Immunomodulation and neuroprotection with mesenchymal bone marrow stem cells (MSCs): a proposed treatment for multiple sclerosis and other neuroimmunological/neurodegenerative diseases.Karussis D, Kassis I, Kurkalli BG, Slavin S.
Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University Hospital, Ein-Karem, Jerusalem, IL-91120, Israel. email@example.com
Bone marrow (BM) derived mesenchymal stem cells (MSCs) (non-hematopoietic, stromal cells) can differentiate under certain circumstances into cells from various neuronal and glial type lineages; they also exert immunomodulatory effects. For potential clinical applications, BM-MSCs offer significant practical advantages over other types of stem cells, since they can be obtained from the adult BM (the patient himself being the donor) and can be easily cultured and expanded posing in parallel a very low risk for development of malignancies. We have shown that BM-MSCs cultured with a cocktail of growth factors (containing FGF and BDNF) differentiate into neuronal/glial lineage cells with a predominance of cells expressing astrocytes' markers. BM-MSCs were effective in suppression of chronic EAE in mice and induced neuroprotection, preserving most of the axons in the CNS of successfully-treated animals. Histopathological studies revealed that MSCs could efficiently migrate into the CNS inflamed tissue (both when administered intravenously and intraventricularly) and differentiated into cells expressing neural-glial lineage markers. Our preclinical results indicate that bone marrow can provide a source of stem cells with a potential for migration into inflamed CNS tissue and differentiation into cells expressing neuronal and glial cell markers. Such an approach may provide a feasible and practical way for in situ immunomodulation, neuroprotection and possibly remyelination/regeneration in diseases like multiple sclerosis. We therefore developed a explorative protocol for the evaluation of this therapeutic approach in a small group of patients with MS and other neurodegenerative diseases.
PMID: 17610906 [PubMed - indexed for MEDLINE
Note that one of the things most often leveled as a probable problem with this kind of approach is that it wouldn't get to the brain and that even if it did it might not become useful cells. This seems to indicate that is not the case. It also indicates that immunomodulation is possible this way, an apparent fact also borne out by studies in RA with this type of stem cell approach.
In fact it is true that it has been years since mice with strokes were given stem cells peripherally that clearly regenerated tissue in the brain(the stem cells were marked with a special dye); stem cells know where inflammation is and "go there" on their own to heal.
I couple this interesting work with the comment from the article below, which was on people with progressed MS who had the other kind of stem cells transplant with chemo
http://members.cox.net/marty.altman/Pag ... Marrow.htm
"We weren't looking for improvement," Freedman told a stem cell seminar at the U.S. National Institutes of Health. "The actual study was to reboot the immune system." Once MS is diagnosed, Freedman said, "you've already missed the boat. We figured we would reboot the immune system and watch the disease evolve. It failed." They had thought that destroying the bone marrow would improve symptoms within a year. After all, MS is believed to be an autoimmune disease, in which immune system cells mistakenly attack the fatty myelin sheath that protects nerve strands. Patients lose the ability to move as the thin strands that connect one nerve cell to another wither. Instead, improvements began two years after treatment
My assumption about these newer types of stem cell therapies is that they too may result in "late"improvements perhaps a log time after the therapy. It's too soon to know yet! But to be quite honest, chemo is so very hard on the body ( there is some brain atrophy just from that phase) that I am very curious to see if there are better late improvements in this group that got the stems with no ablation.
I also believe personally that it is likely these therapies will need to be repeated periodically, but I read another paper by the reseach team that said they would apply for a further study grant and it estimated the cost to treat each person would be 20 thousand dollars.
Well, 20k is a lot but it is what I believe copaxone costs per year and is about half tysabri and rituxan costs. This type of therapy should be not only potentially better than others but it also may be more economical.
There are of course places supposedly offering this type of therapy now in CHina and Central AMerica. I wish some people who did it would start a regimen page........