Multiple sclerosis is a chronic neurological disease that
affects the brain and spinal cord. In multiple sclerosis, an immune reaction
breaks down the covering around neuronal axons, myelin. Depending on where in
the brain or spinal cord this inflammation occurs, patients with multiple
sclerosis may experience weakness, a lack of sensation, double vision, difficulty
walking, difficulty with balance, problems with urination, dizziness, and/or
pain. Over time, patients with multiple sclerosis require assistive devices
such as canes or wheelchairs to get around, and some ultimately become
Multiple sclerosis can be divided into 4 types:
Clinically isolated syndrome – The first episode of MS; about two-thirds of people with a clinically isolated syndrome of MS will go on to have one of the other types listed below
Relapsing-remitting – Patients have symptoms for a
time, which resolve, but then eventually return
Secondary progressive – After some cycles of flare-ups
and remissions, the disease is present all the time; some patients with
relapsing-remitting disease develop secondary progressive MS
Primary progressive – Once symptoms start, they do
not resolve but instead get progressively worse
Fortunately, there are some treatments that can change the
course of multiple
sclerosis. There are several disease-modifying agents available for people
with relapsing-remitting disease and a few for progressive multiple sclerosis.
These drugs can reduce the rate at which symptoms get worse or extend the
length of time between flare-ups. Unfortunately, not everyone can tolerate
these drugs, and, in others, the drugs are not very effective. None of these
drugs is a cure for multiple sclerosis.
Researchers have turned to mesenchymal
stem cells as a possible treatment for multiple sclerosis. These cells have
the ability to regulate the immune system and support the nervous system. There
have been so many clinical trials of stem cells in multiple sclerosis that
researchers can now perform a meta-analysis on them. A meta-analysis is a
special study in which all trials on a particular topic are combined and
analyzed, i.e., a study of studies.
In their recent meta-analysis, Dr. Zhou and co-authors identified 9 clinical studies using mesenchymal stem cells to treat multiple sclerosis. They found that the rate of disease progression with stem cell treatment was 16% at 6 months and 35% at 1 year. This is a faster rate of decline than disease-modifying treatment, but better than no treatment at all. Importantly, the MS patients treated with stem cells had much more severe disease than average—it was a group for whom disease-modifying treatment had failed. From this perspective, stem cell treatment for MS was a great success.
Most patients had no evidence of disease activity at 6
months (72%) and 1 year (62%) after autologous
mesenchymal stem cell treatment. This a substantial duration of time to be
The authors noted that stem cells transplanted via the intrathecal
route (i.e. directly in the cerebrospinal fluid) resulted in a slower
progression of disability.
Taken together, these results are encouraging. The authors also concluded that mesenchymal stem cell treatment was safe. More work with larger patient groups are needed, but this is an exciting avenue of research.
Reference: Zhou, Y., et al. (2019). Autologous Mesenchymal
Stem Cell Transplantation in Multiple Sclerosis: A Meta-Analysis. Stem Cells
International. 2019, Volume 2019 |Article ID 8536785.
While researchers have been puzzled over the precise contributing factors behind Multiple Sclerosis (MS) for many years, it is widely believed that risk factors are both genetic and environmental. Recently, more evidence has been uncovered which points to the role of environmental factors, and specifically, diet, in a person’s likelihood of developing the condition. A new study on the influence of diet has been published in The Journal of Nutrition and indicates a link between red meat consumption and a reduced risk of first clinical diagnosis of central nervous system demyelination (FCD), a precursor to MS.
MS Risk & Red Meat Consumption: A Noteworthy Association
Researchers used data from more than 280 individuals who had experienced FCD, and more than 550 control participants who hadn’t. The participants were ranked according to a points-based diet score which measured how many servings of red meat they consumed as part of a Mediterranean diet. The scores of the people who consumed three or more servings of unprocessed red meat were found to have a reduced risk of FCD, compared to those who consumed two or fewer.
Why Could Red Meat Help?
