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Mesenchymal Stem Cells in Multiple Sclerosis: Recent Evidence from Preclinical to Clinical Studies

by admin | May 6, 2022 | Mesenchymal Stem Cells, Multiple Sclerosis, Stem Cell Research, Stem Cell Therapy

Multiple sclerosis (MS) is a chronic inflammatory disease that attacks myelin, the protective sheath that covers nerves and causes progressive and serious communication issues between the brain, central nervous system, and the rest of the body^[1].

Currently, it’s estimated that over 2.3 million people worldwide, and over one million people in the US have a diagnosis of MS^[2].

While there have been significant improvements in treatments designed to stabilize, delay, and even improve symptoms of MS, new and more effective treatments are needed to improve the long-term outcome associated with the condition.

One area currently being investigated as a potential therapeutic option for treating MS is the use of regenerative medicine, also known as stem cell therapy, and specifically treatment using mesenchymal stem cells (MSCs).

In this review of evidence from preclinical and clinical studies, Gugliandolo et al. examine studies involving the use of MSCs or their derivatives in vivo models of MS and patients affected by MS. The authors also examine and discuss the feasibility of autologous MSCs therapy for MS patients.

Specifically, and when assessed in terms of effectiveness when treating MS, the therapeutic potential of MSCs was associated with their differentiation capacity and paracrine effects, their ability to differentiate toward oligodendrocytes and express oligodendrocyte progenitor cell (OPC) markers, and their capacity for homing (moving towards the damaged area following chemical gradients).

As part of this review, the authors also examined the effectiveness of various sources of MSC in MS models, these sources included bone marrow MSCs (BM-MSCs), adipose tissue-derived MSCs (AD-MSCs), periodontal ligament stem cells (PDLSCs), skin-derived MSCs (S-MSCs), Wharton’s jelly-derived MSCs (WJ-MSCs), human umbilical cord MSCs (UCMSC), human amnion mesenchymal cells (AMCs), placental derived MSCs (PMSCs), and decidua derived MSCs (DMSCs). According to the research reviewed by Gugliandolo et al., all MSCs, regardless of where they were harvested from, demonstrated beneficial effects in the therapeutic treatment of MS.

Specifically, the results demonstrated that MSCs were able to produce some form of protective effects in reducing inflammatory cell infiltration, disease score, demyelination, and blood-brain barrier disruption.

A review of 29 phase 1 or 2 clinical trials registered on clinicaltrials.gov demonstrated that MSCs, regardless of the type and method of administration, demonstrated to be safe and absent of severe adverse effects with the majority demonstrating measurable improvements when used in MS patients.

While clinical trials demonstrated the safety of administration of MSC in MS patients, the authors were particularly interested in learning if autologous MSC transplantation presented some advantages over heterologous administration.

The authors of this review found that samples obtained from healthy controls and MS patients showed similar features, indicating the possibility of autologous stem cell therapy in MS patients. However, other studies found that MSCs obtained from MS patients exhibited a different transcriptional pattern and fewer immunosuppressive functions compared to healthy donor MSCs.

Gugliandolo et al. point out that limits to these experimental studies include the use of animals of a single gender, given that sex-dependent differences exist and the use of different MS models, different number of transplanted cells, different MSCs sources, and routes of administration. These limitations make it difficult to define the optimal treatment in terms of cell type, dose, and administration conditions.

The authors conclude that clinical trials demonstrate the safety and feasibility of MSCs treatment, and also some improvements, but more data on larger cohorts are required to establish their efficacy. Considering the controversial results pertaining to the features of MSCs derived from MS patients, the authors also call for additional research in order to conclusively determine the safety and efficacy of autologous MSCs therapy in MS patients.

Source: “Mesenchymal Stem Cells in Multiple Sclerosis – NCBI.” 17 Nov. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698327/.

^[1] “Multiple sclerosis – Symptoms and causes – Mayo Clinic.” 7 Jan. 2022, https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269.

^[2] “Understanding MS | National Multiple Sclerosis Society.” https://www.nationalmssociety.org/What-is-MS/MS-FAQ-s.

Multiple Sclerosis Stretching and Balancing Exercises

by admin | Mar 16, 2022 | Health Awareness, Multiple Sclerosis

What if there was one simple thing Multiple Sclerosis (MS) patients could do every day to increase energy levels, reduce fatigue, and help prevent the chance of injury from falls?

Great news—there are simple exercises you can do at home without expensive gym memberships or special equipment. Try these stretching, strengthening, and balance moves to help improve your overall wellness.

Marching in Place for Balance

Stand with your feet about hip-width apart. Contract your abdominal muscles, and slowly bring one knee off the floor in a marching position. Lift the thigh parallel to the floor if you can.

Pause for a count of three, and slowly lower the leg. Repeat on the other side. Continue for five repetitions, working your way up to 10–15 repetitions.

Wall Push-Ups for Stretching and Upper-Body Strength

Stand or sit facing a wall, approximately two feet away, with your feet together. Place both palms flat on the wall with arms straight at shoulder height, slightly wider than shoulder-width apart.

