The promise of stem cell and regenerative therapies for multiple sclerosis.
The regenerative capacity of the adult central nervous system (CNS) is severely limited and although partial regeneration can be observed in the CNS of multiple sclerosis (MS) patients, these attempts at repair have been universally unsuccessful in preventing the accumulation of irreversible neurological deficits. Novel therapies to treat MS must therefore take into account the need for both immunomodulation and neuroprotection and, as such, multifaceted treatment strategies are required. Two complimentary approaches that aim to regenerate an incapacitated CNS have recently emerged. Firstly, targeting degraded myelin growth inhibitory molecules released as a consequence of the inflammatory process provides a unique opportunity to manipulate the microenvironment of the degenerating CNS. Proof of concept studies have established that this therapeutic approach has tremendous potential in regenerating damaged axons as demonstrated in models of spinal cord injury (SCI) and experimental autoimmune encephalomyelitis (EAE), an animal model for MS. In addition, stem cell based therapies offer a means of modulating inflammatory immune cells and promoting tissue repair as shown in a number of allogeneic transplant and autoimmune settings. This review attempts to summarise some of these approaches.
Payne
Natalie
N
Monash University, Clayton, Victoria, 3800, Australia. natalie.payne@med.monash.edu.au
Siatskas
Christopher
C
Bernard
Claude C A
CC
D000818:Animals; D002490:Central Nervous System / Q000276:immunology* / Q000378:metabolism; D054360:Chemokine CXCL1 / Q000276:immunology / Q000378:metabolism; D006801:Humans; D008565:Membrane Proteins / Q000276:immunology / Q000378:metabolism; D009103:Multiple Sclerosis / Q000276:immunology / Q000378:metabolism / Q000628:therapy*; D009185:Myelin Proteins / Q000276:immunology / Q000378:metabolism; D009419:Nerve Tissue Proteins / Q000276:immunology / Q000378:metabolism; D009474:Neurons / Q000166:cytology / Q000502:physiology / Q000637:transplantation*; D000070798:Nogo Proteins; D012038:Regeneration / Q000502:physiology; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000276:immunology* / Q000378:metabolism
D054360:Chemokine CXCL1; C482293:LINGO1 protein, human; D008565:Membrane Proteins; D009185:Myelin Proteins; D009419:Nerve Tissue Proteins; D000070798:Nogo Proteins; C000603199:RTN4 protein, human