29 Oct Adipose Stem Cell-Derived Therapy for Multiple Sclerosis
Multiple sclerosis (MS) is a common disorder of the central nervous system that typically affects patients in their 20s or 30s. MS runs a long clinical course leading to crippling symptoms that cause early loss of productivity, need for assistance with daily activities.
MS is caused by an autoimmune reaction against self-directed myelin antigens in the central nervous system, which causes immune deregulation leading to an irreversible axonal damage that results in severe and permanent disability. The cause of MS remains unknown and there is currently no cure; although there are a few therapies that slow its progression.
Autologous mesenchymal stem cells (MSCs) have been shown to induce immunomodulatory and neurodegenerative effects. Adipose-derived stem cells (ADSC) are a type of MSCs that are yielded from subcutaneous fat in abundance. Stem cell therapy has been found to have a neuroprotective effect in the animal model of chronic experimental autoimmune encephalomyelitis.
Two types of cell groups are differentiated from ADSC when used for MS: predominantly neuronal and undifferentiated nonneuronal progenitor cells. There is an interplay of various chemicals, such as growth factors and cytokines that orchestrate this process that leads to remyelination.
The ADSC therapy has to be monitored for rejection by the immune system. These cell lines have the homing capability because of their therapeutic effect at the injured or inflamed tissue. After 1-2 months of treatment, there should overall improvement. Clinical and radiological parameters, such as MRI and tractography should be used to document benefit from this therapy.
These could be in the form of improvement in clinical symptoms, reduction in the size of brain lesions on brain or spine MRI.
Studies in animals have demonstrated that ADSC/MSCs can mature into myelin-producing cells that counter myelin loss in MS disease models. There are questions about the safety and tolerability of ADSC for MS, which is why most robust trials need to be conducted to establish ADSC as a clinically viable treatment for MS.
Research studies are beginning to show that ADSC intrathecal therapy is safe for use in MS and slows disease progression. It is thought that ADSC is a powerful anti-inflammatory and immunosuppressive therapeutic option, and especially useful in rapidly progressive MS. These studies have small numbers are short follow-up periods, and we need to draw conclusions from then cautiously.
Both animal and clinical experiments suggest that ADSC treatment and safe without major adverse effects. ADSC should not be given to cancer patients because it may promote existing tumors.
There has to be a balance between safety, efficacy, and convenience when treating patients with MS. Overall, ADSCs are an attractive therapeutic option for halting and reversing myelin loss in MS. It appears to be the case the ADSC therapy should be reserved for refractory and rapidly progressive MS. It will be interesting to see how ADSC performs when clinically applied on a large scale.