Stem Cell Therapy for Multiple Sclerosis
Multiple Sclerosis, also known as disseminated sclerosis or encephalomyelitis disseminata, is an inflammatory and autoimmune disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring resulting in a broad spectrum of symptoms.
In 1996 the United States National Multiple Sclerosis Society standardized four subtype definitions. Each exhibits a different set of progressive symptoms, at different rates and times.
- Relapsing remitting
- Secondary progressive
- Primary progressive
- Progressive relapsing
In all of the four subtypes of MS the nerves cells ability to communicate in the brain and spinal cord is affected. Nerve cells communicate by sending electrical signals called action potentials down long fibers called axons which are wrapped in an insulating substance, called myelin. In MS, the bodies own immune system attacks and damages the myelin. When myelin is lost, the axons can no longer effectively conduct signals. The name multiple sclerosis refers to scars (scleroses better known as plaques or lesions) particularly in the white matter of the brain and spinal cord, which is mainly composed of myelin.
Although there is no cure for MS, at the present time, there are treatments available that may slow its progression and associated symptoms.
At World Stem cells Clinic in Cancun our physicians treat MS differently from standard methods because, instead of temporarily masking symptoms with drugs, we use a drug-free alternative focused on making physical changes by helping your body to heal and improve functions that may improve your quality of life. There is a growing body of evidence that indicates that by changing the level of inflammation and modifying immune function, via the stem cells, the treatment helps the body to decrease or reverse the progressive demyelination process.
We collect scientific data following your treatment and track your results to help us and others learn and optimize future treatments. As a member of ICMS, the International Cellular Medicine Society we enroll all of our patients in their registry and have them independently contacts our patients over the course of two or more years. During this time they will report on all changes and post the information, without your name or identification. This transparent process is the only way that international progress will proceede.
Autologous Stem-Cell Transplant: Phases of the Procedure:
After a review of your medical records and discussions with medical staff, a protocol is designed especially for you. Specifics of your condition are addressed along with any special needs. It may be similar to the one illustrated below:
At the clinic you will be examined by our physicians. Information including any risks and expectations concerning your treatment, plus answers to any questions you may have will be addressed. A blood draw, to determine cell counts and other chemistries will be collected and cell expansion medication may be administered. Then you will return to your hotel for a restful day or a good nights sleep.
At the clinic our physician/s will review the laboratory results, determine if the cell count is within range, and discuss the response to the stimulation. They may or may not provide additional cell expansion medications and may add adjunctive treatments. The levels of your response will determine if you would return to the hotel, with little restriction on your activities, or possibly go forward with harvesting and processing your cells.
If the cell count and viability is appropriate for harvest either a bone marrow or adipose collection will be utilized. We typically use local anesthetics for adults and general anesthesia for youngsters. The entire procedure normally takes less than 30 minutes. Although some pain is felt when the needle is inserted, most patients do not find the bone marrow or adipose collection procedure particularly painful.
We recently placed a number of videos on our website interviewing our patient’s who discuss the procedure and their lack of discomfort.
After the collection you may return to the hotel, with some restrictions. The bone marrow or adipose collected is processed in our contract State-Of-Art laboratory by trained staff, under the supervision of the lab physician.
As an alternative to the above, cord blood may be used based on the patient’s individual medical condition and options.
At the clinic or at the hospital you will be treated by IV infusion and/or a lumbar puncture, which injects the stem cells into the cerebrospinal fluid. This route transports the cells into the spinal canal and the brain directly influencing the nervous systems, thereby eliminating the brain/blood barrier. If a lumbar puncture is performed, the patient will be required to restrict their activities and potentially spend the day in the hospital or at their hotel.
At the clinic or hospital the patient will receive a post-treatment examination and evaluation prior to their release. Additional therapy and treatments may also be utilized to maximize the placement and activities of the procedure.
Day 6: Optionally there may be the use of additional ancillary therapies to enhance the procedure.
What makes our treatment different ?
Our approach includes stimulation, prior to collection, processing and expansion of the cell along with the use of growth factors, together with an integrated medical approach. This maximizes the growth and implantation potentials yielding optimized potentials of making changes in your disease.
Our staff physicians are all board certified, in their field with years of experience. Your team includes both primary and ancillary care professionals devoted to maximizing your benefits from the procedures. We enroll you in an open registry to track your changes independently, for up to 20 years.
As our patient we also keep you abreast of the newest developments in stem cell research. This is an ongoing relationship to maintain and enhance your health.
