October 27, 2020

The Niche

Knoepfler lab stem cell blog

Stem cell treatments for MS: where do things stand?

Multiple sclerosis (MS) is an often devastating autoimmune disease in which the immune system attacks its own nervous system. More info can be found at the National MS website here.

MS is a very serious health problem globally as about 400,000 people have MS in just the US alone and more than 2 million worldwide suffer from the disease. Almost all of us know someone who has MS. It’s a common disease with a huge negative impact. New treatments are desperately needed.

Multiple SclerosisIn patients with MS, the immune system mistakenly attacks the insulation, called myelin, surrounding nerves. It thus belongs to a class of disorders called demyelinating diseases. This damage basically screws up the function of the nerves in profound ways. The symptoms (see at left) are diverse, but often it first manifests as tingling and numbness, weakness in arms or legs, unusual changes in vision, or changes in cognition.

There is no known cure for MS and while some medications are helpful, they often can have side effects and in many cases the disease progresses anyway. As a result, it is not unusual for MS patients to seek out alternative medicine therapies. One such at least theoretically possible kind of new therapy is based on stem cells.

MS patients regularly contact me and ask about the potential of stem cells to be used for MS.

  • Do stem cells have promise for MS?
  • Can they be used now for MS?
  • What about clinics offering stem cell treatments now?

Great questions.

There is a lot of important stem cell research ongoing for the treatment of MS that have promise. On the government clinical trials website I see 30 studies listed for a search of “stem cells” and “multiple sclerosis”.

However, at this time, although a number of clinics in the US and internationally claim they have effective stem cell treatments for MS via using so-called mesenchymal stem cells (MSCs), the science is just not there to support such claims yet.

Still I see ads on the Internet claiming to provide effective stem cell treatments for MS, but inevitably they lead to dubious clinics.

Nonetheless, there is reason for hope, but patience is required. I know that waiting longer is frustrating and in some cases the disease is so severe that waiting seems impossible. I respect that urgency. Also, I understand the seriousness of the disease and the frustration of being told to try to wait, but many of the so-called “stem cell” treatments for MS offered by for-profit clinics could be dangerous and do far more harm than good. They are also extremely expensive.

More research is needed, particularly FDA approved clinical trials such as those I mentioned above. I would recommend that patients talk to their personal physicians and consider a clinical trial rather than a dubious treatment at a clinic.

Theoretically how might stem cells help MS?

I can see three main ways.

  1. One way is through immunomodulation. What this means is stem cells, particularly one type called mesenchymal stem cells (MSCs), have the power to potentially turn down the level of activity of the immune system. In that way MSCs may be able to reduce autoimmunity and inflammation that leads to cell and tissue damage. Think of it as MSCs turning down the thermostat of immunity in the nervous system.
  2. A second, cutting edge approach that is under investigation is to use MSCs as tools to deliver drugs. In this way, kind of like pizza delivery guys, MSCs might home in on areas of damage in MS and squirt out the equivalent of two-liter (of course much smaller volume in reality) bottles of some chemicals that reduce inflammation right in the zone where it is needed most. They may also “feed” the injured cells pizzas in the form of various supportive substances, proteins, etc.
  3. Finally, nervous system stem cells, rather than MSCs, could be used for cell therapy via transplantation to help re-myelinate nerves and repair the damage.

Bone marrow transplantation (which at its heart is a stem cell therapy) may also be effective to treat or some claim to even cure MS, however this procedure is extremely risky and it alone can kill some patients making it appropriate arguably only for the most extreme cases of MS.

Overall I’m optimistic about stem cell treatments helping MS, but it’s going to take some years and the clinics now offering non-FDA approved treatments for MS should be avoided in my opinion.

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