The Potential of Mesenchymal Stem Cells in Parkinson’s Disease Treatment

The Potential of Mesenchymal Stem Cells in Parkinson’s Disease Treatment

Parkinson’s disease (PD) is a neurodegenerative disorder affecting millions worldwide, causing debilitating symptoms such as tremors, rigidity, and difficulty walking. Existing treatments primarily manage symptoms without addressing the underlying causes, highlighting the need for more effective therapeutic approaches. Mesenchymal stem cell (MSC) therapy has emerged as a promising option, demonstrating potential neuroprotective, anti-inflammatory, and regenerative benefits.

As part of this review, Tambe et al. examine preclinical and clinical evidence on MSCs and their derivatives, including secretomes and exosomes, in PD management. The authors also  analyze challenges and limitations of each approach, including delivery methods, timing of administration, and long-term safety considerations.

The Growing Challenge of Parkinson’s Disease

PD, along with other age-related diseases like Alzheimer’s and stroke, is becoming more prevalent due to increased life expectancy. The disease affects 2–3% of individuals over 65, and by 2040, the number of people living with PD is expected to double. In 2019, PD caused the loss of 5.8 million disability-adjusted life years (DALYs), a significant rise from 2000. 

PD symptoms include postural instability, muscle hypertonia, bradykinesia, resting tremor, and cognitive and language abnormalities, all of which negatively impact the quality of life. PD is diagnosed based on motor symptoms, but non-motor symptoms also contribute to disability. 

Parkinson’s disease primarily results from the accumulation of α-synuclein and a depletion of dopamine due to neuronal loss in the substantia nigra. It also involves disruptions in multiple pathways, including α-synuclein proteostasis, mitochondrial dysfunction, oxidative stress, and neuroinflammation.

Current Treatments for Parkinson’s Disease

While there is no cure for PD, current symptomatic treatments include levodopa, dopamine agonists, MAO-B inhibitors, COMT inhibitors, deep brain stimulation, and lesion surgery. However, these therapies are limited and do not address the underlying causes of the disease. 

Newer interventions like stem cell therapy, neurotrophic factors, and gene therapy aim to address the root causes and potentially slow or stop disease progression. 

Cell-based Therapies for Parkinson’s Disease

Cell-based therapies are gaining attention as potential treatments for PD due to their ability to slow disease progression and replace lost dopamine production. Several cell sources are being researched for their therapeutic potential, each with specific advantages and disadvantages. 

Mesenchymal stem cells (MSCs) are particularly promising due to their unique properties, including self-renewal and multi-potent differentiation potential. MSCs can differentiate into various cell types, including neuronal-like cells, and exhibit therapeutic effects through both cellular differentiation and the paracrine action of secreted growth factors.

Properties of Mesenchymal Stem Cells (MSCs)

MSCs are plastic-adherent cells capable of self-renewal and differentiation into various lineages, including neurons, adipocytes, osteoblasts, chondrocytes, and endothelial cells. This versatility makes MSCs an attractive option for treating PD. 

MSCs also have the potential to exert therapeutic effects through the secretion of factors that promote cell survival, tissue regeneration, and anti-inflammatory actions. In addition to their ability to differentiate into mesodermal lineages, MSCs can produce secretomes and exosomes, which are small vesicles containing proteins, RNA, and other molecules that have demonstrated the ability to influence surrounding cells.

Therapeutic Success of MSCs in PD Management

Preclinical studies on MSCs and their derivatives, including secretomes and exosomes, have shown promising results in PD animal models. MSCs may promote the survival of dopamine-producing neurons and protect against neurodegeneration. Their secretomes, which contain bioactive molecules, can modulate inflammation and stimulate tissue repair. Exosomes, which are extracellular vesicles derived from MSCs, have been shown to improve neuronal function and survival in PD models. These findings suggest that MSC-based therapies could offer a novel approach to managing PD, potentially slowing disease progression and improving motor and cognitive symptoms.

Alternative Delivery Methods for MSC Therapy

One of the significant challenges in MSC therapy for PD is the delivery of these cells to the brain, particularly through the blood-brain barrier (BBB), which restricts the entry of most drugs. 

Traditional delivery methods, such as intravenous, intracerebral, and intramuscular routes, have limitations in terms of efficacy and invasiveness. 

