A stem cell treatment for secondary progressive MS has undergone phase II clinical trials in England.
This is good news because most of the treatments on the market help Relapsing Remitting Multiple Sclerosis, but few new treatments are available for Progressive MS.
What is “Secondary Progressive” MS?
Remember the main MS types, and their symptoms . The source here is the good Julie Stachowiak MS blog at about.com
- Relapsing-Remitting (RRMS): Unpredictable attacks (relapses) followed by periods of relative remission with no new signs of disease activity
- Secondary Progressive (SPMS) : Neurologic decline without acute relapses: A sign that one is evolving from RRMS to SPMS is that the baseline drugs[ CRABT] work less well (Copaxone, Rebif, Avonex, Betaseron and Tysabri); Disability has progressed. This group is fairly large : about 50 % of RRMS evolves into SPMS within age 40.
- Progressive Relapsing (PRMS) : Steady neurologic decline and superimposed attacks.
- Primary Progressive (PPMS) : Decline from the beginning without attacks; problems walking, which gradually get worse; slowly worsening tremor; problems with balance.
Wikipedia, in , singles out the following meds:
- Mitoxantrone (might have cardiac risk for long term use)
- Tysabri (Natalizumab)
- Some Interferons might work for some people.
Recent research in stem cell therapy has brought some new venues for Secondary and Primary Progressive MS. The hope, as in all stem cell therapy, is based on regeneration mechanisms that the stem cells initiate. Diseased tissue would make way for healthy one.
The stem cells infused or injected are of two types:
1) Autologous Mesenchymal Stem Cells (AMSC) : Mesenchymal stem cells (MSCs) are found in multiple human adult tissues including Bone marrow, Joints (synovial tissues), and Fat adipose tissues. (Wikipedia). They are multipotent stem cells that can differentiate into a variety of cell types, including: bone cells, cartilage cells, and fat cells.
Usually, direct injection or placement of cells into a site in need of repair may be the preferred method of treatment, as vascular delivery (infusion) can suffer from a “pulmonary first pass effect” where intravenous injected cells are sequestered in the lungs (Wikipedia). That might present additional challenges for MS.
2) Autologous Hematopoietic Stem Cells (AHSC) : They are also multipotent stem cells, and they give rise to all blood cell types. A phase II study was conducted about infusion of these stem cells on MS patients [ 3]. The results were encouraging: “Relapses dramatically decrease and inflammatory MRI activity is almost completely suppressed...” Yes, they are still talking about improvement in relapses, which does not demonstrate directly progress in SPMS. Progresssive Relapsing (PRMS) , maybe?
Warnings of caution have also been issued  for Mesenchymal Stem Cells Transplants. Of concern are stem cell migrating to wrong parts of the brain, and forming masses, or “… More disturbing, the mesenchymal stem cells seemed to play out their natural biology in the brain – making connective tissue, such as cartilage, in response to inflammatory cues…”
We will let you know when we hear something….
Hope this helps, and talk to your Doctor
- About.com ; Julie Stachowiak
- The Lancet ; “Autologous mesenchymal stem cells for the treatment of secondary progressive multiple sclerosis: an open-label phase 2, a proof-of-concept study” ; Jan 2012
- The Lancet ; “Autologous haematopoietic-stem-cell transplantation for multiple sclerosis.” ; Jan. 2005
- Biology of Blood and Marrow Transplantation ; “Hematopoietic stem cell transplantation for multiple sclerosis: collaboration of the CIBMTR and EBMT to facilitate international clinical studies.” ; Aug 2010
- Brain; Oxford journals ; “Autologous haematopoietic stem cell transplantation fails to stop demyelination and neurodegeneration in multiple sclerosis” ; Feb. 2007
- Beaker; Sanford-Burnham ; “A Word of Caution on Mesenchymal Stem Cells” ; March 2011