Multiple sclerosis (MS) is a nervous system disorder in which the information that flows between the brain and body becomes disrupted. It’s estimated that at least one million people in the U.S. are living with MS. In this condition, the immune system mistakenly attacks healthy tissue in the brain known as the myelin sheath, or the protective coverings for the nerves. This immune system attack also results in inflammation which can further damage nerve cells. Here is how regenerative medicine is used to manage multiple sclerosis.
People with MS can experience a wide range of unpredictable symptoms which may include:
Vision changes
Tremors
Numbness or weakness in the limbs
Slurred speech
Fatigue
Gait changes
Tingling or pain throughout the body
Experts aren’t sure what causes MS, though it’s believed that a combination of genetic and environmental factors contributes to a person’s risk. Women are also two to three times more likely to have the condition.
Regenerative Therapy for MS
Fortunately, the outlook for people with MS has improved over the years. Medications are available to both manage symptoms and modify the progression of the disease. In addition, patients may also be able to explore options such as regenerative therapy to halt the progression of MS and control symptoms without the side effects that come with medications.
Regenerative therapy is used to trigger the natural repair processes within the body, thereby replacing damaged cells with new, healthy ones. In particular, mesenchymal stem cells could be used to repair and replace damaged nerve cells. These cells also have anti-inflammatory properties and can restore the myelin on nerve cells to essentially reprogram the immune system. Patients could then see benefits such as:
Improved coordination and concentration
Reduced muscle spasms and pain
Reduced numbness and tingling
Improved bladder function
Better energy levels
Better balance and range of motion
Improved sense of touch and vision
Slowing or decreased rate of progression
Reduced headaches
Currently, patients may undergo regenerative therapies such as stem cell injections. These cells can regenerate lost or damaged cells, including myelin sheath tissue. They can also modulate the immune system to halt the attack on healthy cells, returning it to a state of rest and allowing the body to restore its proper levels of wellness.
Patients who have undergone stem cell therapy for MS have witnessed noteworthy improvements in the areas of neurologic disability, functional scores, and overall quality of life. Moreover, side effects are mild and generally include headache and fatigue.
While research into regenerative medicine to manage Multiple Sclerosis is ongoing, the findings revealed so far suggest that stem cell therapy and similar treatments hold considerable potential for helping people with MS and other autoimmune disorders.
Multiple sclerosis (MS) is a progressive and disabling autoimmune disease that affects the brain and central nervous system. As MS progresses, the body’s immune system attacks the protective sheath (myelin) that covers nerve fibers resulting in axonal damage and loss that eventually results in paralysis of the limbs; the condition also contributes to a number of other serious communication problems between your brain and the rest of the body[1], including numbness, tremors, and issues affecting vision and speech.
To date, no effective therapeutic medication or treatment for MS exists and medication prescribed for this disease is done so for the purpose of alleviating symptoms and chronic inflammation associated with it; several of these drugs, and especially those with immunomodulatory and immunosuppressive properties have demonstrated to be only partly effective in easing autoimmune reactions.
While current immunotherapies have demonstrated to be effective in reducing the reactivity of autoimmune anti-myelin and MS relapse rate, there remains no approved method for treating or slowing progression of the disease or for repairing myelin damaged as a result of it. As a result, Bejargafshe et al. point out that finding an appropriate clinical treatment for improvement of the neurological damage caused by MS is essential.
The authors also call attention to the numerous studies demonstrating the benefits of mesenchymal stem cells (MSCs) in creating a number of different of autoimmune conditions, including modulating the immune response in MS patients. MSCs are specific multipotent and self-renewing stem cells that have demonstrated to be differentiated into several cell types and can be easily isolated from bone marrow and adipose tissue; this means the patient can serve as a donor for him/herself without risk of rejection.
Bejargafshe et al.’s study reviews several clinical trials evaluating the effectiveness of MSC therapy for MS patients, including several specific clinical trials examining the effectiveness of bone marrow-derived MSCs, adipose-derived MSCs (ADMSCs), USMSCs, human fetal-derived neural stem cells (hNSCs), MSC-derived neural progenitors (MSC-NPs), and hematopoietic stem cells (HSC).