Recent research has explored intranasal delivery of MSCs and their derivatives as a promising alternative. Intranasal administration could allow MSCs and their secretomes to bypass the BBB, delivering therapeutic agents directly to the central nervous system with minimal invasiveness.

The Future of MSC Therapy for Parkinson’s Disease

MSC-released exosomes and extracellular vesicles are gaining attention as potential treatments for PD due to their improved ability to cross the BBB and target specific cells. These vesicles can transport proteins, growth factors, microRNAs, and other bioactive molecules to recipient cells, potentially enhancing the therapeutic effects of MSCs. 

Intranasal delivery of MSCs and their exosomes is an exciting area of research, offering a less invasive method for delivering therapy directly to the brain. This approach could lead to improved outcomes in PD management, especially if combined with other therapies that address the underlying causes of the disease.


Tambe et al. conclude that MSC therapy and its derivatives, such as secretomes and exosomes, hold significant promise for the treatment of Parkinson’s disease. However, challenges such as MSC heterogeneity, delivery methods, and long-term safety must be addressed before MSC-based therapies can become a mainstream treatment for PD. 

Source: Tambe P, Undale V, Sanap A, Bhonde R, Mante N. The prospective role of mesenchymal stem cells in Parkinson’s disease. Parkinsonism Relat Disord. 2024 Oct;127:107087. doi: 10.1016/j.parkreldis.2024.107087. Epub 2024 Aug 10. PMID: 39142905.

Safety and Effectiveness of Orthobiologic Injections for Chronic Low Back Pain

Safety and Effectiveness of Orthobiologic Injections for Chronic Low Back Pain

Chronic low back pain is a widespread issue, affecting over 600 million people globally. It is a leading cause of disability, with significant social and economic consequences. In the United States alone, nearly 27 million adults experience back problems, with approximately 19 million seeking treatment. Discogenic lower back pain, which originates from the intervertebral discs, is the most common cause of this condition, accounting for about 39% of cases. Current treatment methods include conservative approaches, surgical procedures, and minimally invasive interventional techniques.

In this study, Navani et al. aimed to compare the safety and effectiveness of PRP and BMC injections for treating chronic low back pain against a control group. The author’s also sought to measure patient satisfaction and monitor the need for further medical intervention, such as hospitalization, emergency room visits, or spinal surgery.

Understanding Intervertebral Disc Degeneration

The intervertebral disc (IVD) is a crucial structure within the spine that helps absorb shock and provides flexibility. It consists of a central area called the nucleus pulposus, which is surrounded by the annulus fibrosus. The disc is located between cartilaginous endplates that regulate metabolism within the IVD. The disc’s central area is characterized by low oxygen levels and a hypoxic environment, which limits the ability for natural cellular repair.

Degeneration of the intervertebral disc, known as intervertebral disc degeneration (IDD), occurs when there is an imbalance between the disc’s ability to regenerate and the breakdown of its structure. Factors such as aging, disease, or injury can speed up the degeneration process, leading to chronic low back pain. Changes in the structure of proteins and collagen within the disc play a significant role in this degeneration, leading to reduced nutrient exchange and increased acidity within the disc, which further hampers cellular repair.

The Role of Inflammation and Pain

When the intervertebral disc begins to degenerate, it creates an environment that encourages inflammation. The disc becomes populated with proinflammatory substances, such as tumor necrosis factor (TNF) and various interleukins, which hinder the disc’s ability to repair itself. These inflammatory molecules also increase the production of enzymes that break down the disc’s structure, causing further damage. Inflammation not only contributes to the physical degradation of the disc but also sensitizes nerve fibers, leading to increased pain.

New Regenerative Treatments: PRP and BMC

Recent advancements in regenerative medicine have introduced novel treatments aimed at healing the degenerated disc rather than simply managing symptoms. Two promising approaches involve using the patient’s own biological materials: platelet-rich plasma (PRP) and bone marrow concentrate (BMC).

