Stem Cell Therapy Could Stop MS for Many Years, But Funding is an Issue

Experimental stem cell therapy using a patient’s own stem cells could offer many multiple sclerosis patients relief for years. Mark S. Freedman, MD, professor of medicine at the University of Ottawa, talked about the potential benefits of stem cell transplantation during a presentation at the 2015 Annual Meeting of the Consortium of Multiple Sclerosis Centers in Indianapolis, Indiana,

Freedman told the crowd that research is moving very slowly because of a complex regime of checks and balances that are in place in the United States and Western Europe, where regulatory agencies work to make sure that the stem cell product is safe. Unfortunately, he said that some treatment centers do not follow ethical treatment-preparation and safety protocols.

Stem cells are the body’s cells or raw materials capable of self-renewal and building other cells with more specialized functionality. Most come from bone marrow, with a few from the heart, and have the capacity to merge and repair, reduce inflammation, and promote new tissue growth.

Multiple sclerosis is an autoimmune condition in which a patient’s own immune system attacks myelin, a fatty coating that protects nerves in the spinal cord and brain. Stem cell therapy is viewed as having the potential to reverse the process of demyelination.

However, Freedman said that researchers have several ongoing concerns with regards to the use of stem cell therapy, including:

• Who would do stem cell therapy? Who would be qualified?
• What would the conditioning regimen be?
• How will doctors identify patients who would most likely benefit?
• If you see recovery, can doctors anticipate who is going to recover or not?

Freedman said he was surprised when he saw so much recovery in one patient group in a Canadian study. The investigators expected to see a stoppage of the disease, not a recovery. “And if there is a recovery, and it’s delayed, why is it coming up later?” Freedman said.

He wonders if the transplanted cells are doing more than just replacing the immune system, because they certainly have the capacity to differentiate into others.

“There are still a lot of questions, but this is a trial that will definitively show that bone marrow transplantation is better than anything else on the market,” Freedman said. He believes the fact that some of his patients had delayed recovery probably suggests some kind of repair.

Freedman said that immunoablation is just not enough, so mild ablation is probably the way to go and patient selection is going to be one of great concern. His ideal patient would be one with early aggressive disease who has not sustained too much disability and has few comorbidities.

“In summary, stem cell trials for aggressive, inflammatory early MS, bone marrow transplant is an option and with a mild ablative treatment, it could stop the disease for many years,” Freedman concluded.