Multiple sclerosis (MS) has widespread effects on the body. The disease is characterized by a breakdown of the protective cover surrounding the nerves, called the myelin sheath. When the myelin sheath is compromised, it makes it more difficult for the brain to communicate critical messages to the rest of the body. Unfortunately, the ways in which MS affects the body are rarely isolated: when nerve cells are damaged as a result of myelin sheath damage, it leads to a disconnection between the brain and the organs, muscles, and tissues.
Muscle Weakness & Pain
Muscle weakness can impede daily life, and for some, it turns even basic tasks into obstacles. Weakness is often reported by MS patients in the limbs, which can make it difficult to walk, shower, and get dressed. It’s also the culprit behind foot drop, in which the front part of the foot cannot be lifted. This causes individuals to adjust their gait, such as swing their leg outward.
Beyond weakness, MS also often produces muscular pain. Many people with MS experience a sensation of “pins and needles,” sharp pain, tingling, or aches. Involuntary muscle spasms are also common and are experienced primarily in the legs.
Treatment Options
While options such as nerve-blocking agents, muscle relaxants, and pain relievers may be prescribed to treat severe muscle spasms or pain, many patients choose to explore non-drug alternatives first. Working with an occupational therapist, for example, can aid people with muscle pain or weakness in developing different approaches for completing daily tasks and conserving energy. Physical therapists, too, can provide targeted exercises to strengthen key muscle groups, which could help to combat muscle weakness or pain. Lastly, lifestyle adjustments such as improved sleep habits, rest breaks, and assistive devices could help you navigate the muscular challenges presented by MS. Stem cell therapy may also be an alternative option those with MS may consider to potentially help in managing some of the symptoms associated with MS.
Bone generally develops via one of two distinct mechanisms: intramembranous ossification and endochondral ossification. In the former case, mesenchymal progenitor cells directly differentiate into osteoblasts that form bone. In the latter case, the mesenchymal progenitor cells first create a matrix of cartilage that then acts as a template to enable the remodeling or development of bone tissue. This process of endochondral ossification is the predominant way that bone is generating during the healing process after bones are broken and fractures are endured. Using stem cells to facilitate this process can, therefore, be beneficial in non-healing bone fractures.
A new study published in Acta Biomaterialia has proposed that adipose tissue can be used in bone generation as a scaffold on which adipose mesenchymal stem cells can expand and allow for endochondral ossification. The researchers showed how adipose tissue could be used in this way, through what they termed Adiscaf, to successfully generate cartilage tissue and eventually bone tissue formation. The bone tissue that formed through this process contained bone marrow elements, further demonstrating the bone’s integrity and the promise of this procedure.
Compared to other strategies for building scaffolding, this strategy appeared successful because by using adipose tissue, the adipose stem cells were exposed to their native environment and therefore likely maintained functions they otherwise may not have. Not only will these findings help to solidify our understanding of how to nurture stem cells and enable them to differentiate in ways that can be therapeutically applicable, but they also specifically show how adipose tissue may be able to be used to generate a bone organ through endochondral ossification. Future research will likely help to clarify how these findings can be applied to patients to improve bone healing.
Evidence has been accumulating for years showing how stem cells can serve therapeutic functions. Much of this research focuses on how stem cells can be applied to damaged tissue to help regenerate the area. Because stem cells can differentiate into a wide variety of cell types, they can be widely utilized to repair distinct types of tissue. However, a recent paper published in the World Journal of Stem Cells has described how stem cells can also be used to carry therapeutic agents to tissues and organs to help with regeneration.
Stem cells are good candidates for delivering genes, proteins, and small molecules to areas of interest because they have an innate ability to migrate to sites of injury. One challenge for using stem cells for this type of therapeutic delivery is how to load the stem cells with the therapeutic agents. There are pros and cons for the techniques that have been investigated.
Polymeric nanoparticles, are FDA approved and are versatile, uploaded efficiently, and biocompatible. However, it is hard to control the release of the therapeutic agent from the stem cells. Magnetic nanoparticles are not associated with high levels of toxicity and are efficient with loading. However, they can induce oxidative stress in carrier cells.
Silica nanoparticles have quick uptake, are non-toxic, stay within cells for a long time, and are versatile. However, their tendency to stay within cells for a long time can sometimes be a disadvantage when the agent needs to be cleared.
Liposomal nanoparticles are relatively easy to manufacture and are versatile in their therapeutic agent delivery. However, these nanoparticles are less efficient at uptake and need higher concentrations of the therapeutic agent loaded, which can be toxic to cells.
Once stem cells are loaded with bioactive molecules, there are a few ways that they can be guided toward target organs. For instance, they can be systemically infused so that they can migrate to their target areas trough blood flow.
Further research will help to clarify how well stem cells can be used to help deliver therapeutic agents to damaged or impaired tissue. Investigation into the different nanoparticles, stem cells, and potential therapeutic applications will help us better understand the extent to which stem cells can be used in regenerative medicine.
Spinal cord injury is the second leading cause of paralysis in the United States. When the spinal cord is severely injured, nerve cells in the spinal cord are damaged or destroyed. Also, a sort of scar forms in the affected area, which prevents nerve signals from traveling between the brain and the extremities. Consequently, people who sustain spinal cord injuries suffer from paralysis. The degree of paralysis depends on the location of the spinal cord injury; injuries higher on the spinal cord such as the neck or upper back area can lead to paralysis of all four limbs, for example. In almost all cases, the paralysis is permanent once it occurs, because nerve cells in the spinal cord do not regenerate.