Lean in, keeping elbows tucked to your sides. Bring your nose close to the wall, and feel the gentle stretching in your calves and chest. Hold for one breath, checking to make sure your back is straight.

Slowly return to the starting position. Repeat three times, building to as many repetitions as you can.

Single-Leg Pose for Balance

Do this exercise while holding onto a chair or table for stability, especially if you have problems with balance or are receiving treatment for a neurodegenerative condition.

Stand with your feet shoulder-width apart. Lift your arms parallel to the floor, keeping one hand on a stable surface. Straighten one leg in front of you with your heel a few inches off the floor.

Hold and balance for up to 30 seconds. Lower your foot back to the ground. Repeat on both legs for three repetitions.

Over Head Press for Upper-Body Strength

Use lightweight dumbbells for this exercise. If you don’t have weights, try using soup cans or full water bottles.

Holding your weights, stand (or sit) with a straight posture, arms out to your sides, and bent upward with your hands at ear height. Stretch your arms up, keeping your back straight and lifting the dumbbells over your head. Your biceps should be close to your ears. Return to the starting position. Repeat ten times.

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What Natural Treatments Are Available for Multiple Sclerosis?

by Matson Huff | Dec 6, 2021 | Health Awareness, Multiple Sclerosis

MS, or multiple sclerosis, is a chronic condition characterized by the immune system attacking the body’s myelin. Myelin is the substance that coats the body’s nerves, so patients with MS often face issues with their nervous system’s ability to communicate. Patients may experience pain, movement issues, or trouble thinking clearly. There are plenty of medical treatment options available, but these options can be costly, inconvenient, or cause troubling side effects. Patients who are wondering what natural treatments are available for Multiple Sclerosis, may have difficulty finding viable information. With this in mind, here are two adaptable natural treatment methods that may show some positive results when incorporated into a comprehensive treatment plan for MS.

Diet

The evidence to support dietary changes is shaky at best. There is no evidence to show that one specific or specialized diet can treat MS symptoms. With that being said, however, there is plenty of scientific data showing that in theory, MS patients adhering to a generally healthy diet may face fewer symptoms.

MS patients can potentially experience some relief by adding these kinds of foods to their diets:

Omega-3 fatty acids, which are found in fish like salmon and mackerel, as well as some nuts and seeds
Fruits
Vegetables
Whole grains

Patients are advised to cut down on or eliminate high-fat dairy, salt, and saturated fats wherever they can.

Dietary Supplements

Dietary supplements are distinct from herbal supplements, as dietary supplements are meant to replace or bolster naturally-occurring vitamins and minerals needed for regular body function.

Though dietary supplements should not be seen as a cure or treatment for MS, certain vitamin deficits can increase the severity of MS symptoms and flare-ups.

Here are a few dietary supplements that may help to mitigate MS symptoms:

Vitamin D
Antioxidant vitamins (vitamins A, C, and E may potentially slow inflammation)
Calcium

While calcium is not directly related to MS symptoms, it can reduce the risks of osteoporosis, which some MS patients are at a high risk of developing.

Are Natural Treatments Enough?

MS is a complex condition that may require more conventional treatment intervention if the condition is progressing or to help manage symptoms. The options presented here are the easiest and most accessible for MS patients to undertake on their own.

Many patients are also discovering an alternative option through stem cell therapy to additionally help manage the condition. Stem cells have regenerative and anti-inflammatory properties to help damaged tissues and boost the body’s natural healing mechanism.

If you or your loved ones are interested in adopting natural treatments into your MS treatment plan, it is helpful to research and consult if these are viable options to consider. If you are interested in learning more about what natural treatments are available for Multiple Sclerosis, contact a care coordinator today!

Examining the Beneficial Effects of Autologous Mesenchymal Stem Cell Transplantation in Active Progressive Multiple Sclerosis

by admin | Jul 30, 2021 | Multiple Sclerosis, Stem Cell Research, Stem Cell Therapy

Typically understood to support hematopoiesis and to produce the cells of the mesodermal lineage, mesenchymal stem cells (MSCs) found in bone marrow, fat, and other tissues of the body, have recently been found to contain additional properties that include immunomodulator and neurotrophic effects.

Considering earlier studies that have demonstrated favorable effects of MSC treatments in a variety of conditions – including stroke, multiple sclerosis, multi-system atrophy, and amyotrophic lateral sclerosis, Petrou et al. performed this double-blind study as a way to evaluate the best way of administration and the safety and clinical efficacy of MSC transplantation – specifically in patients with active and progressive multiple sclerosis.

The response of the 48 patients with progressive multiple sclerosis and with displaying evidence of either clinical worsening or activity during the previous year in this study were evaluated after being treated intrathecally (IT) or intravenously (IV) with autologous MSCs or with sham injections. Having identified a critical and unmet need for treatment, the goal of Petrou et al.’s study was to examine the therapeutic efficacy of MSC transplantation in this specific population.

Over the course of this controlled clinical trial, participants were randomly assigned to three treatment groups and treated (either intrathecally or intravenously) with autologous MSCs or with sham injections. At the 6-month mark, the authors of this study retreated half of the patients in both the MSC-IT and MSC-IV groups with MSCs, while the remaining participants were treated with sham injections. The same process occurred with patients initially treated with sham injections; meaning that at the 6-month mark, half were either treated with MSC-IT or MSC-IV.