  • Platelet-Rich Plasma (PRP): This therapy involves extracting a small amount of the patient’s blood, processing it to concentrate the platelets, and then injecting it directly into the degenerated disc. Platelets release growth factors and other bioactive substances that promote tissue healing, reduce inflammation, and encourage new tissue growth.
  • Bone Marrow Concentrate (BMC): BMC is obtained by collecting bone marrow from the patient and concentrating it to enrich stem cells and other regenerative cells. These cells have the ability to differentiate into disc-like cells and release anti-inflammatory substances. The use of BMC aims to support the repair of the disc by promoting the formation of new extracellular matrix and reducing inflammation.

Results and Findings

Navani et al.’s showed significant improvement in pain levels and functionality for patients who received PRP or BMC treatments compared to those who did not. Both PRP and BMC therapies were effective in reducing pain, improving function, and enhancing quality of life over a 12-month period. Although there was no significant difference in outcomes between PRP and BMC, both treatments outperformed the placebo. No complications or adverse effects were reported during the study, and none of the participants required surgery, emergency care, or hospitalization related to their treatment.

Limitations of the Study

The study had some limitations, including a small number of participants and variability in the concentration of cells used in the BMC treatments. The differences in harvesting techniques, participant characteristics, and clinical settings may have influenced the results. Additionally, the study’s open-label design could have introduced bias in reporting outcomes.

Factors Influencing Treatment Success

The effectiveness of PRP and BMC treatments can be influenced by several factors, such as the method used to collect bone marrow, the equipment used, and the individual characteristics of the patient, including age, gender, and overall health. Variability in the number of regenerative cells collected may impact the treatment’s ability to repair the disc.

Future Research Directions

More research is needed to determine the optimal number of cells for BMC treatments and to better understand how different biological components within PRP and BMC contribute to the healing process. Exploring multi-targeted approaches that address various structures in the spine, such as facet joints and ligaments, may also enhance treatment outcomes for chronic low back pain.

PRP and BMC for Chronic Low Back Pain

PRP and BMC represent promising regenerative treatment options for chronic low back pain. They aim to repair the damaged intervertebral disc and provide relief without the need for invasive surgical procedures. While both therapies show significant potential, the authors indicatefurther studies are needed to refine the techniques, understand the variability in treatment responses, and establish best practices for their use.


Source: Navani A, Ambach M, Calodney A, Rosenthal R, Li G, Mahoney CB, Everts PA. The Safety and Effectiveness of Orthobiologic Injections for Discogenic Chronic Low Back Pain: A Multicenter Prospective, Crossover, Randomized Controlled Trial with 12 Months Follow-up. Pain Physician. 2024 Jan;27(1):E65-E77. PMID: 38285032.

Mesenchymal Stem Cells and Spinal Cord Injury: A Promising Path to Recovery

Mesenchymal Stem Cells and Spinal Cord Injury: A Promising Path to Recovery

Spinal cord injury (SCI) is a devastating condition that causes severe nerve damage, leading to impaired movement, sensation, and bodily functions. The injury sets off a series of damaging processes, including excessive inflammation, loss of essential nutrients, and scar tissue formation. 

These factors prevent the regeneration of nerve cells, making recovery difficult. Traditional treatments provide limited improvement, but recent research by Lui et al. suggests that mesenchymal stem cells (MSCs) offer hope for patients with SCI.

How SCI Disrupts the Microenvironment 

Following SCI, the body experiences a host of negative effects. Initially, the injury causes direct damage to nerve cells, leading to inflammation and the release of harmful substances. 

The body’s attempt to repair the damage often backfires, as excessive inflammation worsens tissue destruction and inhibits nerve regeneration. Additionally, the blood-spinal cord barrier (BSCB) becomes compromised, allowing immune cells to flood the injured site. 

These immune cells produce harmful molecules like reactive oxygen species (ROS) and cytokines, further aggravating the damage. 

The prolonged inflammation creates a hostile environment that prevents new nerve growth and leads to the formation of scar tissue that blocks potential regeneration.

The Role of MSCs in Repairing the Spinal Cord 

The ability of MSCs to repair spinal cord injuries (SCI) lies in their powerful secretions of bioactive molecules, which help regulate inflammation, promote nerve cell survival, and enhance tissue repair. 

MSCs suppress harmful immune responses by decreasing the activity of pro-inflammatory cells like T-cells and macrophages while promoting anti-inflammatory pathways to minimize further nerve damage. They also release neurotrophic factors that nourish and support nerve cells, encouraging the survival and growth of new neurons to improve recovery. 