According to one of the lead study researchers, the nutrients found in red meat, including omega-3 fatty acids, zinc, protein, potassium, vitamin D, and selenium, are all known to contribute to brain functioning. One critical component to the potential benefits is choosing high-quality meats, however. The research shows sources such as grass-fed beef are linked to the reduced risk, and the study participants largely maintained good eating patterns, as they followed a Mediterranean diet. This approach to eating is known to boost cardiovascular health and prioritizes the intake of healthy fats, vegetables, fruits, and whole grains, among other key components.
Who Do These Findings Affect?
The study findings show that for individuals who had a first-degree relative with MS, the risk would drop from 2 to 4% down to 1 to 2.5%. The greatest benefit is seen among individuals who have an identical twin with MS: for this population, the risk drops from 30 to 50% down to 14 to 32%. The findings also suggest that the more unprocessed red meat the individual consumes, the greater the reduction of risk may be.
Ultimately, the benefits of eating red meat appear to be greatest for the populations with a close relative with MS. It’s worth noting, however, that authorities such as the World Health Organization have issued warnings against red meat, and suggest that it could be carcinogenic to humans. Dietary modifications such as these should, therefore, be discussed with a doctor before being introduced into an individual’s daily routine.
Amyotrophic Lateral Sclerosis(ALS, Lou Gehrig’s disease) and Multiple Sclerosis (MS) are two separate diseases with some important similarities. Both ALS and MS interfere with a person’s ability to move. In both diseases, nerve cells are affected. In fact, in both diseases, cells of the immune system seem to attack and destroy the material that wraps around nerve fibers. Without this covering, nerve cells do not function properly, which is why muscle weakness and other problems occur in both ALS and MS.
Traditional treatments for MS and ALS are different. More than 15 drugs are approved to treat MS. In many patients, one or more of these treatments can help reduce flareups and perhaps slow the progression of the disease (ocrelizumab in progressive MS). ALS, on the other hand, is a very progressive condition. Two drugs (riluzole and edaravone) modestly slow down the rate at which ALS gets worse. Neither MS nor ALS, it should be mentioned, can be cured.
Because of the similarities between these distinct diseases, researchers conducted a clinical trial of both MS and ALS patients. The doctors infused mesenchymal stem cells into patients and followed their progress. The goals of the study were to determine if stem cell infusion was safe and if it was effective.
In MS patients, stem cell infusion helped reduce physical disability (mean score on the Expanded Disability Status Scale improved) for at least six months. In ALS patients, mesenchymal stem cell infusion appeared to stabilize the disease for at least six months (average score on the Amyotrophic Lateral Sclerosis Functional Rating Scale stayed the same). Given that ALS patients tend to decline rapidly, maintaining stability is actually a great success.
Interestingly, researchers conducted an MRI the day after stem cell infusion and found the stem cells were already moving to various places around the brain and spinal cord. This finding suggests that stem cell infusion works very rapidly, and that stem cells target diseased regions within the body.
It should be noted that many patients had temporary symptoms related to the injection such as fever and headache. The symptoms went away within days, however. Importantly, no major adverse events occurred during two years of follow-up.
Taken together, this research suggests that mesenchymal stem cell transplantation is a safe and effective treatment for patients with MS and ALS. Moreover, this infusion causes virtually immediate effects in the central nervous system. While more research is needed, these results may offer hope to patients with these challenging neurological diseases.
Reference: Karussis, D. et al. (2010). Safety and immunological effects of mesenchymal stem cell transplantation in patients with multiple sclerosis and amyotrophic lateral sclerosis. Archives of Neurology. 2010 Oct;67(10):1187-94.
Multiple Sclerosis is a disease of the nervous system that involves the demyelination of nerve cells. As nerve cells lose their myelination, it becomes harder for the cells to communicate with one another. Though there are a number of treatment options for multiple sclerosis, which usually involve immunosuppressants, the conventional treatments do not always work over the long-term and may be associated with unwanted side effects. Given the promising results of stem cells being used in treatments for other nervous system diseases, scientists have reasoned that stem cells could provide a valuable therapy for those with multiple sclerosis.
A recent study published in Cytotherapy has demonstrated for the first time the use of neural progenitors derived from bone marrow mesenchymal stem cells. According to the authors of the study, it has previously been recognized that these cells have the potential to help with multiple sclerosis therapy, whether they come from multiple sclerosis patients or those without multiple sclerosis. Preclinical research has also shown that the use of these stem cells can improve disease in multiple sclerosis models and lead to the recruitment of progenitors to sites of inflammation.
