Stem cell treatment may be the future in the fight against multiple sclerosis.
In fact, a new study has shown encouraging results from one particular type of stem cell therapy. Some have even called it a “game changer.”
However, experts in the field are urging caution as research moves ahead.
Multiple sclerosis (MS) is an autoimmune disease where the body attacks the myelin sheaths that coat the nerves in the brain and spine.
This myelin is essential for the brains synapses to work properly. As the myelin is destroyed, it may cause symptoms from tingling and numbness to tremors, loss of vision, muscle stiffness, weakness, fatigue, and pain.
Many of the current disease-modifying therapies (DMTs) for MS are designed to stop the immune system from attacking the myelin sheaths.
When effective, the therapies can reduce damage, but they aren’t capable of reversing it. Patients may continue to deteriorate despite being on a DMT.
Different types of stem cell treatments
Over the past 20 years, stem cell therapy has shown promise in stopping MS activity.
There are different types of stem cell therapy.
Hematopoietic stem cell transplantation (HSCT) uses the patient’s own bone marrow to create cells without memory of MS.
HSCT is considered an experimental treatment and has not yet been approved by the U.S. Food and Drug Administration (FDA) for MS.
A common misconception is that HSCT will reverse MS progress. It has only shown success in stopping MS activity.
“Bone marrow does not provide new cells for brain building. They give you derived bone marrow cells like T and B cells,” explained Dr. Jaime Imitola, the director of the Progressive Multiple Sclerosis Multidisciplinary Clinic and Translational Research Program at the Wexner Medical Center at The Ohio State University.
HSCT can take a toll on the body. And it can be life threatening.
The process is complex. Chemotherapy is used to stimulate the production of bone marrow and its release into the blood stream.
This enriched blood is collected from the patient and stored for later use. Patients then spend another 11 days in the hospital with several chemotherapies to wipe out their immune system.
The stored blood is then infused back into the patient. This causes the body to reboot to a healthier time.
MS affects everyone differently. Called a snowflake disease, no two patients present the same way.
While some MS patients have mild disabilities, or none at all, there are those that have lost the ability to walk, write, or talk. There is no cure.
Study produces encouraging results
A total of 110 patients took part in an international study out of Northwestern University, led by Dr. Richard Burt.
The group was divided between those on DMT and those having the HSCT stem cell therapy.
Within one year of the study, 39 relapses occurred in the DMT group. One relapse occurred using the transplant.
The team also found improvement in MS disabilities for those who received the transplants.
Also, at the one–year mark, there were no severe toxicities or deaths in those who received the transplants.
“These preliminary results from one of the first well-controlled clinical trials of HSCT for MS are exciting,” Bruce Bebo, PhD, executive vice president of research at the National Multiple Sclerosis Society, told Healthline. “This trial adds to a growing body of knowledge that is helping to define the precise risks and benefits of HSCT and who is more likely to benefit.”
The trial is ongoing, but it is no longer recruiting new participants.
“Stem cell therapy brings hope to patients,” Imitola told Healthline. “But should be taken with caution.”
“Consensus is that the data over [the] last 6 to 10 years is solid in that there is improvement in patients [using HSCT],” he added. “But these have been compared to controls. The big question is if HSCT can replace DMT.”
“MS is the result of the environment, an agent, and one’s genetic background,” Imitola noted.
An agent may be a modifiable risk factor such as smoking cigarettes or taking vitamin D, or a virus, such as Epstein-Barr virus.
“HSCT reboots the immune system to a state prior to the genesis of MS. It does not change the genetic background of the patient,” said Imitola.
Imitola cautioned against creating expectations by calling it a “game changer.” He said that is misleading. There is more work to do and there are other international trials trying to confirm and compare HSCT with available treatments.
He did say the study will help with determining the best candidates for transplantation.
According to the National MS Society website, additional controlled trials are being planned that will help determine who may respond best and which approach to HSCT is optimal for treating MS.
The website states that, “Research to date suggests that those most likely to benefit from HSCT are 50 years or younger, have had MS for five or fewer years, have active relapsing-remitting MS but are still walking, and whose disease is not adequately treated by available disease-modifying therapies”
A patient’s perspective
Healthline caught up with longtime MS advocate Jennifer Digmann, who has progressive MS and is in a wheelchair. This study did not apply to her, but she finds it interesting.
“This subject intrigues me, but I never have seriously considered stem cell therapy,” Digmann said. “While my multiple sclerosis is progressive and awful at times, I don’t want to upset the apple cart, if you know what I mean. I have it pretty good and I don’t want to take that risk.”
“Wiping out my immune system could lead to a host of new problems and I fear I’d wish to just have MS,” she added. “Maybe if I was a little younger, I may think differently. And if I had children that also could be a factor.”
Editor’s note: Caroline Craven is a patient expert living with MS. Her award-winning blog is GirlwithMS.com, and she can be found @thegirlwithms.