Because spinal cord injuries are common and the consequences are usually permanent, researchers have been aggressively and tirelessly researching ways to treat this condition. One approach is to try to form new nerve cells in the spinal cord using stem cells. Mesenchymal stem cells can become new nerve cells given the right set of circumstances. Unfortunately, simply injecting mesenchymal stem cells into patients with severe spinal cord injuries cannot reverse paralysis. On the other hand, using exosomes from mesenchymal stem cells may be the push that stem cells need to become nerve cells in the spinal cord.
Exosomes are tiny packets of cellular material released by stem cells. They contain a variety of potentially beneficial substances; perhaps the most important in cell regeneration is micro RNA (miRNA). miRNA can cause complex changes in cells that simple drugs, proteins, or even regular RNA cannot. Researchers cannot easily deliver miRNA to where it is needed in the body, but exosomes taken from stem cells can deliver miRNA right where it needs to be.
Researchers collected human mesenchymal stem cells and placed them in an environment that would cause them to become nerve cells. But instead of simply using the stem cells directly, they instead collected the exosomes from those stem cells. Those exosomes could then be used to prompt mesenchymal stem cells to become nerve cells. Simply put, the exosomes drove the process more efficiently than the stem cells alone.
What does this all mean? Exosomes taken from the mesenchymal stem cells could eventually be used to treat spinal cord injury. Those special exosomes would magnify the nerve cell-creating effect, perhaps restoring nerve cell function to a damaged spinal cord. Considerable research needs to be done before this possibility becomes a clinical reality, but this knowledge helps researchers design targeted experiments in the future.
A couple of weeks ago, scientists published findings showing that implanting human stem cells that are embedded within the engineered tissue can lead to the recovery of sensory perception in rats. The recovery of sensory perception is also accompanied by healing within the spinal cord and the ability to walk independently. The stem cells used in this experiment were collected from the membrane lining the mouth.
These results help demonstrate the potential for stem cells to help with spinal cord injuries but also point to the utility of combining stem cells with other factors to enhance their therapeutic effects. In this case, the researchers used a 3-dimensional scaffold to enable stem cells to attach and to stabilize them in the spinal cord. By adding growth factors, such as human thrombin and fibrinogen to the engineered tissue scaffolding, the researchers also increased the chances that attached stem cells would grow and differentiate.
The researchers compared the effects of their stem cell implants in paraplegic rats with the effects of adding no stem cells. Whereas the control rats who did not receive stem cells did not experience any improvement in mobility or sensation, 42% of the rats that did receive stem cells became better at supporting their weight on their hind limbs and at walking.
While these results are pre-clinical and do not apply directly to humans, the researchers conclude that further research is warranted. Given the positive impact of stem cells on the spinal cord in animals, it is reasonable to assume that stem cells may also benefit the human spinal cord. Further research will help clarify whether these stem cells can be adequately used to help treat patients with paraplegia.
Wharton’s jelly is a rather unique body fluid. It is the connective tissue found within the umbilical cord. While Wharton’s jelly is connective tissue, it more closely resembles gelatin. Historically this material was discarded as medical waste; however, Wharton’s jelly has been shown to contain a number of therapeutic substances. Among these healing substances found within Wharton’s jelly is an abundant supply of mesenchymal stem cells.
One of the most intriguing features of Wharton’s jelly is that it contains a virtually limitless supply of mesenchymal stem cells. There are about 4 million new births in the United States each year, 5 million in the European Union, and over 100 million worldwide. The potential pool of cells is staggering when you consider only a small amount of Wharton’s jelly can contain millions of stem cells. Notably, Wharton’s jelly is usually discarded after the delivery of a healthy baby. If this material could be donated instead of discarded, researchers believe they have found an abundant, renewable resource from which to draw mesenchymal stem cells.
However, the abundance of Wharton’s jelly is not the most impressive feature of the substance. The stem cells found in Wharton’s jelly are rather unique. Perhaps most importantly, the cells are immuno-privileged. This means they are not readily recognized by the immune system. Consequently, the stem cells can be taken from the umbilical cord, purified, and then injected into a patient with little risk of the patient having an immune reaction to the cells. These particular mesenchymal stem cells are also interesting because they are relatively “primitive,” which means they have some of the same properties of embryonic stem cells. However, Wharton’s jelly can be obtained without controversy, while harvesting embryonic stem cells from aborted tissue remain highly controversial.
Stem cells taken from Wharton’s jelly are already being used in some clinical studies. For example, researchers in one clinical study injected type 2 diabetes patients with Wharton’s jelly-derived mesenchymal stem cells. Within six months of treatment, 7 of 22 patients became insulin-free and 5 were able to reduce the amount of insulin they needed by more than 50%. Only one patient out of the 22 did not respond to the stem cells at all. The cells have also been tested in systemic lupus erythematosus, better known as simply lupus. Forty patients received Wharton’s jelly mesenchymal stem cells intravenously. Thirteen patients enjoyed a major clinical response while 11 enjoyed a partial clinical response of their lupus symptoms.
As more clinical studies are done on Wharton’s jelly-derived mesenchymal stem cells, we will learn what other diseases can be treated with this once-discarded substance. Early indications show a very promising future.
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