The authors of this study conclude that cell-based therapies, including those mentioned in this study, have shown to repair the CNS, protect against inflammation caused by an autoimmune response, are safe and effective, and demonstrate new opportunities for preventing and treating a wide range of neurodegenerative diseases, including MS.
In addition, the authors concluded that while nearly all of the various types of stem cells evaluated provide benefits, adult MSCs, because of their safety and ease of extraction, are the most common source of stem cells used for this application, with bone marrow being the major source of MSCs used. Clinical trials indicate the observed multipotency and highly-differentiated potential of UC stem cells also make them a viable treatment option, but the need to maintain a supply of UC stem cells through cell banks limit their appeal on the basis of availability.
Interestingly, among the potential cell therapies evaluated, adult adipose stem cells (ASC) appear to be among the most suitable cells for the treatment of MS. In addition to being very safe to use, adult ASCs are easy to separate from adipose tissue, are available from several different parts of the body, are available in a large concentration per unit area, and relatively inexpensive when used in a stem cell transfusion. Considering the benefits listed above, as well as those observed in clinical studies, the authors conclude that ASCs and HSCs are appropriate candidates for the treatment of MS.
Progressive multiple sclerosis is a significant disruptive neurodegenerative disease that interferes with the brain’s ability to control the body; the condition continues to get worse over time and, to date, has no known therapeutic treatment or cure.
Petrou Et. Al’s double-blind clinical trial examined the therapeutic efficacy of mesenchymal stem cell (MSC) transplantation in active progressive multiple sclerosis and explored the most favorable route of cell delivery (intravenous or intrathecal injections).
Prior to this study, previous trials examining various types of MSC administration in the therapeutic treatment of multiple sclerosis have demonstrated the clinical safety of MSC administration but have not identified treatments to suppress central nervous system (CNS) inflammation associated with the progression of diseases like progressive multiple sclerosis.
Several studies have also demonstrated that CNS loses the ability to repair and regenerate over time. Considering that stem cells, and specifically MSCs, have demonstrated to provide additional benefits, including immunomodulatory and neurotrophic effects, when used in the treatment of stroke and multi-system atrophy, they appear to be a viable potential therapeutic treatment for active progressive multiple sclerosis.
For the purposes of Petrou Et. Al’s study, a total of 48 participants with a mean disease (active progressive multiple sclerosis) duration of 12.70 years were included as part of this study either as part of a placebo group, MSC-IV group, or MSC-IT group; selected treatment was applied at 3-month and 6-month marks of the study.
At the conclusion of this study, the authors report no serious, treatment-related adverse effects were observed and significantly fewer patients in the MSC-IT and MSC-IV groups experienced treatment failure when compared to the placebo group.
By reviewing changes observed in ambulation index, the sum of functional scores, 25-foot timed walking test, PASAT and OWAT/KAVE cognitive test, and the rate of change in T2 lesion load on MRI observed after the 6th-month treatment, researchers also found beneficial effects in both the MSC-IT and MSC-IV groups.
It appears that repeated intrathecal injection of MSC during the second round of treatment (Month 6) significantly improved the effects measured during the first round of similar treatment (Month 3); similar, but less significant benefits were also observed in the MSC-IV group. Specifically, researchers report that these observed benefits may indicate the involvement of immunomodulatory and neuroprotective mechanisms.
Of particular interest is the fact that the benefits with clinical significance were observed in participants with progressive multiple sclerosis found to be previously unresponsive to conventional immunotherapies and currently with limited treatment options.
In conclusion, this study found short-term clinical efficacy and perhaps neuroprotection by administration of MSCs to participants with progressive multiple sclerosis. The researchers also found that while repeated injections of both MSC-IT and MSC-IV produced beneficial effects, intrathecal administration appears to produce more clinically significant and observable benefits than MSC-IV.
These findings are recommended for use in the design of future studies examining the impact of cell therapy on neurodegeneration and neuronal regeneration and warrant Phase III study to confirm the therapeutic potential of cellular therapy in neurodegenerative and neuroinflammatory diseases, including multiple sclerosis.
A recent open-label, single-arm, phase 1 clinical trial designed to evaluate the safety and tolerability of repeated intrathecal (IT) administration of autologous mesenchymal stem cells (MSCs) from bone marrow in patients with progressive multiple sclerosis demonstrated findings and benefits resulting in the initiation of an FDA-approved randomized, placebo-controlled and blinded phase II large group study to demine further efficacy of this procedure.
