Therapeutic potential of umbilical cord-derived MSCs in arthritis: Insights from preclinical and clinical studies

Among different types of arthritis, osteoarthritis (OA) and rheumatoid arthritis (RA) remain the most common and primary cause of pain and disability worldwide, characterized by progressive joint degeneration and persistent inflammation. Although there have been developments in pharmacology, the available treatment program slows disease progression and provides only symptomatic relief. However, their ability to repair and restore damaged tissue is limited. This highlights the importance of regenerative therapy in actively modulating the immune system while stimulating tissue regeneration. We conducted a narrative review of PubMed, Scopus, Web of science, ClinicalTrials.gov, and ChiCTR, focusing on preclinical and clinical studies of umbilical cord-derived mesenchymal stem cells (UC-MSCs) therapy in OA and RA. Recently, UC-MSC have been emerging as a promising therapeutic approach due to their immunomodulatory and regenerative properties. Because they are harvested noninvasively, these cells have greater proliferative capacity and lower immunogenicity than MSCs derived from bone marrow or adipose tissue. UC-MSCs do not replace damaged cells; instead, they signal other cells to produce bioactive substances that reduce inflammation and promote cartilage repair. Data from emerging preclinical and clinical trials, which show significant improvements in WOMAC and VAS scores and a decrease in DAS28 with minimal adverse effects, suggest that UC-MSCs will improve pain and function and, in turn, overall quality of life. UC-MSCs represent a mechanistically distinct and clinically promising therapeutic effect for OA and RA, addressing both the inflammatory and degenerative condition of joint disease. However, there are still large, well-designed, standardized clinical trials that can best optimize doses and treatment plans. This narrative review summarizes the various forms of arthritis, disease pathogenesis, and preclinical and clinical evidence for the use of UC-MSCs in the treatment of arthritis, such as OA and RA.