How are dendritic cells changing rheumatoid arthritis treatment strategies?
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Rheumatoid arthritis (RA) is a systemic autoimmune disease that leads to the development of a generalized inflammatory process in the human body. It is most often manifested by severe pain and swelling in the small joints of the hands, wrists, feet, knees, shoulders, and elbows.
If left untreated, RA may cause severe damage to the joints and surrounding tissues and may also cause problems with the heart, lungs, or nervous system. The exact reasons for the development of this condition are still unknown, but specialists consider smoking, being overweight, and environmental exposure, such as polluted air, as risk factors.
With the diagnosis being timely established, the symptoms of the disease can be controlled with the help of conservative treatment and rehabilitation methods. If the patient has severe damage to the joints, surgery, including arthroplasty, can be performed.
In the last decade, alternative therapies for RA have been actively studied, which can alleviate the symptoms of the disease and help the patient restore motor functions. In particular, rheumatoid arthritis treatment with tolerogenic dendritic cells is used.
Content
- What are dendritic cells?
- The use of dendritic cells in the treatment of rheumatoid arthritis
- Dendritic cell therapy abroad
What are dendritic cells?
Dendritic cells (DCs) are one of the key elements of human immunity. These cells help trigger and control the immune response by presenting antigens to T lymphocytes, the white blood cells that play a critical role in adaptive immunity.
Dendritic cells act as a kind of intermediary, creating a connection between the main components of the immune system:
- Dendritic cells actively "scan through" the tissues of our human body, looking for external agents that can negatively affect the functioning of the human body. Should such an agent be detected, dendritic cells will "capture" it, process it, and present its particles to T lymphocytes. This process allows T lymphocytes to "learn" about the threat and mobilize the immune system to fight it.
- The peculiarity of dendritic cells is that they can be activated by certain signals, such as cytokines. In response to these signals, dendritic cells enhance their work, better recognizing and transmitting information about harmful microorganisms and substances. Signals from various sources, such as infections or smoking, may activate dendritic cells. This leads to the release of inflammatory mediators such as TNF and IL-1, which intensify inflammation in the joints and other tissues.
Scientific studies have found that dendritic cells can be used in therapeutic strategies to restore immune balance in cases of autoimmune diseases such as RA.
A 2009 study published in Nature Reviews Rheumatology demonstrated that, under certain conditions, a dangerous autoimmune reaction may be triggered without dendritic cells. Their role in the mechanism of development of rheumatoid arthritis is actively investigated but is not yet completely clear. However, scientists believe that dendritic cells can actively participate in the pathogenesis of this disease, in particular when starting and maintaining the activity of the autoimmune process. According to a series of data, dendritic cells can also contribute to the development of complications of RA.
As of today, methods of rheumatoid arthritis therapy are being actively improved in medicine, taking into account the tolerogenic properties of dendritic cells. These cells are collected from myeloid progenitors in the laboratory, after which they are "acquainted" with the antigen and modified in order to suppress autoimmune reactions in the human body.
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The use of dendritic cells in the treatment of rheumatoid arthritis
Given their key role in the immune system, dendritic cells may be both a cause and a cure for rheumatoid arthritis and other autoimmune diseases. For example, in rheumatoid arthritis, they can produce the cytokine TNF-α (tumor necrosis factor alpha), a protein that plays a key role in regulating the body's immune response, and thereby exacerbate the course of the disease. TNF-α is involved in a variety of biological processes, including inflammation, apoptosis, and the regulation of cell growth. Its increased activity or production may contribute to the development of a number of diseases, including rheumatoid arthritis.
Based on the involvement of dendritic cells in the regulation of immune processes, researchers have developed a mechanism for their use to alleviate the symptoms of RA. Briefly, it can be described as follows:
- As we mentioned above, dendritic cells "present" antigens (or particles of harmful agents) to T lymphocytes for effective immune function.
- Tolerogenic dendritic cells (tolDCs) are dendritic cells modified to suppress autoimmune reactions. For example, in rheumatoid arthritis, the autoimmune reaction attacks the joints, causing them to become inflamed and damaged.
- To obtain tolDCs, dendritic cell precursors are harvested from the patient's blood. These cells are modified in the laboratory, resulting in the formation of tolDCs. The modified cells are then "loaded" with the specific antigen needed in a specific case.
- When tolDCs are injected back into the patient's body, they "teach" the immune system not to respond to this antigen. This helps to reduce the inflammatory response and autoimmune joint damage in RA.
- As a result, the use of tolDCs reduces the activity of RA and the severity of its symptoms.
Therapy using tolDC is currently one of the most promising methods for treating autoimmune diseases, including RA. The method was developed based on studying dendritic cells collected from the bone marrow of a mouse. In 2015, several tolDC-based clinical trials were conducted for the first time to treat rheumatoid arthritis. Studies in mice have found that tolDC therapy can control even advanced RA. The subsequent use of the method in humans has confirmed that tolDC therapy is well tolerated by patients and is effective for rheumatoid arthritis treatment.
In addition, several promising methods of targeting dendritic cells to reduce the activity of RA symptoms are being studied. For example, interrupting the communication between dendritic cells and T lymphocytes could reduce the severity of inflammation. In addition, targeting a special type of dendritic cells, namely plasmacytoid cells, could be another method of treating the disease since these cells play an important role in triggering inflammatory processes.
DENDRITIC CELL THERAPY - Professor Frank Gansauge
Dendritic cell therapy abroad
DСs for rheumatoid arthritis are a relatively new method that is not available in all countries. However, many patients may consider treatment abroad. For example, innovative therapeutic approaches are widely used in Germany, one of the best countries for this type of therapy.
When planning treatment abroad, it is important to carefully select a suitable hospital. Treatment at German clinics provides access to a number of high-quality medical centers with leading specialists in the field of immunotherapy. When deciding on the exact location of your treatment, you should pay attention to the statistics of successful treatment outcomes, the level of technical equipment, and the comfort of staying at the hospital. A determining factor for many people is also the cost of medical services.
Prices in Germany for the treatment of 4 stages of rheumatoid arthritis can vary depending on many factors, including the severity of symptoms, the patient's age, and their general condition. The cost of rheumatoid arthritis medicine in Germany may also depend on the level of the therapy centers and the experience of doctors in using a particular treatment method.
The medical tourism agency Booking Health connects patients with the best doctors, and each hospital undergoes a thorough pre-selection before being listed on the website. As a result, the website helps patients more easily navigate the intricacies of organizing treatment abroad. Booking Health also helps with visas and insurance, translation of medical documents, booking airline tickets, and accommodations.
An expert opinion from a specialist who knows the latest techniques for treating autoimmune diseases can often change the life of a patient with rheumatoid arthritis. Today, specialized hospitals are using more and more promising methods of treating this disease, based on the latest advances in molecular biology, and providing patients with RA with a much higher quality of life. By exploring the available options, including abroad, you will surely be able to choose the one that best suits you.
Choose treatment abroad and you will for sure get the best results!
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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