From the Guidelines
Natural Killer (NK) cell therapy is not currently recommended for the treatment of autoimmune diseases like Rheumatoid Arthritis (RA) due to its experimental nature and lack of strong evidence supporting its efficacy and safety. The most recent and highest quality study, the 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis 1, does not mention NK cell therapy as a recommended treatment option for RA. Instead, it focuses on the use of disease-modifying anti-rheumatic drugs (DMARDs), including conventional synthetic DMARDs (csDMARDs), biologic DMARDs (bDMARDs), and targeted synthetic DMARDs (tsDMARDs).
Some key points to consider when evaluating the potential role of NK cell therapy in RA treatment include:
- The dual role of NK cells in autoimmunity, where they can either promote inflammation or suppress it by eliminating autoreactive T cells and regulating dendritic cell function
- The experimental nature of NK cell depletion and adoptive transfer approaches, which require further research to determine their safety and efficacy
- The need for regular follow-up with rheumatologists and immunologists to monitor disease activity and treatment response
- The potential side effects of NK cell therapy, including cytokine release syndrome, and the need for immunosuppressive medication adjustments during treatment
The EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update 1 also do not mention NK cell therapy as a recommended treatment option. The research agenda outlined in this study highlights the need for further research in various areas, including the identification of new biomarkers to stratify patients and predict therapeutic response, but does not specifically address NK cell therapy.
In the context of real-life clinical medicine, the current lack of strong evidence supporting the efficacy and safety of NK cell therapy for RA treatment means that it should not be considered a recommended treatment option at this time. Patients with RA should be treated with established DMARDs, and NK cell therapy should only be considered in the context of clinical trials or experimental studies.
From the Research
Role of Natural Killer (NK) Cell Therapy in Autoimmune Diseases
- There is no direct evidence in the provided studies to support the role of Natural Killer (NK) cell therapy in the treatment of autoimmune diseases, such as Rheumatoid Arthritis (RA) 2, 3, 4, 5, 6.
Current Treatment Options for Rheumatoid Arthritis
- The current treatment of RA consists of nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, conventional disease-modifying antirheumatic drugs (cDMARDs), biologic and targeted synthetic DMARDs 2, 3, 4.
- Cell-based therapies, such as mesenchymal stem cells (MSC), adoptive transfer of regulatory T cells (Treg), and chimeric antigen receptor (CAR)-T cell therapy, have exhibited effective and promising interventions to RA 2.
Emerging Therapies for Rheumatoid Arthritis
- Mesenchymal stem cells (MSCs) provide a promising alternative for the treatment of RA, especially in refractory cases, with minimal adverse events and improved clinical outcomes 5.
- Biologic agents, such as TNF-alpha inhibitors, have been shown to be effective in reducing clinical signs of inflammation in RA patients who have failed synthetic DMARDs 3, 6.