Multiple sclerosis, or MS, is a progressive condition where the body’s immune system attacks myelin, the protective sheath covering the nerves of the central nervous system, resulting in debilitating communication problems between the brain and the rest of the body.
While the specific cause of MS has yet to be determined, the disease itself is characterized by specific areas of inflammatory CNS demyelination that either regenerates or progresses into a chronic condition with accompanying loss of neurons, neuroglial cells, and glial scarring.
Roughly 10% to 15% of MS patients experience progressive symptoms from the onset of the disease, including motor weakness, paralysis, sensory dysfunction, loss of coordination, and cognitive decline.
Although there are immunosuppressive and immunomodulatory therapies that serve to slow the progression of MS, therapeutics designed to protect, repair, or regenerate neural tissue as a way of restoring neurological function do not currently exist. Considering that, mesenchymal stem cells gathered from bone marrow have demonstrated the ability to promote tissue repair through the secretion of paracrine factors.
Study Design and Findings
The treatment phase of this phase 1 trial, conducted at Tisch MS Research Center of New York, involved select participants with progressive MS receiving three separate IT injections of autologous mesenchymal stem cell-defined neural progenitors (MSC-NPs) spaced three months apart; each participant was then assessed the day of treatment, then the day, week, and month following each administration. As part of the post-treatment assessment, participants were assessed again three and six-month after receiving the third dose.
Analyzing the results of this study, researchers found no serious adverse effects or hospitalizations associated with this IT MSC-NP treatment; this included no specific incidents of chemical or infectious meningitis.
Brain MRI scans gathered during the course of this study demonstrated no changes and specifically were characterized by the absence of new or additional T2 lesions or related progressions associated with the patient’s MS. These findings led researchers to conclude that multiple IT administrations of MSC-NP’s are safe in the short-term and well-tolerated in participants with progressive MS.
Over the course of the study, all participants were strictly monitored for changes associated with clinical status. Assessment information gathered at the three and six-month post-treatment marks demonstrated that 75% of the subjects in this study demonstrated specific neurological improvement associated with this IT MSC-NP treatment when compared to established benchmarks, including neurological improvement associate with:
Expanded disability status scale (EDSS)
Timed 25-ft walk (T25FW)
MRC muscle strength scale
Bladder function
Key findings and observations contributing to this study include previous studies of experimental autoimmune encephalomyelitis (EAE) animal models of MS led to the experimental design of this study including multiple dosing of MSC-NPs (as opposed to single dosing).
When constructing this research study, researchers also determined that the intrathecal route of administration for cell delivery was important. While previous research has demonstrated administering bone marrow MSCs intravenously has proven to suppress EAE through immune response, intravenous administration has not demonstrated to cross the blood-brain barrier in amounts sufficient to directly impact and/or benefit the CNS; the IT route of administration appears to maximize the therapeutic potential to benefit the CNS and spinal cord.
This study concluded that IT therapy with MSC-NPS is safe and well-tolerated in patients with progressive MS and demonstrated a number of neurological benefits. As a result of this phase 1 trial, an initiation of FDA-approved randomized, placebo-controlled, and blinded phase II study in a larger group study to better determine efficacy in patients with progressive MS.
Receiving a diagnosis of multiple sclerosis (MS) is understandably overwhelming. Fortunately, life with MS today is far different than it once was, thanks to several new treatment methods that help patients manage symptoms effectively. If you have been newly diagnosed with MS, here’s what you can do to cope with your diagnosis and stay in control of your health.
Learn as Much as You Can
The uncertainty can be among the most difficult aspects of being newly diagnosed. The more you know about MS, the better prepared you’ll be for any changes you experience.
Multiple Sclerosis is a chronic inflammatory disease in which the immune system attacks the myelin, or protective coating around the nerve fibers throughout the spinal cord and brain. As the myelin is destroyed and replaced by scar tissue, many symptoms involving the central nervous system develop.
With that said, it’s possible to maintain a good quality of life with MS, and the condition is almost never fatal. Organizations like the National Multiple Sclerosis Society (NMSS) have many resources to help you learn more.