Prior to the start of this study, Petrou et al. established a number of primary and secondary endpoints. Predetermined primary endpoints of this study included: the safety of the MSC-IV and MSC-IT treatments and the difference among the three groups in relation to performance on the Expanded Disability Status Scale (EDSS) at 6- and 12-month intervals. Predetermined secondary endpoints included the difference between the sham-treated and MSC-IT or MSC-IV treated group in the number of relapses and the relapse rate, the number of MRI gadolinium-enhancing lesions, the annualized rate of change in the T2 lesion load on MRI, percent brain volume change, performance on a series of physical and cognitive functions, and the retinal nerve fiber layer thickness.

At the conclusion of this 14-month trial, the authors reported that the study demonstrated positive results in all predetermined primary endpoints. More specifically, throughout the course of this study, the authors discovered that significantly fewer patients experienced treatment failure in the MSC0IT and MSC-IV groups compared with those in the sham-treated group. Additionally, over the course of the following year, nearly 59% and 41% of patients treated with MSC-IT and MSC-IV exhibited no evidence of multiple sclerosis activity; this is compared with less than 10% of patients in the sham-treated group.

Significant improvements of those receiving MSC-IT treatment (compared to sham treatment) were also observed in the following: ambulation index, the sum of functional scores, 25-foot timed walk test, 9-hole peg tests, PASAT and OWAT/KAVE cognitive tests, and newer biomarkers, including retinal nerve fiber layer and motor network. The authors also report beneficial, but less significant effects were observed in the MSC-IV groups.

Although the authors report a number of limitations associated with this study, including a small number of patients in each group, the short duration of the study, and the crossover design of the study (which could have resulted in a “carry-over” effect from the first cycle of treatment), they also conclude that the clinically significant findings observed in patients with progressive multiple sclerosis who were previously unresponsive to traditional or conventional therapies provide clear evidence of short-term efficacy and possible indications of neuroprotection induced by administration of autologous MSCs in patients with progressive multiple sclerosis.

In addition, the authors found that intrathecal administration of MSCs appears more beneficial than intravenous, as well as the potential benefits provided by receiving repeated injections of MSCs.

As such, Petrou et al. conclude by calling for a larger phase III study to confirm these findings and as a way to further evaluate the therapeutic potential of autologous MSCs in neuroinflammatory and neurodegenerative diseases, including active progressive multiple sclerosis.

Source: (2020, December 1). Beneficial effects of autologous mesenchymal stem cell … – PubMed. from https://pubmed.ncbi.nlm.nih.gov/33253391/

How Can Stem Cells Help Multiple Sclerosis?

by Matson Huff | May 24, 2021 | Multiple Sclerosis, Stem Cell Therapy

Multiple sclerosis (MS) is an autoimmune condition in which the immune system attacks the protective sheath covering nerve fibers, known as the myelin. As a result, communication issues between the brain and other parts of the body occur. While there are currently several medications that can treat MS, some have serious side effects and may eventually stop working. So we ask ourselves ” How can stem cells help Multiple Sclerosis? ”

Recently, stem cell therapy has emerged as a new potential treatment option for people with relapsing-remitting MS (RRMS). In this version of the disease, symptoms may subside and then reappear in what’s known as a relapse. Eventually, RRMS can develop into a different form of MS in which symptoms stop subsiding.

Stem Cell Therapy for MS

Stem cells have the unique ability to transform into virtually any other differentiated cell type in the body. There are different stem cell therapy options in the field of Regenerative Medicine today. For instance, one is using hematopoietic stem cells that can differentiate into blood cells. In certain circumstances, doctors may use hematopoietic stem cell transplantation (HSCT) to treat RRMS.

First, doctors prescribe medication to increase the production of bone marrow stem cells. They then take some blood and reserve the stem cells for later use. Next, they prescribe strong medications, including chemotherapy, to suppress the immune system. Patients will require monitoring during this period of weakened immunity, and may therefore require a prolonged hospital stay.

Thereafter, the stem cells will be injected into the bloodstream to form new white blood cells and create an entirely new immune system. Until your immune system is functioning fully and independently, you’ll receive medications such as antibiotics to fight off illnesses or infections.

The treatment can take weeks, and recovery may take several months. Each individual is different, but many see a return to normal immune system functioning within six months.

Is Stem Cell Therapy a Potential Option for MS?

MS is a chronic disease for which there is currently no full cure, but results of stem cell therapy clinical trials are promising. In one, 69% of people had no relapse of MS symptoms or new brain lesions five years after receiving the treatment.

As with any treatment, it’s important to consider the risks involved with HSCT as well. For this therapy in particular, the risks of immune system suppression can be considerable. Nonetheless, for people with highly inflammatory RRMS with serious relapses and progressing symptoms, the risk/benefit ratio may be worth reviewing. Other studies are also showing potential for those with Multiple Sclerosis that how shown to be safe and effective.

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Mesenchymal Stem Cells in Multiple Sclerosis: Recent Evidence from Preclinical to Clinical Studies