Additionally, MSCs help prevent the formation of dense glial scar tissue, which can obstruct axon regrowth, by regulating proteins like MMP-2 and BDNF that break down scar tissue and create space for new nerve connections. Furthermore, MSCs contribute to angiogenesis, promoting blood vessel growth to ensure that the injured site receives adequate nutrients and oxygen for healing.

Optimizing MSC Therapy for SCI 

To ensure MSC therapy is effective for SCI treatment, the authors call for additional research to determine the most efficient timing, dosage, and delivery method.

Timing for MSC Transplantation

Studies suggest that MSCs work best when introduced during the subacute phase (approximately two weeks after injury). This timing allows MSCs to reduce inflammation while the injury is still healing. If administered too early, the highly inflammatory environment may kill MSCs before they can have a therapeutic effect. If given too late, scar tissue may already be well established, limiting their benefits.

Optimal Dosage

According to Liu et. al, research on animals suggests that higher doses of MSCs (greater than one million cells) lead to better functional recovery. 

However, an excessively high dose might provoke an unwanted immune response. In humans, doses typically range from 10 to 100 million cells, though further research is needed to determine the optimal amount.

Optimizing MSC Delivery for Spinal Cord Repair

MSCs can be delivered in different ways. Intravenous (IV) injection is the least invasive, but many cells get trapped in organs like the lungs before reaching the spinal cord. Direct injection into the injury site is more targeted but carries risks of additional damage. Intrathecal injection (into the spinal fluid) is a promising middle ground, as it allows MSCs to circulate in the cerebrospinal fluid and reach the injury without additional trauma.

Advancing MSC Therapy for Spinal Cord Injury: Challenges and Future Prospects

Although MSC therapy holds great promise, several challenges remain before it can become a routine treatment for SCI. Researchers need to refine techniques for improving MSC survival, homing (their ability to find the injured site), and integration into the spinal cord. Scientists are also exploring genetic modifications and biomaterial scaffolds to enhance MSC effectiveness. Additionally, large-scale clinical trials are necessary to confirm safety and efficacy in human patients.

In the future, personalized MSC therapy – where treatment is tailored to each patient’s specific injury and biological factors – could revolutionize SCI treatment. 

Liu et al. conclude that ongoing advancements in stem cell research, MSC transplantation has the potential to improve the quality of life for SCI patients by restoring lost function and promoting recovery in ways that were once thought impossible.

Source: Liu, Y., Zhao, C., Zhang, R. et al. Progression of mesenchymal stem cell regulation on imbalanced microenvironment after spinal cord injury. Stem Cell Res Ther 15, 343 (2024). https://doi.org/10.1186/s13287-024-03914-x

Exploring the Promise of Neural Stem Cells in Treating Neurological Diseases

Exploring the Promise of Neural Stem Cells in Treating Neurological Diseases

Neurological diseases such as Parkinson’s disease, Alzheimer’s disease, Huntington’s disease, and ALS (amyotrophic lateral sclerosis) affect millions of people around the world. These conditions often develop slowly and progressively damage the brain and spinal cord, leading to symptoms such as memory loss, difficulty moving, problems with speech, and the inability to perform daily tasks. While current treatments can help manage symptoms and slow progression, they don’t repair the underlying damage to nerve cells.

Neural stem cell therapy is a new approach that may change this. By tapping into the body’s natural ability to grow and repair nerve tissue, researchers hope to develop treatments that can do more than ease symptoms – they may one day restore function and improve quality of life for those living with neurological diseases.

As part of this review, Yang et al. discuss the application and value of NSCs in neurological diseases as well as the existing problems and challenges.

Defining Neural Stem Cells

Neural stem cells, or NSCs, are special types of cells that exist in the brain and spinal cord. They are able to make more of themselves and can also develop into different types of brain cells. These include neurons, which carry signals in the brain; astrocytes, which provide support and nutrients to neurons; and oligodendrocytes, which help protect nerve fibers by forming a coating around them.

In early development, NSCs help build the brain and nervous system. In adults, small numbers of NSCs remain in certain parts of the brain, where they play a limited role in maintaining brain health. However, their natural healing abilities are not enough to repair the kind of widespread damage seen in conditions like Parkinson’s or ALS. 

