Gianna is an associate editor of The American Journal of Managed Care® (AJMC®). She has been working on AJMC® since 2019 and has a BA in philosophy and journalism & professional writing from The College of New Jersey.
Several clinical trials have found mesenchymal stem cell therapy effective in treating neural damage in patients with multiple sclerosis (MS), according to a review published in Stem Cell Investigation.
Several clinical trials have found mesenchymal stem cell (MSC) therapy effective in treating neural damage in patients with multiple sclerosis (MS), according to a review published in Stem Cell Investigation.
Patients develop MS when autoantibodies target the self-myelin antigens, causing demyelination. One of the main symptoms of myelin dysfunction is neurological disabilities. Currently, there is no curative method for MS, nor is there an approved method for improvement of disease progression by repairing the damaged myelin. However, clinical trial results point to the safety and efficacy of certain MSC therapies in modulating immune responses in patients with MS.
“MSCs are multipotent cells with high proliferative and self-renewal capacities, as well as immunomodulatory and neuroregenerative effects,” the researchers said.
Although the underlying cellular and molecular mechanisms of stem cell therapy in patients with MS is not understood, tirals have yielded encouraging results. For example, “Upon intravenous injection, MSCs are able to traffic into the brain lesions and improve the survival rate of brain cells.” Results also revealed that injection of MSCs decreases disease severity and improves quality of life in patients with MS.
Stem cells can be easily isolated from different sources of the body, including peripheral blood, adipose and bone marrow tissues, umbilical cord blood, and placenta. The review analyzed the safety and efficacy of trials involving stem cells derived from these various sources.
The injection of bone marrow—derived autologous MSCs has been revealed to improve the disease’s severity, patients’ cognitive functions, and overall quality of life due to the cells’ neuroprotective and anti-inflammatory properties. Clinical studies also found that adipose-derived MSC therapy “is a safe method which improves MS disabilities, such as sexual problems and social activities,” in patients. The researchers determined adult adipose tissue stem cells are “one of the most suitable cells for MS treatment.” This is due to the fact that adipose tissue is easy to separate, produces a high volume of cells per unit area, and has relatively inexpensive extraction costs.
In addition, umbilical cord—derived MSCs are attractive treatment options because they are extracted from easily attainable tissue, absent of any ethical dilemmas. In comparison, human fetal-derived neural stem cells (HNSCs) can be considered one of the best treatments for patients with MS because they are the precursors of neuronal cells. However, “HNSCs are obtained from brain specimens of several fetal human donors from spontaneous miscarriages that occurred after the eighth week after conception…Due to ethical reasons and the lack of the same opportunity to make these cells, it is difficult to use them,” researchers said.
A type of stem cell—based therapy developed for the treatment of hematological malignancies like lymphoma and leukemia has been explored in recent investigations. Studies proposed hematopoietic stem cell transplantation “can prohibit MS disease progression for 4 to 5 years in 70% to 80% of patients.”
The researchers conclude hematopoietic stem cell and various MSC treatments result in “significant improvements in quality-of-life, neurologic disability, and functional scores,” among patients with MS.
Bejargafshe MJ, Hedayati M, Zahabiasli S, et al. Safety and efficacy of stem cell therapy for treatment of neural damage in patients with multiple sclerosis [published online December 27, 2019]. Stem Cell Investig. doi: 10.21037/sci.2019.10.06.