According to the CDC, stroke continues to be a major cause of serious disability for adults. It is also estimated that nearly 800,000 people in the United States have a stroke each year[1]. While 80% of those experiencing a stroke survive for at least one year following the event, more than 70% will continue to experience long-term disabilities.
Stroke is divided into three distinct phases: acute, subacute, and chronic phases. The acute phase of stroke occurs within 24 hours of the actual ischemic event. The subacute phase starts at 24 hours and lasts up to 3 months. The chronic phase of stroke, by definition, starts at 3 months.
While stroke patients tend to see some response to rehabilitation efforts occurring in the chronic phase, they tend to quickly plateau, leaving many with serious chronic neurological and functional disabilities. To date, there are no approved treatments for the chronic phase of stroke.
For the purposes of this study, Steinberg et al. report the two-year outcomes of their phase 1/2a study examining chronic stroke patients after implantation of mesenchymal stem cells (MSCs). This study specifically examined the outcomes of 18 patients who were at least 6 months post-stroke onset and had chronic motor deficits secondary to the nonhemorrhagic stroke.
At the 1-year point of this study, the authors reported the implantation of bone marrow-derived MSCs (BMD MSCs) was generally safe, well-tolerated, and associated with significant improvement in clinical outcomes.
There were no correlations between improvement in clinical outcomes and cell dose, baseline patient age, or baseline stroke severity. However, two years after implantation of MSCs, those enrolled in this study experienced significant improvement in motor impairment scales as indicated by a number of scores, including the ESS, NIHSS, F-M total, and FMMS scores.
Although all enrolled patients experienced at least one Treatment-Emergent Adverse Event (TEAE), with headache and nausea being the most common, 94.4% of the TEAEs were determined to be unrelated and no one withdrew from the study.
Interestingly, the authors reported that there also appears to be a significant correlation between the size of newly appearing transient lesions primarily in or adjacent to the premotor cortex – a finding that remained consistent at month 12 and month 24 of this study.
While Steinberg et al.’s reported findings are encouraging, the authors point out that the small scale and uncontrolled study design mean the findings should also be interpreted with caution.
Steinberg et al conclude that their findings associated with this completed, open-label, single-arm phase 1/2a study was consistent with the data at the 1-year point and indicated that treatment of chronic stroke with BMD MSCs after 2 years continued to be safe and was associated with sustained and significant improvements in clinical outcomes.
Given the findings of this study, the authors highlight the potential of MCSs, and specifically SB623 cells used in this study, as a potential treatment for patients with chronic ischemic stroke.
Current estimates indicate that kidney disease currently affects over 37 million US adults and over 10% of the global population[1]. Characterized by gradual loss of function, kidney disease generally progresses over time and culminates in the inability to remove waste and excess fluid from the blood[2].
Often demonstrating little to no symptoms in its early stages, chronic kidney disease tends to demonstrate increasing and dangerous symptoms as the condition advances.
To date, treatment for chronic kidney disease has been centered around causal control as a way of slowing the progression of the condition. However, these therapeutic treatment efforts, including multidrug therapy, have demonstrated an inability to reverse the condition from progressing to end-stage renal disease (ESRD) and requiring additional therapy, dialysis, or kidney transplantation.
Considering the high cost and disruption to normal life function associated with dialysis and the severe shortage of viable kidney donors, neither dialysis nor transplant has proven to be ideal or often recommended treatment strategies. As a result, there has been renewed interest in new and more effective therapeutic options to alleviate, cure, or prevent kidney disease and to improve a patient’s survival and quality of life.
Evaluating the numerous and growing therapeutic applications associated with stem cells’ ability for self-renewal, proliferation, and differentiation, Liu et al.’s review explores the potential benefits offered toward improving renal function and supporting structural repair in those afflicted with kidney disease.
Despite the promising benefits of using stem cells to kidney repair and disease treatment demonstrated through prior preclinical study, the authors point out that certain ethical issues regarding the origin of stem cells, and specifically embryonic stem cells (ESCs) need to be addressed and overcome before clinical application of SCs.
Regardless of the stated drawbacks, Liu et. al concludes that the existing evidence demonstrates that stem cell therapy appears to be a clinically viable alternative for kidney disease, specifically for restoring normal kidney function and for progressing understanding about tissue regeneration, drug screening, and disease modeling.