According to the authors, scientists are now learning how to grow these cells in the lab and use them in therapy to help the body heal from neurological disease.

Barriers to Natural Nerve Repair

Unlike other parts of the body, the brain and spinal cord do not heal easily after injury or disease. When neurons die, they are not naturally replaced. This is a major reason why neurological diseases are so difficult to treat. For example, in Parkinson’s disease, dopamine-producing neurons in the brain die off, leading to tremors and difficulty with movement. In ALS, the motor neurons that control muscle movement degenerate, eventually affecting a person’s ability to walk, speak, and breathe.

Most treatments available today focus on easing symptoms or slowing down how quickly the disease progresses, but they are unable to fix the problem at its source. Neural stem cell therapy aims to do just that – repair or replace damaged nerve cells, restore connections, and support the brain’s ability to function normally again.

Mechanisms of Neural Stem Cell-Mediated Healing

Neural stem cells do more than simply turn into new neurons. Research has shown that they can protect existing nerve cells from further damage and promote the growth of axons, which are the long fibers that send messages from one neuron to another. In diseases where nerve fibers lose their protective coating, NSCs may also help rebuild that layer and improve communication between cells.

In addition, these cells release helpful molecules that support brain health, such as brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF). These substances help nourish nerve cells and keep them alive longer. NSCs also seem to help reduce inflammation, which is a common feature in many neurological conditions and can make symptoms worse. By calming the immune system and supporting blood vessel growth, NSCs are able to create a healthier environment for the brain and spinal cord to recover.

Tailoring Therapy to Specific Diseases

Each neurological disease affects a specific set of brain or nerve cells. In Parkinson’s disease, it’s the dopamine-producing neurons in a region of the brain called the substantia nigra. In Alzheimer’s disease, neurons are lost across many parts of the brain, affecting memory and thinking. Huntington’s disease causes damage in the parts of the brain that control movement and emotions. ALS destroys the motor neurons that control voluntary muscles.

Because these diseases target particular cell types, Yang et al. believe neural stem cell therapy offers a tailored approach to treating these diseases. By delivering NSCs directly to affected areas, researchers hope to replace the cells that have been lost, support the survival of remaining neurons, and help rebuild the pathways the brain needs to function. This is different from current treatments, which manage symptoms without addressing the actual damage in the brain or spinal cord.

Findings from Clinical Research

While this field is still developing, the authors point to early clinical trials that have already tested neural stem cell therapy in patients with ALS and Parkinson’s disease. In one study involving 12 ALS patients, stem cells were injected into the spinal cord. The procedure was found to be safe, and some patients experienced a slower progression of their symptoms over the next two and a half years.

Another small study combined NSC therapy with a vaccine aimed at boosting the immune system. In this study, patients with ALS lived longer and showed improvements in function for at least a year. Yet another group of ALS patients received stem cells derived from fetal tissue, and most of them remained stable with no serious side effects for 18 months. A larger follow-up study involving 18 ALS patients also confirmed the safety of the treatment over a five-year period.

For Parkinson’s disease, a recent study transplanted NSCs into the brains of eight patients. Most participants reported better movement and coordination in the months and years that followed. Brain scans also showed signs of increased dopamine activity, which is usually low in people with Parkinson’s. 

Although the studies are small, the authors indicate that they suggest that NSC therapy is well tolerated and has the potential to improve quality of life for patients with serious neurological conditions.

Future Outlook for Neural Stem Cell Therapy

Neural stem cell therapy has the potential to change how neurological diseases are treated. Instead of simply managing symptoms, this novel approach aims to repair and rebuild the nervous system. While the science is still evolving, Yang et al. point to early studies in patients with ALS and Parkinson’s disease as evidence that NSC therapy is safe and may lead to real improvements in function and quality of life.

Source: Yang L, Liu SC, Liu YY, Zhu FQ, Xiong MJ, Hu DX, Zhang WJ. Therapeutic role of neural stem cells in neurological diseases. Front Bioeng Biotechnol. 2024 Mar 7;12:1329712. doi: 10.3389/fbioe.2024.1329712. PMID: 38515621; PMCID: PMC10955145.