Our promise is to provide you with travel and lodging support, access to bilingual staff members throughout the entire process and most importantly the best medical care possible.
References and Articles:
Exp Hematol.2012 Nov;40(11):892-8. doi: 10.1016/j.exphem.2012.07.003. Epub 2012 Jul 4.
Autologous hematopoietic stem cell transplantation with reduced-intensity conditioning in multiple sclerosis.
Shevchenko JL, Kuznetsov AN, Ionova TI, Melnichenko VY, Fedorenko DA, Kartashov AV, Kurbatova KA , Gorodokin GI Novik AA.
Pirogov National Medical Surgical Center, the Department of Haematology and Cellular Therapy and the Department of Neurology, Moscow, Russia.
High-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation (AHSCT) is a new and promising approach to multiple sclerosis (MS) treatment. In this article, we present the results of a prospective phase II open-label single-center study with the analysis of the safety and efficacy of high-dose immunosuppressive therapy+AHSCT with reduced-intensity conditioning regimen in 95 patients with different types of MS. The patients underwent early, conventional, and salvage/late transplantation. Efficacy was evaluated based on clinical and quality of life outcomes. No transplantation-related deaths were observed. The mobilization and transplantation procedures were well tolerated. All the patients, except one, responded to the treatment. At long-term follow-up (mean 46 months), the overall clinical response in terms of disease improvement or stabilization was 80%. The estimated progression-free survival at 5 years was 92% in the group after early AHSCT vs 73% in the group after conventional/salvage AHSCT. Statistically significant difference between the survival probabilities of two groups was determined (p = 0.01). No active, new, or enlarging lesions in magnetic resonance imaging were registered in patients without disease progression. All patients who did not have disease progression were off therapy throughout the post-transplantation period. AHSCT was accompanied by a significant improvement in patient’s quality of life with statistically significant changes in the majority of quality of life parameters (p < 0.05).The results of our study support the feasibility of AHSCT with reduced-intensity conditioning in MS patients. Multicenter cooperative studies are needed for better assessment of treatment results and optimization of the treatment protocol of AHSCT with reduced-intensity conditioning regimens in MS.
Copyright © 2012 ISEH – Society for Hematology and Stem Cells. Published by Elsevier Inc. All rights reserved.
Multiple Sclerosis reversed with stem cell therapy 11:57 30 January 2009 by Linda Geddes
Three years later, 17 of the (24) patients had improved by at least one point on a standard disability scale, while none of the patients had deteriorated.
Bone Marrow Stem Cells Show Exciting Potential For Multiple Sclerosis Treatment Medical News Today Article Date: 06 May 2010 – 1:00PDT
The procedure was well tolerated and the participants were followed up for a year. No serious adverse effects were encountered. The results of clinical scores were consistent with stable disease. The results of neurophysiological tests raised the possibility of benefit. (see below study)
Multiple Sclerosis ‘reversed’ with stem cell therapy11:57 30 January 2009 by Linda Geddes
Three years later, 17 of the (24) patients had improved by at least one point on a standard disability scale, while none of the patients had deteriorated.
Safety and Feasibility of Autologous Bone Marrow Cellular Therapy in Relapsing-Progressive Multiple Sclerosis
The lack of serious adverse effects and the suggestion of a beneficial effect in this small sample of patients with progressive disease justify conducting a larger phase II/III study
C M Rice1, E A Mallam1, A L Whone1,2,3, P Walsh1, D J Brooks2, N Kane1, S R Butler3, D I Marks4 and N J Scolding1?
Clinical Pharmacology & Therapeutics (2010) 87 6, 679–685. doi:10.1038/clpt.2010.4
Early-Stage Multiple Sclerosis Reversed By Stem Cell Transplant
Medical News Today Article Date: 31 Jan 2009 –
Researchers from Northwestern University’s Feinberg School of Medicine appear to have reversed the neurological dysfunction of early-stage multiple sclerosis patients by transplanting their own immune stem cells into their bodies and thereby”resetting” their immune systems.
“This is the first time we have turned the tide on this disease,” said principal investigator Richard Burt, M.D. chief of immunotherapy for autoimmune diseases at the Feinberg School
Stem Cell Transplant Study Shows Promise For Multiple Sclerosis
Article Date: 12 Jun 2009 – 3:00 PDT
“Some 81 percent of patients in the early phase study showed signs of improvement with the treatment, which used chemotherapy to destroy the immune system, and injections of the patient’s bone marrow cells taken beforehand to rebuild it.”
