Multiple sclerosis is a chronic, progressive neurological disease that currently has no cure. While there are treatments available that can help to manage symptoms and slow the progression of the disease, they are often ineffective or come with undesirable side effects. As a result, patients with secondary progressive multiple sclerosis (SPMS) often find themselves without many options.
SPMS can seriously impact patient quality of life and can eventually result in death. The medical community needs to develop more effective treatments for this condition. The pathological processes that cause SPMS may involve neurodegeneration. One potential new treatment that may improve patient outcomes is stem cell therapy.
Adipose-derived mesenchymal stem cells (ADMSCs), as their name suggests, are derived from adipose (fat) tissue. They can be obtained through a minimally invasive procedure called liposuction. Once isolated, ADMSCs can be expanded in culture and differentiated into various cell types, including neurons, oligodendrocytes, and astrocytes. This makes them a versatile tool that could potentially be used to treat a variety of conditions.
AdMSCs have shown promise in the treatment of a variety of diseases and conditions, including SPMS. This is due to their ability to modulate the immune system, produce neurotrophic factors, and promote angiogenesis (the formation of new blood vessels). By doing so, AdMSCs are thought to help reduce inflammation and improve neuronal function.
A clinical trial, Adipose-derived mesenchymal stem cells (AdMSC) for the treatment of secondary-progressive multiple sclerosis: A triple blinded, placebo controlled, randomized phase I/II safety and feasibility study, looked into the potential treatment of using stem cells for SPMS.
Results of the Trial
The goal of the trial is to determine the safety and feasibility of stem cell therapy for SPMS. 34 patients were chosen for the study. Patients received lipectomy to collect adipose tissue, and the tissue was then sent to a lab where the ADMSCs were derived from the adipose tissue.
Patients either received a placebo, a 1,000,000 dose of stem cells, or 4,000,000 doses of stem cells that were infused intravenously. 11 patients received a placebo, 10 received the low stem cell dose, and 9 patients received the high dose of stem cells. Four patients did not receive the treatment because there were abnormalities in the stem cells that were going to be used in the treatment.
The researchers monitored patient safety through laboratory parameters, adverse events, vital signs, and spirometry. The researchers used expanded disability status score (EDSS), magnetic-resonance-imaging (MRI), quality-of-life by questionnaire SF-36, EuroqoL-5D and MusiQoL, and more. To qualify for the study, patients had to have an EDSS between 5.5 and 9.
The results of the study were promising in that stem cell therapy continues to show that it is safe for a number of conditions, including SPMS. There were serious adverse events that occurred during the course of the study, but none of the events were related to the treatment. Patients experienced a number of adverse events, the most common being urinary infection, respiratory infection, and anemia.
The clinical trial confirmed that ADMSCs are safe and feasible for patients with SPMS. The medical community needs to continue to run clinical trials to understand the mechanisms behind how stem cell therapy can improve SPMS outcomes.
Surprisingly, there were no significant changes in EDSS or MRI in patients that received the stem cell therapy. Other clinical trials have shown that stem cells are able to improve SPMS patient outcomes. The researchers theorized that the patients they studied in their clinical trial on average had more severe SPMS as compared to other clinical trials.
The disease may have progressed too far for the stem cells to be able to repair the underlying damage. The nerves may have been too damaged for stem cells to make a real difference. Additionally, this clinical trial used ADMSCs while the other clinical trials had used bone-marrow derived meschemyal stem cells. The progression of the disease in combination with the other type of stem cell could have led to a different outcome.
The researchers concluded that there needs to be more research to determine the efficacy of the treatment. While more research is needed to confirm the efficacy of adipose-derived stem cells in the treatment of secondary progressive multiple sclerosis, the available evidence suggests that they hold great promise.
