Mesenchymal stem cell therapy (MSCT)
They can produce many different types of cells, including muscle and cartilage.
Early research suggests they might help to promote myelin repair and have a positive effect on the immune system.
MSCT and MS
MSCT for MS - what do we know?
Researchers are exploring the potential of mesenchymal stem cell therapy to protect nerves from damage and to encourage the repair of existing damage. A number of pilot studies have investigated the safety and effectiveness of MSCT. These studies have highlighted a number of minor side effects, and have revealed some promising early results.
MSCT involves isolating MSCs from the bone-marrow. These cells are then multiplied in the lab and infused back into the blood or the fluid surrounding the spinal cord of the person undergoing therapy.
Promising results in a mouse model of MS
An early study looked at MSCs found in the fat tissue of mice as a tool for transplantation in MS. In transplanting these stem cells to mice with an experimental form of MS, markers of inflammation in the spinal cord and brain were reduced. This follows research that showed MSC therapy reduced inflammation by making the immune system less active.
Researchers have also shown that giving MSCs to a mouse model of MS can protect nerves from damage and help to reduce the severity of the condition. In this study, the rate of nerve loss was reduced in mice that received MSCs.
Clinical trial results
A number of early clinical studies have investigated the safety of isolating, growing, and re-injecting someone’s own MSCs. These studies have provided evidence of the safety and tolerability of MSC therapy, with only a number of minor side effects reported.
An early, pilot study involved ten people with progressive MS. Researchers tested the safety of effectiveness of MSC injection into the fluid surrounding the spinal cord (intrathecal injection). One year after the therapy, one person had experienced an improvement in disability as measured by Expanded Disability Status Scale (EDSS) score. Four people saw no change in their level of disability, and five people experienced a worsening of disability. Researchers reported that whilst this study highlighted the feasibility of this treatment, larger studies were needed to more fully test the effectiveness of MSC therapy.
In 2012 the results of a small, phase 2 study were published. This study involved 10 people with secondary progressive MS, and researchers found that treatment with MSCs led to an improvement in visual clarity (acuity) and the speed at which messages were sent from eye to brain. These results suggest that the treatment may be neuroprotective. The treatment was well tolerated, with no serious adverse events reported.
The future for MSCT for MS
We are funding a number of research projects, some of which are co-funded with the UK Stem Cell Foundation. These include the STREAMS clinical trial of MSCT for people with MS, which is part of the international MESEMS programme evaluating this treatment option.
There are also a number of other clinical trials going on around the world. These are phase 2 trials looking at the safety of the procedure and possible benefits, and it is too early to say whether MSCT will become an effective treatment for MS.
The MESEMS trial is an international, multi-centre trial investigating whether autologous MSC treatment is safe and effective for people with relapsing remitting or progressive forms of MS. As part of this study, we are supporting a phase 2 trial at Imperial College London (STREAMS) to test if early treatment with MSCs is more effective than later treatment. The STREAMS trial will involve 15 people with highly active MS, who have evidence of inflammation on an MRI scan (at least one active lesion).
Researchers will test if the treatment is safe and whether it is effective at reducing the number of new active lesions as seen on MRI scans. The STREAM trial finished recruiting in 2016, with MESEMS sites in other countries all doing so by spring 2018. Allowing for follow up and analysis of results, they expect to report in 2019.
Understanding more about mesenchymal stem cells in progressive MS
We are funding a project that will investigate how MSCs interact with and affect the cells of the immune system in people with secondary progressive MS. Researchers will compare these interactions to those seen in people without MS. This project will help us to better understand the way in which mesenchymal stem cells work and how they may be beneficial as a treatment for people with MS.