Stem cell transplants, which are used to treat diseases and tissue damage, have made some encouraging strides in recent years. There have been advancements in particular autoimmune diseases affecting the nervous system, which are caused by the immune system attacking body cells.
Immune suppression is also necessary for cell therapy treatment. But unlike medications that completely reset the immune system rather than suppressing it, this suppression is not as severe. Stem cell therapy can be applied in three different ways, according to scientists. First, it is the replacement of damaged myelin (the protective structure in the shape of a sheath around nerve cells) in the central nervous system by healthy oligodendrocytes strengthened by stem cells. In the latter, blood stem cells are used to replace a person’s compromised immune system. The third is to gain from the tissue’s stem cells’ capacity for repair.
Studies employ a variety of stem cell types. These include human embryonic stem cells (hESCs), mesenchymal stem cells (MSCs), neural stem cells (NSCs), autologous blood stem cells (AHSCs), and induced pluripotent stem cells (iPSCs) (hESCs).
Although hESC transplants have received a lot of attention to date, they are an effective strategy for the management of autoimmune diseases. hESCs cells have the potential to differentiate into neurons, astrocytes, and oligodendrocytes, making them useful for the treatment of many neurological conditions that are currently incurable, including MS and spinal cord injury.
Multiple sclerosis is one of the most complicated neurological conditions (MS). because the disease’s underlying pathological mechanism is poorly understood and the available treatments are insufficient. As a result, applications of regenerative medicine are best suited to treat this illness. hESCs are a suitable tool for treating MS because of their pluripotency (the capacity to differentiate into different cell types), proliferation, and differentiation into nerve cells. Because of these characteristics, hESCs are a perfect source for nerve cells.
MS’s underlying pathology
A lack of myelin sheath around neurons in the central nervous system results in MS, a neurological condition that is chronically inflammatory and neurological in nature. Around the world, this illness affects a sizable number of people of all ages. Women who live in northern countries are particularly at risk. The most typical type of multiple sclerosis (MS) is relapsing-remitting MS (RRMS). In this interpretation of the situation, the symptoms occasionally get worse and occasionally get a little better. 70% of patients with RRMS experienced worsening MS symptoms after 15 to 20 years. Although MS is not directly inherited, it has a genetic basis. There is no known cure for MS, and the underlying mechanisms are still being investigated. The MS treatments currently in use only reduce disease symptoms.
MS Treatment Options Currently Available and Their Limitations
Many oral therapy techniques have been authorized since 2010 to treat symptoms. The therapies that are currently accessible focus on the disease’s immunological mechanism. The majority of treatments combine immunosuppressant medications and work to stop the symptoms from getting worse. Treatments are effective at reducing symptoms, but they are unable to restore neurons’ function, halt the disease’s progression, or make up for the damage. Interferons, immunosuppressants, corticosteroids, and monoclonal antibodies are a few examples of treatments that target immune system cells and mediators. But they are insufficient to safeguard nerve cells and can only slow the disease’s progression.
The cost of MS treatment is high. As the disease worsens, so does the cost of treatment. Treatment costs per patient per year range from $8,000 to $54,000.
MS Cellular Therapies
Following a stem cell transplant, the first treatment strategy is the administration of immunosuppressive medications. This strategy is justified by the creation of a new immune system while suppressing immune system activity in T and B cells.
Despite the fact that there are established MS therapies, the majority of patients progress to a point where they are unable to benefit from them. One method for repairing the damage and stopping the disease from getting worse is to ensure the formation of the myelin sheath.
Stem cell therapy is an effective treatment and a fresh strategy to get around the drawbacks of existing therapeutic approaches in the field of regenerative medicine. MS can be treated with stem cell therapy anywhere in the world. However, depending on local laws, different countries have different treatment costs. Outside of the United States, medical care can cost anywhere from $20,000 to $100,000. The cost of an AHSC transplant for MS treatment in the UK was also less expensive (2,800 euros).
Therapy using autologous blood stem cells
High-dose immunosuppression was given first, and then the patient received autologous (patient’s own cells) blood stem cell therapy for MS. The immune system has been suppressed because a new system has been installed in its place, which has replaced the T and B cells that were attacking the patient’s neurons’ myelin sheath. The patient’s blood is drawn to obtain bone marrow stem cells, which are then frozen. Chemotherapy is then used to devastate the diseased immune system. The patient receives blood stem cells from the thawed frozen stem cells to rebuild their immune system.
Mechanosensitive Stem Cells
The immunomodulatory effects of MSCs include the suppression of T cell proliferation, alteration of dendritic cell maturation and function, inhibition of natural killer cell functions, and suppression of B cell proliferation and differentiation. In one study, 10 patients with advanced MS responded favorably to the administration of MSCs derived from bone marrow.
Cognitive Stem Cells
Adult brain NSCs have the capacity to differentiate into oligodendrocytes and participate in the process of myelin formation in MS patients. NSCs can strengthen oligodendrocytes while also secreting growth factors and controlling the immune system, among other advantageous functions. Therapeutic plasticity is the quality of having multiple positive effects. Cells must be flexible enough to adapt to tissue establishment and survival for NSC therapy to be effective in MS. NSCs with the ability to differentiate into functional neurons and glia cells are found in the subventricular zone and subgranular zone of the hippocampus in the adult central nervous system.
Pleiomorphic Stem Cells
In MS patients, this population of cells can develop into oligodendrocytes, which produce myelin. In a study, it was found that oligodendrocytes made from iPSCs moved to the region of the brain with MS lesions in a non-human primate model. Consequently, it is believed that oligodendrocytes made from iPSCs can be used to treat MS. Transplanting cells from iPSCs has been used to conduct extensive research on the therapeutic potential of iPSCs in various animal models. The clinical application of iPSCs must prioritize safety and efficacy.
Comparison of Human Embryonic Stem Cells and Other Cellular Therapy Techniques
MSCs have healing and immunosuppressive properties. The variety of MSCs derived from adult sources, however, lessens their therapeutic potential. NSCs also have some limitations because they can only differentiate into oligodendrocytes in certain microenvironments. Additionally, the quantity and longevity of AHSCs derived from bone marrow are insufficient for treatment.
In numerous animal models, the therapeutic potential of iPSCs has been studied. However, tumorigenesis is a possibility in iPSCs with undifferentiated cells. Additionally, even when the harvests’ own cells are used in the treatment, some studies have seen an immune system response.
When given to the patient, bone marrow-derived stem cells have been found to make the disease worse. because the immune system’s autoimmunity is brought on by the large amounts of cytokines that these cells were secreting. On the other hand, since human embryonic stem cells only secrete small amounts of cytokines, they are a better tool for a therapeutic approach. Clinical research needs to be done, though, before using human embryonic stem cells for treatment.
Over the past few years, significant progress has been made in the study of cellular therapies for multiple sclerosis. The cellular therapies discussed in this article are currently undergoing clinical trials. But more work needs to be done. On the efficiency and dependability of experimental methods, there is still no agreement. Therefore, treatments for multiple sclerosis using cells are regarded as experimental. More research and clinical trials should be carried out to dispel concerns about the effectiveness and safety of cellular methods in order for these studies to become a standard treatment method. Research teams focusing on these issues must collaborate and receive funding from various institutions in order for these to be successful.