Multiple Sclerosis (MS)

Multiple sclerosis is a systemic autoimmune disease. It affects the central nervous system, which encompasses both the brain and the spinal cord.

In patients with MS, the immune system attacks the myelin sheath that protects nerve endings and connections. These inflammatory lesions are often visible through MRI scans. They progressively impair communication between nerves and motor cells. This disease is particularly feared because it leads to the progressive loss of limb function and movement. 

Symptoms of Multiple Sclerosis

The exact symptoms experienced by a patient with multiple sclerosis will vary depending on the areas attacked by the autoimmune inflammatory process. However, as demyelinating lesions accumulate, so do the flare-ups of the disease and the intensity of the symptoms. 

Eventually, patients will develop secondary intractable disease.

Standard Treatment for Multiple Sclerosis

Multiple sclerosis (MS) is mainly treated with a combination of conventional oral medication or injectable drugs.

Some patients with relapsing remitting MS may respond to the treatments available for MS and manage to minimize the frequency of recurrent attacks or prevent them altogether. Unfortunately, patients with the non-responding disease, and the overwhelming majority of patients with primary or secondary progressive MS, do not respond to conventional medications available for MS. Such patients are regarded as incurable. 

Use of Mesenchymal Stem Cells for the treatment of Multiple Sclerosis

Patients with uncontrolled or progressive disease may benefit from immunosuppressive medications, sometimes even following more aggressive conditioning designed to ablate all mature lymphocytes, including self-reactive T cells, alongside autologous hematopoietic stem cell transplantation  (HSCTs). Following HSCT, newly generated T cells may be trained to acquire self-tolerance. This will reconstitute a  patient’s normal immune system, allowing it to terminate otherwise resistant disease. 

This process is similar to the induction of self-tolerance in utero during embryogenesis at the early stages of pregnancy. Unfortunately, HSCT is a major procedure with serious potential risks.

Thanks to its capacity to induce anti-inflammatory and immune regulatory effects, treatment with autologous MSCs, or even from those coming from an unrelated placenta and cord tissue, represent a safe alternative treatment for patients with MS. In theory, since MSCs are truly multi-potent, a patient’s own MSCs may potentially be differentiated to oligodendrocytes (or myelin-synthesizing cells) and then used to induce re-myelination. Alternatively, nanoparticles secreted by MSCs may induce remyelination by differentiating a locally residing patient’s own MSCs.

As an alternative, a combination of different treatments can be used with similar expected effects. This involved using immunosuppressive treatments to minimize the proportions of self-reactive lymphocytes, followed by the use of growth factors to stimulate the secretion of multipotent stem cells from the bone marrow. These can then be enriched alongside newly-derived normal T cells. This treatment can be regarded as a safe micro-HSCT, and can replace the combination of more hazardous HSCT with dTMS. 

Furthermore, circulating MSCs may be targeted to the central nervous system by safe and non-invasive low energy acoustic shockwave therapy (AST), which dilates the blood vessels and increases the flow of regulatory cells to the central nervous system. Exposure of circulating multipotent stem cells to harmless low energy multi-colour laser light therapy (LLLT) can also be used to activate and enhance the regenerative capacity of multipotent MSCs.The supportive use of all three devices– dTMS, AST and LLLT – can be applied to improve the outcome of cell therapy for MS patients. It can be used among both patients treated by MSCs expanded ex vivo and those treated by enrichment of autologous multi-potent stem cells.

Supported by our pre-clinical investigations and based on our clinical experience, a large number of patients with MS who fail to respond to conventional MS medications may benefit from safe outpatient treatment with MSCs.

Unfortunately, at present, the use of MSCs enriched ex vivo in cell-processing centres is not approved by regulatory authorities. 

Because of these regulatory barriers, MSC-based treatments for MS or for  other resistant autoimmune diseases can only be accomplished in one of our satellite clinics abroad, in places with more permissive regulations.