Stem Cell Treatments have been making headlines for years. From controversy to life saving treatment, they have certainly made waves. But how can stem cells be applied to Multiple Sclerosis?
What is a stem cell?
First, let’s investigate what exactly IS a stem cell. There are several things that define a stem cell. One is they are capable of developing into multiple different types of specialized cells. Which means they can become any type of cell in the body, also why doctors are so interested in them for treatments for illnesses and disorders. Another is they are able to divide to produce more stem cells. And finally they are capable of creating functional tissue. Stem cells are always found in the body, from early embryonic stages, until adulthood. Depending on the type of stem cell, they can be found in various places in the body:
HSCs (haematopoietic stem cells) these are adult stem cells that are found in blood and bone marrow and are able to produce all the cells needed to create blood and the immune system.
MSCs (mesenchymal stem cells) these are adult stem cells found in a few places in the body, fat tissue, skin and bone marrow. These cells produce other cells which help other stem cells work properly.
NSCs (neural stem cells) these are specialized stem cells that help repair myelin in the brain. These can also be created from other stem cells, particularly MSCs.
hESCs (human embryonic stem cells) these are cells derived from embryos. They can produce every other type of cell in the body. There is an issue with the therapeutic use of these however, they have been unfortunately found to cause tumors in some cases.
iPSCs (induced pluripotent stem cells) these are cells that have been manipulated from other adult cells to create different types of cells. These also have the issue of causing tumors.
The stem cells that are most used for therapeutic use are HSCs and MSCs. (There have been some treatments that have been studied that use embryonic cells as well. Obviously there are ethical issues that go along with these types of cells and treatments.) Once the stem cells are removed, they are cultured and then applied to treatment. There are two main categories of treatment that stem cells may provide for multiple sclerosis. Anti-inflammatory therapy and remyelination.
Types of Stem Cell Treatments:
The anti-inflammatory therapy, aHSCT, can be described as “rebooting in the immune system”. It starts with harvesting your own stem cells from bone marrow, which is called mobilization. Then you will undergo high-dose chemo therapy which destroys your current immune system, this process is called immunoablation. Then the stem cells, which have already been cultured, are infused back into the body and a new immune system is born! Unfortunately it’s not that simple. Usually you will need to stay in the hospital for around 2 weeks to make sure you respond well to treatment. But assuming all goes well, you can expect to be functioning somewhat normally within 4-6 months after the treatment has concluded.
Currently there are many studies going on to assess the effectiveness of HSCT. In one such study, 24 patients were followed with the goal of having no disease activity for 3 years post treatment. In 69.6% of the patients studied, there was no new disease activity within those 3 years. Going even further, within 7.5 years, eight patients had shown enough improvement to stop receiving their disability payments and they returned to work. In 13 years post treatment, not one patient had a full relapse, and only one lesion was documented on an MRI scan. However, one patient did die during the treatment due to complications with the chemotherapy that was administered.
Remyelination is another type of stem cell treatment. This approach involves harvesting cells from various parts of your body, often from adipose (fat) tissue. You can also use previously harvested embryonic tissue. The cells are then grown in cultures to promote development of myelin forming cells. The cells are then directly injected into the nervous system to have best access to the brain.
Availability and Side effects:
Currently Stem Cell treatments are not FDA approved. There are several clinics in other countries that administer HSCT, but only a few clinics in the US offer it currently, and only for individuals who meet certain requirements. Usually this is a treatment for people who have had limited improvement with other “conventional” treatments and have significant impairment. However, one way to access stem cell treatments is through clinical trials. There are many going on currently and who are looking for participants. Check in with your doctor to see if this might be a good treatment for you.
This is a very invasive treatment, so there are serious side effects to consider. With HSCT, you will be essentially destroying your immune system, so the risk of infection is high. There is also a chance of having a negative reaction to the chemotherapy that is administered as well, which happened in the trial I referenced and resulted in patient death. This is one of those treatments that you have to weigh the risk to benefit ratio, and determine if it is a good choice for you.
Stem Cell Treatments appear to be very promising. Obviously they come with their risks, but doesn’t any treatment? Hopefully in the future more studies can be done to show their efficacy and it will become an FDA approved course of treatment. Until then, we can look to clinical studies to access this treatment if we choose to do so.
Have you looked into Stem Cell treatments? Have you done it yourself? Let me know!
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