Although stem cells demonstrate promise in this regard and while the immunomodulatory properties of mesenchymal stem cells (MSCs) appear to make them the most promising SC for treating kidney disease, the authors also point out that further research is needed before definitively concluding which source of SC is best suited for this application.
As a result of this review, and in an effort to realize these findings into clinical applications in the future, the authors call for larger rigorously designed clinical trials to further assist in determining the clinical efficacy of SC therapy in kidney disease – including the appropriate selection of cell types, number of SCs required, and the appropriate route of administration.
Parkinson’s disease (PD) is a debilitating neurodegenerative disorder that currently affects nearly 6 million people worldwide and is currently the second most common neurological condition, behind only Alzheimer’s.
Although the exact cause of PD remains unclear, the condition is characterized by the gradual loss of nerve cells in the brain responsible for producing the neurotransmitter dopamine[1]. While no cure for PD currently exists, current therapeutic treatment approaches focus on improving quality of life but are not able to prevent or slow the progression of the disease.
Recent research has demonstrated positive effects of mesenchymal stem cell (MSC) transplantation that has been associated with secromes; noted beneficial effects include providing a self-regulated regenerative response that limits the area of lesions. Additionally, these MSC-derived secretomes compose soluble factors and encapsulated extravesicles (EV). These EVs have been found to have a significant impact on physiological processes, including cell-to-cell communication.
Considering MSCs are readily available and easily isolated from a number of sources, including adipose tissue, umbilical cord Wharton’s Jelly, bone marrow, and dental pulp, these stem cells are thought to hold potential as a therapeutic approach to managing PD.
As part of this review, d’Angelo et al. highlight a number of studies demonstrating the potential of MSCs in improving a number of conditions and symptoms consistent with those demonstrated in PD. In these studies, animal models demonstrate improved motor behaviors and correction of functional impairment after transplantation of MSCs.
The authors point out that further research exploring cell-free, therapeutic, personalized approaches for the different neurodegenerative diseases, including PD, is needed.
d’Angelo et al. also note that, while MSC-derived secretomes have shown positive effects on neuronal cell survival, differentiation, and proliferation, further studies are needed to fully understand all of the bioactive molecules.
Since MSC-derived secretomes are able to stimulate neurotrophic and neuronal survival pathways and appear to counteract neuronal death, they could potentially be a beneficial tool in future management and prevention efforts for a number of neurodegenerative conditions, including Parkinson’s disease, Alzheimer’s disease, and stroke.
Mesenchymal stem cells are critical in many types of innovative and healing therapies. Regenerative medicine, also known as stem cell therapy, can help manage condition symptoms and progression. Conditions can be an autoimmune disease or joint injuries.
Because of this, certain supplements may help support the health of mesenchymal stem cells in the body. Encouraging healthy stem cells can help potentially improve the outcomes of stem cell therapies for injuries and other conditions.
Useful Supplements
Many different supplements are likely to support the health of mesenchymal stem cells. More research is needed on the direct effect of these supplements on mesenchymal stem cells specifically.
Still, there is plenty of scientific research to support the idea that certain supplements boost tissue growth. This tissue growth includes the development of mesenchymal stem cells.
Chondroitin/Glucosamine: Typically, these supplements are used to treat the symptoms of arthritis. They are usually harvested using shellfish.
Glucosamine promotes the growth of cartilage, which entails the development of mesenchymal stem cells. Also, some laboratory trials have shown that these supplements can encourage the longevity of stem cells.
Turmeric: This spice is often used in Indian cuisine. It also has anti-inflammatory properties. In part, turmeric’s effectiveness is related to the presence of curcumin. This chemical compound decreases inflammation and supports general health.
Some research has suggested that patients with Alzheimer’s disease can see improvements by taking turmeric supplements. Curcumin is believed to support and protect mesenchymal stem cells, as well.
How Do Supplements Support Mesenchymal Stem Cell Growth?
Not all supplement brands are created equally. Be sure to read ingredient lists carefully before purchasing supplements.
Further research is needed to explore how and what supplements can potentially help mesenchymal stem cells, but there is no current information to show that these supplements could not help promote the growth of mesenchymal stem cells.
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.
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