In the current study, scientists wanted to establish the safety and dosing of intrathecal neural progenitors derived from bone marrow mesenchymal stem cells in the treatment of multiple sclerosis and investigated the use of these cells in six patients with progressive multiple sclerosis who were not responding to conventional treatments. The patients were treated with between 2 and 5 injections of the stem cells, and they were evaluated for an average of 7.4 years following their first injection.
Not only were there no safety issues that arose with any of the treated patients, but 4 of the 6 patients demonstrated measurable clinical improvement through the use of stem cell treatment. The results of this pilot study provide support for both the tolerability and effectiveness of stem cell therapy for multiple sclerosis. Future research will help to clarify the specific protocols that may be used to achieve the desired results in this group of patients.
Reference: Harris, VK, Vyshkina, T, & Sadaiq, SA. (2016). Clinical safety of intrathecal administration of mesenchymal cell-derived neural progenitors in multiple sclerosis. Cytotherapy, 18(12), 1476-1482.
Multiple sclerosis (MS) is a chronic inflammatory condition of the central nervous system. The disorder produces a broad range of symptoms, including fatigue and poor muscle coordination, which can make exercise daunting. Yet, research shows that in addition to prescription-based approaches, complementary therapies such as exercise may help to alleviate symptoms and minimize the risk of secondary conditions. Discover more about the relationship between exercise and MS below.
How Does Exercise Help MS?
Exercise has been shown to improve a number of MS symptoms. In addition to promoting better overall health, embarking on an aerobic fitness routine has helped people with MS improve strength and cardiovascular fitness, maintain better bladder and bowel function, and reduce fatigue and depression. Additionally, exercise program participants have reported a more positive attitude and increased social activity.
What’s the Best Type of Exercise for MS?
While light to moderate activity can help to control MS symptoms, any activity that’s too strenuous can have the opposite effect, exacerbating issues like fatigue and increased risk for injury. It’s, therefore, a good idea to work with a professional, such as a physical therapist, before beginning any new exercise routine.
Light activities like gardening, low-impact aerobic exercises, stretching, and progressive strength training are well-suited for many people with MS. Additionally, water-based exercises are especially ideal. Water provides buoyancy, enabling participants to move in ways they may not be able to on land while eliminating the risk of fall injuries. Plus, accessories like flotation vests and pool noodles can be implemented to maintain safety. Finally, the water keeps participants cool, thereby reducing the risk of overheating which can cause MS symptoms to flare.
If you’re interested in pursuing a fitness program to help manage your MS symptoms, be sure to work with your care providers to find an approach that will best suit you.
A new study has shown that a protocol for treating Multiple Sclerosis with stem cells is safe. According to the researchers, the potential for using stem cells in Multiple Sclerosis therapy warrants further investigation. The results of the study were published in the Journal of Translational Medicine.
Stem cells – and specifically, mesenchymal stem cells, have been increasingly used in the treatment of immune and inflammatory conditions. Based on the success that has been seen in these areas, scientists reasoned that mesenchymal stem cells may also represent a useful approach to treat Multiple Sclerosis, a neurological disease that involves the abnormal attack by the immune system on the myelin sheath that insulates nerves and allows nerve cells to communicate effectively and efficiently with one another.
To test this idea, the scientists used umbilical cord mesenchymal stem cells in 20 Multiple Sclerosis patients. The patients were given intravenous injections of the stem cells each day for seven days. The researchers evaluated the patients – with both neurological testing and nervous system imaging – at baseline, one month after treatment, and one year after treatment. The researchers found that the stem cell treatment improved neurological scores in patients and that lesions in the brain and cervical spinal cord were inactive one year after the stem cell injections. There were no serious adverse side effects associated with the treatment.
Based on these findings, it is possible that stem cells will provide a useful treatment option for those with Multiple Sclerosis. With more research, we will better understand exactly how stem cells can be used to help this population of patients.
Reference: Riordan, N.H. et al. (2018). Clinical feasibility of umbilical cord tissue-derived mesenchymal stem cells in the treatment of multiple sclerosis. Journal of Translational Medicine, 16(57), 1-12.