title: Anti-inflammatory role and immunomodulation of mesenchymal stem cells in systemic joint diseases: potential for treatment.
abstract: BACKGROUND
  Mesenchymal stem cells (MSCs) are multipotent stromal cells characterized by their ability to differentiate into adipocytes, chondrocytes, osteocytes and a number of other lineages. Investigation into their use has increased in recent years as characterization of their immunomodulatory properties has developed, and their role in the pathophysiology of joint disease has been suggested.
  
  
  METHODS
  MSCs demonstrate immunosuppressive functionality by suppressing T- and B-cell responses following activation by cytokines such as IL-6 and IL-1α. They also can be induced to exert pro-inflammatory effects in the presence of acute inflammatory environment due to the actions of TNF-α and IFN-γ. In inflammatory joint diseases such as rheumatoid arthritis, MSCs in bone marrow migrate to joints by a TNF-α-dependent mechanism and may be in part responsible for the disease process. MSCs have also been demonstrated in increased numbers in periarticular tissues in osteoarthritis, which may reflect an attempt at joint regeneration.
  
  
  CONCLUSIONS
  Clinical applications for MSCs have shown promise in a number of inflammatory and autoimmune disorders. Future work is likely to further reveal the immunosuppressive characteristics of MSCs, their role in the pathophysiology of joint diseases and provide the basis for new avenues for treatment.
authors.affiliation: The Royal Liverpool University Hospital, Department of Trauma and Orthopaedics, Prescot Street, Liverpool, Merseyside L7 8XP, UK.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: MacFarlane
authors.forename: Simon Matthew
authors.initials: SM
authors.lastname: Graham
authors.forename: Peter S E
authors.initials: PS
authors.lastname: Davies
authors.forename: Nectarios
authors.initials: N
authors.lastname: Korres
authors.forename: Helen
authors.initials: H
authors.lastname: Tsouchnica
authors.forename: Manolis
authors.initials: M
authors.lastname: Heliotis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Mantalaris
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Tsiridis
mesh_terms: D000818:Animals; D001168:Arthritis / Q000628:therapy*; D006801:Humans; D056747:Immunomodulation; D059630:Mesenchymal Stem Cells / Q000166:cytology / Q000276:immunology*