Clinical Outcome of 50 Progressive Multiple Sclerosis Patients Treated with Cellular Therapy in Iraq
International Journal of Stem Cells 2011 Nov; 4(2): 113~11
|Abdul Majeed A. Hammadi, Andolina Marino, Saad Farhan|
|Bone Marrow Transplantation Centre, Medical City, Baghdad, Iraq, Bone Marrow Transplantation Center, Trieste, Italy, Department of Neurosurgery, Almustansyrea Medical College, Baghdad, Iraq|
Background and Objectives: Multiple Sclerosis is a disease characterized by multifocal areas of demyelination in the brain and spinal cord, with associated inflammatory cell infiltrates, reactive gliosis, and axonal degeneration. It typically presents in young adults with episodic neurologic dysfunction, our aim is to find new simple method to treat multiple sclerosis by hematopoietic stem cells derived from peripheral blood. Methods and Results: 50 patients suffering from multiple sclerosis worsening despite pharmacological treatment were treated by means of several intrathecal injections of peripheral blood cells harvested by aphaeresis after G-CSF(granulocyte colony stimulating factor) treatment. 24 patients (48%) had a reduction of EDSS score. 8 patients had a relapse, but it was milder than usual and more easily controlled by cortisone. Conclusions: Since mesenchymal cells increase in the peripheral blood after G-CSF stimulation, a peripheral blood harvest seems easier and cheaper than mesenchymal cells cultivation prior to the injection. It seems a reasonable treatment for progressive multiple sclerosis
Comment: We have been using a modified approach to this practice for 3 years prior to this publication. When combined with multiple other stimulants the cell counts are both superior and faster to achieve.
Fat Tissue Stem Cells Offer Hope For Multiple Sclerosis Treatment
Article Date: 24 Apr 2009 – 1:00 PDT
“All three patients in our study showed dramatic improvement in their condition after the course of SVF therapy.”
Immune System Helps Transplanted Stem Cells Navigate In Central Nervous System
Medical News Today Article Date: 02 Jun 2010 – 5:00 PDT
“In this study, we’ve taken an important step by showing the navigational cues in an inflammatory environment like MS that guide stem cells,”
Non-expanded adipose stromal vascular fraction cell therapy for multiple sclerosis? “
Journal of Translational Medicine 2009, 7:29 doi:10.1186/1479-5876-7-29 Riordan NH, et al
Although non-expanded SVF cells have been used successfully in accelerating healing of Crohn’s fistulas, to our knowledge clinical use of these cells for systemic immune modulation has not been reported. In this communication we discuss the rationale for use of autologous SVF in treatment of multiple sclerosis and describe our experiences ( with three patients.”
(These are excerpt from the three patient observations)
#233 Three months after the stem cell infusions the patient reported a significant improvement of his balance and coordination as well as an improved energy level and mood.
#255 His gait, balance and coordination improved dramatically oven a period of several weeks. His condition continued to improve over the next few months and he is currently reporting a still continuing improvement and ability to jog, run and bike for extended periods of time daily.
#231 The patient also reported significantly improved memory, sexual function, and energy level. Currently, the patient is taking only multivitamin, minerals and Omega 3.
Precision with Stem Cells a Step Forward for Treating M.S., Other Diseases
October 13, 2011 Health & Medicine
Scientists have improved upon their own previous world-best efforts to pluck out just the right stem cells to address the brain problem at the core of multiple sclerosis and a large number of rare, fatal children’s diseases.
Details of how scientists isolated and directed stem cells from the human brain to become oligodendrocytes – the type of brain cell that makes myelin, a crucial fatty material that coats neurons and allows them to signal effectively – were published online and in the October issue of Nature Biotechnologyby scientists at the University of Rochester Medical Center and the University at Buffalo.
Scientists injected the cells into the brains of mice that were born without the ability to make myelin. Twelve weeks later, the cells had become oligodendrocytes and had coated more than 40 percent of the brain’s neurons with myelin – a four-fold improvement over the team’s previous results published in Cell Stem Cell and Nature Medicine.
“These cells are our best candidates right now for someday helping patients with M.S., or children with fatal hereditary myelin disorders,” said Steven Goldman, M.D., Ph.D.,the leader of the team and professor and chair of the Department of Neurology at the University of Rochester Medical Center. “These cells migrate more effectively throughout the brain, and they myelinate other cells more quickly and more efficiently than any other cells assessed thus far. Now we finally have a cell type that we think is safe and effective enough to propose for clinical trials.”
