Stem cell treatment for ankylosing spondylitis

SpA diseases (spondyloarthritis) are a family of autoimmune inflammatory conditions that have common manifestations such as inflammation of the sacroiliac joints, spinal cord or peripheral joints, and are often predisposed by genetic factors such as the HLA-B27 gene. The spondyloarthritis family includes reactive arthritis, axial spondyloarthritis, psoriatic arthritis, and arthritic spondylitis, which is also associated with inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease.
What is ankylosing spondylitis?
Ankylosing spondylitis (AS) is a progressive inflammatory rheumatic disease primarily affecting the axial skeleton and sacroiliac joints. The primary clinical manifestation of AS is frequent back pain and progressive bamboo spine stiffness. Other affected areas include oligoarthritis (arthritis affecting two to four joints), usually the shoulders and hips. Other patients report degenerative disc disease or enthesopathy, disruption of the connective tissue between bones and tendons (entheses), ligament enthesopathy, and anterior uveitis. Although extensive research has been conducted, our current understanding of the underlying pathogenesis of ankylosing spondylitis is still minimal. Common causes are usually due to hereditary causes (eg HLA-b27), infections and autoimmune attacks.Ankylosing spondylitis is classified as a type of arthritis of the spine and causes severe inflammation of the joints of the spine, leading to severe chronic pain and frequent discomfort. In patients with more advanced AS, chronic inflammation leads to the formation of new bone formations, causing sections of the spinal cord to become fused (fixed, immobile), commonly referred to as a “bamboo spine.” Bamboo spine usually develops due to ossification of the outer fibers of the annulus fibrosus (intervertebral discs), resulting in osteonecrosis of the hip or the formation of syndesmophytes (bony growths occurring within the ligament) between adjacent vertebrae.
Spondyloarthropathy is considered highly hereditary and is often associated with progressive stiffness, rheumatoid arthritis, peripheral arthritis, gouty arthritis, and a chronic inflammatory response in the spinal and pelvic regions.

Who gets ankylosing spondylitis?
In most patients, the diagnosis of ankylosing spondylitis is made at an early age and usually always leads to some physical impairment and a decrease in overall quality of life. It is estimated that more than 90 percent of patients with ankylosing spondylitis carry mutations in the HLA-B27 gene. Recent studies also show that men are 2-3 times more likely to be diagnosed than women. Other known causes of AS include tumor necrosis factor-alpha (TNF-α) and IL-1.ANCA (antineutrophil cytoplasmic antibodies) are also associated with ankylosing spondylitis, but do not necessarily correlate with how severe the patient’s condition will be.
Symptoms and complications of axial spondyloarthritis
When ankylosing spondylitis begins to develop, patients report chronic inflammation of the spine, and X-ray studies often show new bone formation in all segments of the spinal cord. Ultimately, calcification of the vertebral and paravertebral ligaments leads to aggravation of nerve endings, resulting in chronic pain. The rate of new bone formation varies from patient to patient, but is usually caused by increased differentiation of osteoblast cells. Patients diagnosed with spinal arthritis are at very high risk of developing vertebral fractures, osteoporosis, lupus, spinal cord injury, hypertension, heart disease such as CHF, pulmonary complications leading to COPD or IPF (upper lung disease), and metabolic syndromes such as like like diabetes, neuropathy and diabetic nephropathy. Patients with AS also have a higher prevalence of dementia and Alzheimer’s disease, primary Sjögren’s syndrome, ALS and MND compared to the general population. If left untreated, the condition worsens over time, leading to loss of spinal mobility and limited movement in lateral and forward flexion. Other systemic disorders common in patients with AS include weight loss, chronic fatigue, and fever. For most patients, the pain is often worse with rest, but may improve with mild exercise.
Diagnosis of ankylosing spondylitis stage 4: advanced level
Ankylosing spondylitis and axial spondylitis can now be diagnosed by checking for changes in the sacroiliac joints and spine using x-rays such as MRI. Genetic screening is also performed to check for the presence of the HLA-B27 marker. Patients who are HLA-B27 positive have a higher than average risk of developing certain types of autoimmune diseases. In patients with acute inflammatory attacks, simple blood tests can be used to measure CRP (C-reactive protein) concentrations and ESR. Complications-risks-treatment-axial spondyloarthritis (erythrocyte sedimentation rate). However, it should be noted that in many patients with ankylosing spondylitis, ESR and CRP do not increase, so normal CRP and ESR results may not correspond to the actual amount of inflammation.
General criteria for diagnosing spondyloarthritis include:
Frequent inflammatory back pain
Family history of inflammation in the tendon-bone joints, heel, shoulder or hip joints.
Positive test for the HLA-B27 gene – DNA testing
Increased levels of inflammation, measured using blood tests for CRP/hs-CRP or ESR.
Family history of spondyloarthritis or other rheumatic/autoimmune diseases.Previous diagnosis: chronic lymphocytic thyroiditis
Fair response to non-steroidal anti-inflammatory drugs (NSAIDs)
Psoriasis
History of spinal inflammation
Inflammatory bowel disease
Frequent eye inflammation (uveitis)
Inflammation of the sacroiliac joint was confirmed by MRI.

