Chronic inflammatory demyelinating polyneuropathy or CIDP is a neurologic condition in which the immune system interferes with the function of the nerves. Specifically, CIDP affects the peripheral (not central) nerves and nerve roots. Consequently, patients with CIDP have chronic weakness in their muscles. Muscle weakness usually occurs symmetrically (at the same time and degree on both the right and left sides of the body). Patients usually notice gradual problems emerging, like difficulty climbing stairs, standing up from a seated position, or walking.
Treatment for CIDP includes intravenous immune globulin (IVIG), steroids, or plasma exchange. Fortunately, about 9 out of 10 people with CIDP will respond to one or more of these treatments. However, about 10 to 15% of patients do not respond to any of the typical treatments. These patients either have partial or no recovery. Partial recovery means patients can walk but have substantially reduced strength. No recovery means that patients have severe, long-term disability.
From past work, scientists have shown that stem cell treatment is potentially helpful in treating immune-related disease. Thus, researchers are attempting to use stem cells to treat patients with severe CIDP that do not respond to standard treatments. Drs. Qin and colleagues recently reviewed the progress in the field of hematopoietic stem cell transplantation for CIDP.
The authors report several small clinical studies using stem cells to treat CIDP. Remenyi et al. showed that stem cells combined with other CIDP treatments helped a 26-year-old patient regain sensation and muscle strength, and symptoms of CIDP did not return. Mahdi-Rogers et al. demonstrated some success with stem cells in three patients with CIDP. One had complete remission and all three had at least temporary improvement in muscle function. Axelson et al. showed a bedridden person with CIDP could achieve disease remission with stem cell transplantation and another CIDP treatment. Similarly, Scheibe et al. and Barreira et al. independently reported that two patients who were paralyzed in all four limbs because of CIDP had complete relief of symptoms after stem cell treatment plus cyclophosphamide.
Of course, these extraordinary results must be considered preliminary. The review article mentions fewer than 50 CIDP patients treated with stem cells. Nonetheless, the favorable safety profile and early indications of success with stem cells are highly encouraging, especially for people with CIDP who have failed to improve after standard CIDP treatments.
Reference: Zhen Q., et al. (2020). Progress in Hematopoietic Stem Cell Transplantation for CIDP. Int J Med Sci. 2020; 17(2): 234-241.
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