Advancements in Mesenchymal Stem Cell Applications for Traumatic Spinal Cord Injury: A Systematic Clinical Review

Advancements in Mesenchymal Stem Cell Applications for Traumatic Spinal Cord Injury: A Systematic Clinical Review

Spinal cord injury (SCI) can lead to lasting health challenges, impacting motor, sensory, and autonomic functions. Recovery from such injuries is particularly difficult due to the central nervous system’s limited ability to repair itself. As a result, scientists have turned to stem cell therapies, particularly mesenchymal stem cells (MSCs), as a potential solution to help treat traumatic spinal cord injuries (TSCI). 

In this review, Montoto-Meijide et al. explore the role of stem cell therapy in TSCI treatment, the safety and efficacy of MSCs, and the ongoing research aimed at improving these therapies.

Spinal Cord Injury and the Need for Effective Treatments

A spinal cord injury results from trauma that damages the spinal cord, leading to various degrees of paralysis and loss of sensory functions. Recovery is limited because the central nervous system does not regenerate easily, meaning that cells, myelin (which insulates nerve fibers), and neural connections are difficult to restore. Traditional treatments focus on alleviating symptoms and preventing further injury, but they do not offer a cure or promote regeneration. As a result, researchers are exploring stem cell therapies, which have shown potential in regenerating damaged tissues and promoting recovery.

An Overview of Mesenchymal Stem Cells (MSCs)

Stem cells are unique in that they can self-renew and differentiate into different types of cells. MSCs are a type of adult stem cell that can develop into various cell types, including bone, cartilage, muscle, and fat cells. MSCs are particularly promising in SCI treatment because of their ability to regenerate tissues and support healing. These cells have shown anti-inflammatory, anti-apoptotic (preventing cell death), and angiogenic (promoting new blood vessel growth) properties, all of which could aid in the healing of spinal cord injuries.

There are different types of stem cells, including embryonic and adult stem cells. Each source has its advantages and drawbacks. Bone marrow MSCs are the most commonly used in research and clinical trials, but adipose tissue and umbilical cord MSCs are gaining attention due to their availability and regenerative capabilities.

The Role of MSCs in Treating Spinal Cord Injuries

MSCs offer several benefits when applied to SCI treatment. They can promote tissue repair, reduce inflammation, and enhance the formation of new blood vessels. When introduced into an injured spinal cord, MSCs have been shown to:

  • Promote axonal (nerve fiber) regeneration
  • Reduce inflammation around the injury site
  • Support the survival of nerve cells
  • Enhance the formation of new blood vessels, aiding in tissue repair

These capabilities make MSCs an exciting avenue for research into TSCI treatment. Clinical trials and studies have shown that MSCs can lead to improvements in motor and sensory functions, although the extent of these improvements varies.

Clinical Evidence and Findings

A systematic review of clinical studies involving MSCs for TSCI was conducted, analyzing data from 22 studies, including 21 clinical trials. According to the authors, these findings suggest that MSC-based therapies can lead to improvements in sensory and motor functions, although these effects are often more pronounced in sensory functions than motor functions. Improvements in patients’ ASIA (American Spinal Injury Association) impairment scale grades have been reported, indicating positive outcomes for many individuals.

The safety of MSC therapies was also a key focus of these studies. Overall, MSC-based treatments were found to have a good safety profile, with no significant adverse effects such as death or tumor formation reported in clinical trials. Some studies did report mild side effects, such as temporary inflammation or mild discomfort, but these were generally short-lived and not severe.

The Future of MSC Therapy and Other Potential Treatments

MSC therapy represents one of the most promising areas of research for TSCI, but it is not the only potential treatment. Other therapies, including gene therapies, neurostimulation techniques, and tissue engineering approaches, are also being explored to address the challenges of spinal cord injury. The authors believe these approaches could complement MSC therapies or offer new avenues for healing and recovery.

For MSC therapy to become a standard treatment for TSCI, additional research is needed. Clinical trials with larger patient groups, longer follow-up periods, and standardized protocols will be necessary to better understand how MSCs can be used most effectively in treating spinal cord injuries. Additionally, researchers are exploring the best stem cell sources, optimal timing for treatment, and the ideal dosage to maximize benefits.