Treatment options for ankylosing spondylitis in 2024
Traditional antirheumatic drugs may help relieve back pain, sleep disturbances, acute phase reactions of peripheral arthritis, and temporarily improve quality of life; however, the main contributing factor to axial spondyloarthritis is new bone formation, which is usually not affected. With this new alternative treatment for AS, try to focus on managing osteogenic differentiation to prevent new bone formation and induce a period of sustained remission of the disease.

Traditional methods of treating spondyloarthritis:
There is currently no treatment for hereditary ankylosing spondylitis. The success of modern biological treatments and traditional pharmaceuticals can help control disease and reduce pain; however, early intervention is vital. It can be difficult to make a confirmed diagnosis in the early stages, so a lengthy diagnostic phase will be required. To identify the cause of your symptoms, you can start with annual physical exams and tests.
Commonly used non-surgical treatments for ankylosing spondylitis include physical therapy and exercise. Regular physical therapy can help restore some joint function. Occupational therapy is a great way to strengthen the tissues and muscles needed for a flexible, healthy body. Non-impact exercises can provide patients with rapid relief from pain and stiffness. This natural therapy may help reduce the risk of future disabilities.
Prescription drugs – DMARDs – NSAIDs
NSAIDs (nonsteroidal anti-inflammatory drugs) are the most common first treatment used to control symptoms. This family of drugs includes naproxen, aspirin, and ibuprofen. Other disease-modifying antirheumatic drugs (DMARDs) may be added to the treatment regimen for patients who do not respond to NSAIDs. DMARDs, such as sulfasalazine, involve local steroid injections to reduce stiffness, inflammation, and other discomfort.Long-term use of the drugs has been associated with severe reactions, liver cirrhosis, renal failure or gastrointestinal bleeding, peptic ulcers, hepatorenal damage, and cardiovascular events such as MI.
TNFα antagonists
Tumor necrosis factor-alpha is a physical blocker that is often called an “antagonist.” These TNFα antagonists include biologics such as infliximab, etanercept, adalimumab, and golimumab. Biologic drugs, such as interleukin 17 inhibitors and TNF blockers, can cause the immune system to stop or slow down the inflammation process; however, a course of inhibition of the production of proinflammatory cytokines such as IL-17, IL-22, IFN-γ, and TNFα may lead to serious side effects and, in some patients, reactivate tuberculosis or make patients more prone to new infections.
Surgical treatment of bamboo spine
Thanks to medical advances, surgery is very rarely used today. However, in some advanced cases, if pain or severe swelling occurs quickly, surgery may be necessary. The operations will mainly be aimed at replacing damaged joints with new artificial joints. Such surgeries are common in knee replacements and total hip replacements. Corrective surgery is also necessary for patients with severe flexion deformities (downward curvature of the spine), especially in the cervical spine (neck).

Risks of surgery
Joint replacement surgeries are inherently risky and temporary, as artificial joints require replacement over time. In addition, preparation for surgery that requires general anesthesia further complicates the procedure and increases the risk of surgery. Any sudden changes in the upper airway can lead to problems with airway intubation. In some cases, direct spinal or epidural anesthesia may not be possible due to extensive calcification of the injured ligaments. Stiffness of the thoracic ribs can reduce lung function or lead to aortic regurgitation.

Stem cell treatment for ankylosing spondylitis
Over the past two decades, significant progress has been made in approaches to regenerative treatment of spondyloarthritis.
The enhanced mesenchymal regeneration (MSC+) protocol includes a proprietary combination of adult mesenchymal stem cells, osteoblast-specific growth factors, adipocytes and chondroblasts with cell surface proteins consisting of ≥95% CD90, CD73, CD105 markers
We offer a viable treatment option for patients who have otherwise not responded to traditional treatments. MSC+ cells have significant regenerative and immunomodulatory properties that can help reduce inflammatory responses and help repair surrounding tissues by secreting soluble factors contained in growth factors during treatment.

For the treatment of immune-mediated inflammatory diseases, our clinic has developed a unique combination therapy using hematopoietic stem cells and MSC+ cells, which is particularly effective in stabilizing the abnormal rate of osteogenic differentiation
MSC+ cells are engineered to provide low immunogenicity and immunomodulatory properties. MSC+ therapy for ankylosing spondylitis does not require immunosuppressive drugs. MSC+ cells do not express HLA-DR, making them an ideal therapeutic medium for transplantation into inpatients with immune-mediated diseases. MSC+ can destroy dysfunctional cells, reboot the immune system, replacing damaged cells with cells that have differentiated into the standard B and T cells needed for homeostasis of the immune system.

Treatment protocol:
Total number of MSC+ cell infusions: The total number of endogenous cells and the range of growth factors will vary depending on the patient’s needs. Multipoint delivery of cells can be accomplished by radiographing (if necessary) via intravenous drip, direct injection, or intrathecal route.
Recommendations and requirements for the treatment of spondyloarthritis
Treatment of spinal arthritis and ankylosing spondylitis with stem cells will take a total of 2-3 days. Due to varying degrees of severity, our medical team will need to evaluate patients using current medical records. The assessment can be completed in person or online (online submission). After review, a detailed treatment plan will be provided, which will include details such as the exact total number of nights required and the total medical costs of treating ankylosing spondylitis with MSC+ stem cells. To begin the evaluation process, have all current medical records ready and contact us today.