Markos, Hady Gamal Wagih FahmyKhalil, Kareem Ahmed KamaleldinShalaby, Rawda Ashraf NaguibAbdelmagied, Salma Alaaeldeen Ahmed2024-06-092024-06-092022Pharmacy Graduation Projectshttp://repository.msa.edu.eg/xmlui/handle/123456789/6046Faculty Of Pharmacy Graduation Project 2020 - 2022Rheumatoid arthritis is an auto-immune disease characterized by loss of self-tolerance in the joints; consequently resulting in inflammation in joints, cartilage destruction, and bone erosion (Mitra, 2013). Recent studies deducted that stem cells are a promising candidate that could achieve a balanced equilibrium between addressing the pathophysiology of RA and overcoming conventional drugs` disadvantages. MSCs are multipotent stem cells primarily transformed in the bone marrow; in addition, it has a crucial role in repairing and forming skeletal tissues, such as; adipocytes, chondrocytes, and osteocytes (Greish et al., 2012). Besides MSCs' chondrogenic differentiation potential, it also orchestrates the activity of the immune system through direct and indirect interactions and it also has a significant anti-inflammatory effect. Also, the plant extract of Paeonia lactiflora Pallas that shows a great anti-inflammatory effect in different studies is going to be tested alone and in combination with MSC to observe if it potentiates its effect. On the other hand, the objective involves a brief discussion of the pathophysiology of rheumatoid arthritis, stem cells, and their isolation scheme as well as the method of disease induction. Moreover, it also involves the investigation of disease parameters and exploring the modulatory effect of mesenchymal stem cells on RA. At the end of the treatment period real-time PCR was used to detect the following genes: alkaline phosphatase (mALP), transcription factor sp7 (mOsterix) and collagen type I or alpha 1 (mCOL-I). Moreover, a western blot was also employed to measure both Sirt-1 and Foxp3 in the joints. The results showed a significant increase in osteogenic markers and a significant reduction in pro-inflammatory cytokines, in the MSC group and the plant extract group when compared to the other groups (P<0.05). To sum up, this study illustrated that MSC and plant extract showed a beneficial role in the treatment of RA through their anti-inflammatory and immunosuppressive properties. Moreover, it had a much more significant role when both were combined as it provided a better prognosis than when MSC is used alone.enجامعة أكتوبر للعلوم الحديثة و الأدابMSA universityOctober university for modern sciences and artsUniversity of Modern Sciences and ArtsStem CellsAutoimmuneOther