Pursue a Definitive Diagnosis
Due to the broad spectrum of symptoms—many of which can mimic other conditions—MS can be challenging to diagnose. Moreover, there is no single test that can definitively diagnose MS; instead, data from several tests are often needed, including an MRI, neurological assessment, and spinal tap.
A doctor must rule out any other possible conditions and find evidence of damage in two distinct areas of the central nervous system which have occurred at least a month apart for a firm diagnosis. This step is important, as it will allow you to pursue the proper channels for treatment.
Understand the Nature of MS Symptoms
MS symptoms can span far and wide and be unpredictable in nature. Your MS may not look the same as someone else’s. Common symptoms include pain or tingling, slurred speech, fatigue, dizziness, memory issues, and vision changes, among others. You may find that some symptoms are only temporary, while others last longer.
Seek Prompt Treatment
The type of treatment you pursue will depend on the severity of your symptoms and your current overall condition. With that being said, many doctors recommend starting treatment right away, as some therapies may delay the progression of the disease and reduce symptom severity.
Track Symptoms & Triggers
While symptoms can be unpredictable, tracking them is important to help your healthcare team determine whether treatments are working as they should. Newly diagnosed patients can benefit from starting a daily journal of their symptoms. You might also jot down notes about the day’s conditions, which could help to pinpoint triggers. For instance, some people find that stress, heat, and infection can lead to flare-ups or relapses.
Partner with the Right Doctor
It’s important to find the right specialist to help you treat your MS, being that it’s a lifelong condition. Your doctor should welcome any questions you have, help you understand your treatment options, and make you feel comfortable. The NMSS website offers a database of doctors who specialize in MS so you can choose one who’s local to you.
Explore Alternative Medicine
While medications are an important part of controlling the symptoms and progression of MS, you might also want to try complementary or alternative medicine. For example, some patients find relief with non-drug treatments such as supplements, acupuncture, and massage. The NMSS is also advocating for research in innovative therapies such as stem cell therapy to further alleviate symptoms and prevent disease progression, with the potential to even repair some tissue damage that has already occurred. If you are interested in learning more contact a care coordinator today for a free assessment!
While heat sensitivity in people with multiple sclerosis (MS) has been widely studied, the question of how cold weather affects patients still looms large. It was back in 1890 when optical issues (a common issue associated with MS) were linked to a rise in body temperature. More than a century later, MS patients still struggle to stay cool in the summer. As cooler weather approaches, however, the impending chill presents its own set of challenges.
Of course, winter introduces health issues even in people who aren’t affected by MS. Shorter days and increased darkness impact sleep patterns, which can ultimately lead to fatigue. Seasonal depression is also a common issue that emerges once the winter months descend.
Unfortunately, it appears that cold weather exacerbates MS symptoms. Specifically, pain, mobility challenges, fatigue, and depression seem to worsen. For one, the nerve damage caused by MS may be impacted by the winter weather, leading to spasticity and stiffness. Icy surfaces can also increase the risk of falls, making mobility challenges even more of a concern.
The “MS hug,” a feeling of pressure around the torso, becomes more pronounced for many patients in colder temperatures. Numbness and tingling may also worsen. Patients who experience Reynaud’s phenomenon, in which the blood vessels in the extremities narrow and cause discomfort, also report increased intensity in the winter.
Although there is still limited research on how cold weather impacts MS and why patients can still take certain measures to control symptoms throughout the winter months. Dressing in plenty of warm layers, eating warm foods, minimizing trips outdoors, and maintaining a moderate indoor temperature to reduce the shock when you do have to trek outside may help.
You might also consider discussing a supplement regimen with your specialist. Vitamin D levels often drop with decreased exposure to sunlight, so taking a daily vitamin could help to boost overall health and provide some relief for cold-related MS symptoms. Call a Stemedix Care Coordinator at 800-531-0831 and learn how our practitioner-grade supplements through Metagenics may help you and receive 10% off your first order!
This website and its contents are not intended to treat, cure, diagnose, or prevent any disease. Stemedix, Inc. shall not be held liable for the medical claims made by patient testimonials or videos. They are not to be viewed as a guarantee for each individual. The efficacy for some products presented have not been confirmed by the Food and Drug Administration (FDA).
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