“Characterizing and isolating the exact cells to use in stem cell therapy is one key to ultimately having success,” said Sim. “You need to have the right cells in hand before you can even think about getting to a clinical trial to treat people. This is a significant step.”
In the experiments described in Nature Biotechnology, for instance, the team was able to use a molecule called BMP4 to direct the stem cells to become support cells of the brain – astrocytes – while another molecule called Noggin led them to become oligodendrocytes.
“These cells are very responsive to cues in their local environment,” said Goldman. “It’s crucial to select the right type of stem cell, but it’s just as important to create an environment with the molecular signals necessary to produce the type of cell needed for a particular condition or illness.”
The current work focuses on the creation of myelin; besides its loss in multiple sclerosis and childhood disorders, myelin loss plays a role in diseases as diverse as cerebral palsy, diabetes, high blood pressure, and some cases of stroke. While Goldman’s team has had previous success remyelinating the brains of mice born without the substance, the new results identify a specific subset of cells that appear to be the most efficient yet at producing myelin and improve the hope of developing cell therapy as a way to treat these diseases.
An eventual treatment of a disease like M.S. might involve injecting stem cells to create myelin in the brains of patients. Along those lines, Martha Windrem, Ph.D., an author of the paper and assistant professor in Rochester’s Department of Neurology, has developed methods to inject cells in such a way that they migrate throughout a large swath of the brain, laying down myelin on neurons as they go.
Note: This approach is similar to the growth factors and bone marrow harvest currently employed in our protocols.
Immunosuppressive properties of mesenchymal stem cells: advances and applications.
Mesenchymal stem cells (MSCs) have been isolated from a variety of tissues, such as bone marrow, skeletal muscle, dental pulp, bone, umbilical cord and adipose tissue. MSCs are used in regenerative medicine mainly based on their capacity to differentiate into specific cell types and also as bioreactors of soluble factors that will promote tissue regeneration from the damaged tissue cellular progenitors. In addition to these regenerative properties, MSCs hold an immunoregulatory capacity, and elicit immunosuppressive effects in a number of situations. Not only are they immunoprivileged cells, due to the low expression of class II Major Histocompatibilty Complex (MHC-II) and costimulatory molecules in their cell surface, but they also interfere with different pathways of the immune response by means of direct cell-to-cell interactions and soluble factor secretion. In vitro, MSCs inhibit cell proliferation of T cells, B-cells, natural killer cells (NK) and dendritic cells (DC), producing what is known as division arrest anergy. Moreover, MSCs can stop a variety of immune cell functions: cytokine secretion and cytotoxicity of T and NK cells; B cell maturation and antibody secretion; DC maturation and activation; as well as antigen presentation. It is thought that MSCs need to be activated to exert their immunomodulation skills. In this scenario, an inflammatory environment seems to be necessary to promote their effect and some inflammation-related molecules such as tumor necrosis factor-α and interferon-γ might be implicated. It has been observed that MSCs recruit T-regulatory lymphocytes (Tregs) to both lymphoid organs and graft. There is great controversy concerning the mechanisms and molecules involved in the immunosuppressive effect of MSCs. Prostaglandin E2, transforming growth factor-β, interleukins- 6 and 10, human leukocyte antigen-G5, matrix metalloproteinases, indoleamine-2,3-dioxygenase and nitric oxide are all candidates under investigation. In vivo studies have shown many discrepancies regarding the immunomodulatory properties of MSCs. These studies have been designed to test the efficacy of MSC therapy in two different immune settings: the prevention or treatment of allograft rejection episodes, and the ability to suppress abnormal immune response in autoimmune and inflammatory diseases. Preclinical studies have been conducted in rodents, rabbits and baboon monkeys among others for bone marrow, skin, heart, and corneal transplantation, graft versus host disease, hepatic and renal failure, lung injury, multiple sclerosis, rheumatoid arthritis, diabetes and lupus diseases. Preliminary results from some of these studies have led to human clinical trials that are currently being carried out. These include treatment of autoimmune diseases such as Crohn’s disease, ulcerative colitis, multiple sclerosis and type 1 diabetes mellitus; prevention of allograft rejection and enhancement of the survival of bone marrow and kidney grafts; and treatment of resistant graft versus host disease. We will try to shed light on all these studies, and analyze why the results are so contradictory.
Comment: This is an excellent example of a literature review and then subsequent inquiry into some of the known and as yet to be found pathways that allow the stem cells their ability to positively impact diseases. I think it’s interesting that “mother nature’ allows these cells such a pervasive impact on the inflammatory processes. Great design…