Autologous mesenchymal stem cell therapy in progressive multiple sclerosis: an open label study.
Despite updating knowledge and a growing number of medications for multiple sclerosis (MS), no definite treatment is available yet for patients suffering from progressive forms of the disease. Autologous bone marrow derived mesenchymal stem cell (BM-MSC) transplantation is a promising method proposed as a therapy for MS. Although the safety of these cells has been confirmed in hematological, cardiac and inflammatory diseases, its efficacy in MS treatment is still under study. Patients with progressive MS (expanded disability status scale score: 4.0 -6.50) unresponsive to conventional treatments were recruited for this study. Twenty-five patients [f/m: 19/6, mean age: 34.7±7] received a single intrathecal injection of ex-vivo expanded MSCs (mean dose: 29.5×10(6) cells). We observed their therapeutic response for 12 months. Associated short-term adverse events of injection consisted of transient low-grade fever, nausea /vomiting, weakness in the lower limbs and headache. No major delayed adverse effect was reported. 3 patients left the study for personal reasons. The mean (SD) expanded disability status scale (EDSS) score of 22 patients changed from 6.1 (0.6) to 6.3 (0.4). Clinical course of the disease (measured by EDSS) improved in 4, deteriorated in 6 and had no change in 12 patients. In MRI evaluation, 15 patients showed no change, whereas 6 patients showed new T2 or gadolinium enhanced lesions (1 lost to follow-up). It seems that MSC therapy can improve/stabilize the course of the disease in progressive MS in the first year after injection with no serious adverse effects. Repeating the study with a larger sample size, booster injections and longer follow-up using a controlled study design is advised.
Immunogenetics Research Centre, Department of Immunology, Tehran University of Medical Sciences, Tehran, Iran.
Mandana Mohyeddin
MM
Bonab
Mohammad Ali
MA
Sahraian
Aida
A
Aghsaie
Sanaz Ahmadi
SA
Karvigh
Seyed Massoud
SM
Hosseinian
Behrouz
B
Nikbin
Jamshid
J
Lotfi
Saeideh
S
Khorramnia
Mohammad Reza
MR
Motamed
Mansoureh
M
Togha
Mohammad Hossien
MH
Harirchian
Nahid Beladi
NB
Moghadam
Katayoun
K
Alikhani
Samira
S
Yadegari
Sirous
S
Jafarian
Mohammad Reza
MR
Gheini
D000328:Adult; D001324:Autoantigens / Q000276:immunology; D018450:Disease Progression; D018572:Disease-Free Survival; D004351:Drug Resistance; D005260:Female; D005334:Fever / Q000209:etiology / Q000517:prevention & control; D005500:Follow-Up Studies; D005682:Gadolinium / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D020528:Multiple Sclerosis, Chronic Progressive / Q000150:complications / Q000628:therapy*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology / Q000517:prevention & control; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D001324:Autoantigens; D005682:Gadolinium