues, thus exerting a comprehensive effect. In arthritis, pain and functional impairment persist because of continued tissue destruction resulting from the wear and tear of the cartilage and inflammation. Stem cell therapy is expected to support new cartilage formation while suppressing inflammation, thereby increasing the possibility of functional recovery.
However, proper evaluation and explanation by specialists are important because the therapeutic effects of stem cells change depending on the patient’s age, disease stage, degree of joint damage, or other underlying diseases, and cannot be expected to lead to dramatic improvements in all patients.

Flow of treatment at the Regenerative Medicine Division of Korokai Medical Corporation

The Regenerative Medicine Division of Korokai Medical Corporation provides stem cell therapy through the following process in an attempt to improve pain and functional impairment caused by arthritis.

• Initial consultation and tests: We will ask the patient about symptoms and medical history and evaluate the joint damage using imaging tests such as X-ray and MRI.
• Stem cell collection and culture: The patient’s own stem cells will be harvested from the bone marrow or fat and grown in culture while ensuring strict safety control.
• Preparation of the treatment plan: We will formulate an individual plan while considering the method (e.g., injection, intravenous infusion) and frequency of stem cell administration and combination with other therapies (e.g., rehabilitation, drug therapy).
• Administration of stem cells and follow-up: After administering stem cells to the joint, we will check the degree of improvement in pain and motor function, as well as the presence or absence of adverse reactions, by performing tests on a regular basis. Additional dose administration may be considered, if necessary.

Possibility of stem cells contributing to arthritis treatment

Arthritis is a disease caused by multiple factors such as aging, excessive load, and autoimmune abnormality, and in which cartilage and bone destruction lead to pain and limited range of motion. It is not easy to fundamentally repair the damaged joint tissue. Stem cell therapy has received attention as an innovative means aimed at cartilage and bone regeneration, inflammatory suppression, and pain relief using regenerative medicine approaches. Although there are individual differences in terms of whether patients feel the effects, the therapy holds high promise for fundamental improvements.

The Regenerative Medicine Division of Korokai Medical Corporation offers stem cell-based regenerative medicine as a medical institution approved by the Ministry of Health, Labour and Welfare. *4

If you are interested in stem cell therapy, please contact our hospital for consultation.
The Regenerative Medicine Division of Korokai Medical Corporation carefully selects evidence-based treatment and offers regenerative medicine according to each individual’s concerns based on novel comprehensive treatment strategies. To optimize the results, a combination of oral therapy, such as bioidentical hormone replacement therapy or peptide therapy, and stem cell therapy will be used.

*4 Source:  Ministry of Health, Labour and Welfare

The Regenerative Medicine Division of Korokai Medical Corporation – a stem cell therapy clinic in Tokyo

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[1] Therapeutic Method
The treatment involves harvesting and culturing stem cells from the patient’s adipose tissue and then injecting them locally at the affected area or administering them via intravenous infusion.
[2] Risk of side effects
At the time of fat collection: Adverse reactions such as internal bleeding, swelling, postoperative infection, postoperative scar, and pain at the injection site may be observed.
At the time of stem cell administration: Adverse reactions such as pain at the injection site, allergic reaction, and pulmonary embolism may be observed.
[3] Contact information
The Regenerative Medicine Division, Korokai Medical Corporation
5th floor, Precious 18, 4-14-6 Minami-Azabu, Minato-ku, Tokyo
TEL:03-6277-4650
[4] Pricing
This treatment is a private therapeutic strategy that is not covered by public health insurance.
For culture of approximately 100–180 million stem cells
*Since the number of stem cells that can be grown varies from person to person, it may be less than 100 million stem cells.
1 cycle costs 2.5 million yen (tax included)
3 cycles cost 7.2 million yen (payment in installments: 2.5 million yen each for the first and second cycles, 2.3 million yen for the third cycle)
5 cycles cost 11.5 million yen (tax included) (payment in installments: 2.5 million yen each for the first through fourth cycles, 1.5 million yen for the fifth cycle)
For culture of approximately 200–280 million stem cells
*Since the number of stem cells that can be grown varies from person to person, it may be less than 200 million stem cells.
1 cycle costs 3.8 million yen (tax included)
3 cycles cost 11.1 million yen (tax included) (payment in installments: 3.8 million yen each for the first and second cycles, 3.5 million yen for the third cycle)
5 cycles cost 17.5 million yen (tax included) (payment in installments: 3.8 million yen each for the first through fourth cycle, 2.3 million yen for the fifth cycle)
Please consult us for further details.
[5] Route of acquisition
Stem cells will be cultured at the affiliated CPC.
[6] Presence or absence of devices/drugs approved for the indications in Japan
No approved drugs for the indications are available in Japan.
[7] Safety information from other countries
There are no reports on safety in other countries.
*Significant risks may not have been identified.
[8] The fact that it has not been approved
Drugs used in this treatment are yet to receive approval in accordance with the Pharmaceutical and Medical Device Act.
[9] Unapproved drugs/devices
Public aid systems (such as Relief Systems for Adverse Drug Reactions and Infections Acquired through Biological Products) are not applicable to unapproved drugs and devices.
[10] Notification of regenerative medicine provision plans
To perform this treatment, we have submitted the notification of regenerative medicine provision plans to the Ministry of Health, Labour and Welfare in accordance with the Act on the Safety of Regenerative Medicine.
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3210146
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3230187
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3240017
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3230218