The therapeutic potential of mesenchymal stem cell transplantation as a treatment for multiple sclerosis: consensus report of the International MSCT Study Group.
Current therapies for multiple sclerosis effectively reduce inflammation, but do little in terms of repair to the damaged central nervous system. Cell-based therapies may provide a new strategy for bolstering regeneration and repair through neuro-axonal protection or remyelination. Mesenchymal stem cells modulate pathological responses in experimental autoimmune encephalitis, alleviating disease, but also stimulate repair of the central nervous system through the release of soluble factors. Autologous and allogeneic mesenchymal stem cells have been safely administered to individuals with hemato-oncological diseases and in a limited number of patients with multiple sclerosis. It is therefore reasonable to move mesenchymal stem cells transplantation into properly controlled human studies to explore their potential as a treatment for multiple sclerosis. Since it is likely that the first such studies will probably involve only small numbers of patients in a few centers, we formed an international panel comprising multiple sclerosis neurology and stem cell experts, as well as immunologists. The aims were to derive a consensus on the utilization of mesenchymal stem cells for the treatment of multiple sclerosis, along with protocols for the culture of the cells and the treatment of patients. This article reviews the consensus derived from our group on the rationale for mesenchymal stem cell transplantation, the methodology for generating mesenchymal stem cells and the first treatment protocol for multiple sclerosis patients.
Freedman
Mark S
MS
University of Ottawa, Ottawa Hospital Research Institute, Ontario, Canada. mfreedman@ottawahospital.on.ca
Bar-Or
Amit
A
Atkins
Harold L
HL
Karussis
Dimitrios
D
Frassoni
Francesco
F
Lazarus
Hillard
H
Scolding
Neil
N
Slavin
Shimon
S
Le Blanc
Katarina
K
Uccelli
Antonio
A
D000818:Animals; D002490:Central Nervous System / Q000503:physiopathology*; D003299:Cooperative Behavior; D004311:Double-Blind Method; D019317:Evidence-Based Medicine; D006801:Humans; D007391:International Cooperation; D045164:Mesenchymal Stem Cell Transplantation; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000601:surgery*; D009416:Nerve Regeneration; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012107:Research Design