A Promising Future for Spinal Cord Injury Treatment

While spinal cord injuries are currently devastating and challenging to treat, stem cell therapy, particularly with MSCs, offers a hopeful future. Early studies suggest that MSCs can help promote tissue repair, reduce inflammation, and improve motor and sensory functions, although further research is needed to confirm these findings and explore long-term effects. The scientific community continues to make strides in understanding how MSCs and other therapies can help people with TSCI recover and regain functionality, offering hope for the future.

Source: Montoto-Meijide R, Meijide-Faílde R, Díaz-Prado SM, Montoto-Marqués A. Mesenchymal Stem Cell Therapy in Traumatic Spinal Cord Injury: A Systematic Review. Int J Mol Sci. 2023 Jul 20;24(14):11719. doi: 10.3390/ijms241411719. PMID: 37511478; PMCID: PMC10380897.

Links Between Sex Hormone Ratios and Metabolic Syndrome and Inflammation in U.S. Adult Men and Women

Links Between Sex Hormone Ratios and Metabolic Syndrome and Inflammation in U.S. Adult Men and Women

Metabolic syndrome (MS) is a group of conditions that occur together, raising the risk for cardiovascular disease (CVD) in men and women and is associated with a number of diseases including sleep apnea, liver disease, polycystic ovary syndrome (PCOS), and hormone-sensitive cancers. 

The prevalence of metabolic syndrome varies by region and population, but it is estimated to affect around 20-25% of the global adult population. Currently, it’s estimated that approximately 1 billion people worldwide may have metabolic syndrome. 

Additionally, sex hormones play a critical role in sex differences and cardiovascular disease risk associated with MS.  However, the relationship between sex hormone rations and metabolic and inflammatory markers are unclear according to sex and age differences.  

As part of this study, Dubey et al. evaluated the associations of sex hormone ratios with MS and inflammation among males and females. 

Currently CVD accounts for 33%-40% of all mortality in the United States and European Union. Men are more likely to be at risk for CVD than women, however the risk of women developing CVD increases drastically after menopause.   

According to the authors, this study found that the Free Estradiol Index (FEI) is a more reliable indicator of metabolic syndrome (MS) and high C-reactive protein (CRP) levels than other hormone indexes in men across all age groups. For women over the age of 50, FEI is also strongly associated with these conditions. However, in women under 50, the Free Androgen Index (FAI) is more closely linked to MS and high CRP levels. 

Based on these findings, Dubey et al. recommend that doctors regularly check these hormone ratios to identify individuals at risk for cardiovascular disease (CVD) and to manage MS and inflammation early.

In men, FEI emerged as the strongest predictor of MS and high CRP levels, regardless of age. This finding aligned with the limited existing research primarily focusing on older men.  The authors point out that this study is among the first to demonstrate this association in younger men. For women aged 50 and older, a high FEI was consistently linked to adverse metabolic and inflammatory profiles. Emerging studies continue to support these findings and suggest that managing FEI levels could help reduce the risk of MS and related inflammatory conditions in older women.

For younger women under 50, FAI was identified as the most critical factor associated with MS and high CRP. The study’s findings in this area supports other research indicating that higher androgen levels are a common feature in women with MS before menopause. 

In both men and women, low levels of Sex Hormone-Binding Globulin (SHBG) were linked to higher rates of MS and CRP, indicating that SHBG is an important marker of metabolic health across all ages and sexes.

The results of this study suggest that regular evaluation of sex hormone ratios, particularly FEI and FAI, is crucial for assessing and managing the risk of MS and inflammation. The authors point out that this approach could help doctors identify individuals at risk for CVD and develop early intervention strategies. However, it is important to note that Dubey et al’s study design does not allow for the establishment of a cause-and-effect relationship. Additionally, hormone levels were measured only once, which may not accurately reflect long-term exposure.

The authors conclude the findings of this study highlight the importance of monitoring sex hormone ratios to better understand and manage metabolic and inflammatory conditions. The authors also call for additional research, especially long-term studies, to confirm these findings and to further explore the role of these hormone ratios in different age groups and sexes.

Source: Dubey P, Singh V, Venishetty N, Trivedi M, Reddy SY, Lakshmanaswamy R, Dwivedi AK. Associations of sex hormone ratios with metabolic syndrome and inflammation in US adult men and women. Front Endocrinol (Lausanne). 2024 Apr 10;15:1384603. doi: 10.3389/fendo.2024.1384603. PMID: 38660513; PMCID: PMC11039964.

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