Allogenic Stem Cell Therapy for Amyotrophic Lateral Sclerosis (ALS) in India: A Detailed Overview
Exploring the potential of Allogenic stem cell therapy in India — an emerging avenue for treatment and management of the neurodegenerative disorder Amyotrophic Lateral Sclerosis (ALS)
Overview:
Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disorder, primarily affecting the motor neurons of the human brain and spinal cord. Commonly known as Lou Gehrig’s disease, the ailment eventually leads to degeneration of those neurons responsible for controlling voluntary muscle movements. As a result, the patient faces muscle weakness, atrophy, eventually leading to paralysis. ALS causes complete loss of a patient’s ability to move, breathe, swallow, or speak. A patient suffering from ALS often faces complete respiratory failure within 3-5 years of diagnosis, resulting in death.
The biggest challenge about ALS is that there are no effective treatments available at present to reverse the symptoms or prevent the disease from progressing in the human body. There are very few medications, such as riluzole and edaravone, which also offer very modest benefits. In the last few years, stem cell therapy has emerged as a ray of hope and a promising pathway of research for Amyotrophic Lateral Sclerosis (ALS).
The advancements in stem cell therapy research indicate that stem cell therapy has the potential to not only slow down and stop the degenerative process in the neurons but also reverse the impacts of the disease on the human body. Allogenic stem cell therapy, which involves transplanting the donor’s stem cells to a patient’s body, has been showing positive results for a potential ALS treatment. India is witnessing an increased inclination towards the clinical trials of this treatment.
In this detailed article, we explore the potential of Allogenic stem cell therapy for the treatment of Amyotrophic Lateral Sclerosis (ALS) in India.
What is Amyotrophic Lateral Sclerosis (ALS)?
Also known as Lou Gehrig’s disease is a progressive neurological disorder, primarily affecting the motor neurons — a type of nerve cell, which are mainly responsible for carrying signals from the brain and spinal cord to the muscles, resulting in voluntary movement. Once these neurons are damaged or destroyed, they’re not able to transmit the electrical impulses from the brain/spinal cord to the muscles. As a result, the nervous system starts losing grip over the muscles, resulting in the key symptoms an ALS patient commonly faces — muscle weakness, atrophy, restricted muscle movement, inability to breathe, and eventually paralysis. As the disease becomes more severe, the patients are unable to walk, speak, eat, or even breathe.
The exact cause of ALS is still widely unknown; however, certain factors such as genetic mutations, environmental factors, and oxidative stress are considered to be the main contributors to the development of the disease.
| Key Insights:ALS is commonly found in patients aged between 40 to 70. However, it may also appear in people of younger age groups. Classification of ALS disease: Sporadic ALS and Familial ALSSporadic ALS: 90% of the patients suffer from this type of ALS, and it does not show any clear genetic linkFamilial ALS: 5-10% of the patients suffer from this type of ALS, and it is inherited |
Symptoms of Amyotrophic Lateral Sclerosis (ALS)?
Below are the key symptoms of ALS, and these progress as the ailment’s life cycle progresses in the patient’s body.
- Weakness in the Muscles: Patients suffering from ALS experience weakness in muscles as the most common and primary sign of the disease. The weakness typically begins in the limbs or speech muscles.
- Atrophy: Degeneration of motor neurons causes shrinking of muscles, making them weaker.
- Twitching: Fasciculations are another key symptom that people suffering from ALS experience. This includes muscle spasms in the arms, legs, and tongue.
- Loss of Movement Coordination: People with ALS begin to lose muscle coordination, which leads to difficulty in movements (such as lifting objects, walking, and, in fact, swallowing).
- Difficulty with Speech: As the disease becomes severe with time, the patients begin to lose control over the muscles that control speech, leading to difficulties in speech.
- Difficulty in Swallowing: Due to the impairment of muscles, the patient also finds it difficult to swallow.
- Respiratory Failure: ALS eventually weakens the respiratory muscles, causing the failure of the overall respiratory system, including difficulty in breathing. This is one of the most common causes of death in ALS patients.
Allogenic Stem Cell Therapy for ALS
Medical researchers and healthcare experts believe stem cell therapy to be a promising approach for treating ALS. This is because stem cell therapy has the potential to regenerate the damaged motor neurons, repair broken neural circuits, and offer neuroprotection. The capacity of stem cells to differentiate into different types of cells and their ability to replace or repair them make them a favorable treatment option.
What is Allogenic Stem Cell Therapy?
Allogenic stem cell therapy uses stem cells from a donor to treat ALS patients. The stem cells useful for this treatment can be sourced from embryonic stem cells, induced pluripotent stem cells (iPSCs), or adult stem cells such as mesenchymal stem cells (MSCs). These transplanted cells help in the replacement of damaged or degenerated cells. This creates the possibility of restoring the normal function of the nervous system.
For the treatment of ALS, the allogenic stem cell therapy specifically aims at the replacement of damaged motor neurons in the human brain and spinal cord. This helps in the regeneration of the neural circuits to repair and resume voluntary movement.
Allogenic stem cells also offer the possibility offer neuroprotective effects, minimizing inflammation, oxidative stress, and the underlying mechanisms of neuronal death.
Types of Stem Cells Used in ALS Treatment
- Autologous Stem Cells: For these stem cells, the patient is the donor. These cells are derived from different sources of the patient’s body, including bone marrow, adipose tissue, or peripheral blood. This therapy minimizes the risks of rejection of the cells by the patient’s immune system.
- Allogenic Stem Cells: Allogenic stem cells come from a donor. These cells are derived from different parts of the donor’s body, such as embryonic stem cells, induced pluripotent stem cells (iPSCs), or mesenchymal stem cells (MSCs) from umbilical cord tissue or bone marrow. For these stem cells, there’s a potential risk of immune rejection because they are from a different donor. However, this risk can be reduced with the help of immunosuppressive medications.
Mechanisms of Allogenic Stem Cell Therapy in ALS
Neuronal Regeneration:
Stem cells, such as pluripotent cells like iPSCs can differentiate into motor neurons. This creates scope for replacing the damaged motor neurons caused by ALS. With this regeneration, the possibilities of disease slowing down increase, and some motor functions are restored as well.
Neuroprotection:
Mesenchymal stem cells (MSCs) are one of the most widely used stem cell sources for treating ALS. These types of stem cells help in secreting growth factors and cytokines, which further help protect the existing motor neurons. It is particularly important for cases where inflammation and oxidative stress are the main contributors to neurodegeneration.
Reduction of Inflammation:
For the patients suffering from ALS, inflammation is a common symptom, and it plays a crucial role in damaging motor neurons. MSCs help in regulating the immune response and minimizing neuroinflammation. This may further help in slowing down the progression of the disease.
Angiogenesis:
Stem cells may also help promote the growth of new blood vessels in the targeted areas (brain and spinal cord). This further improves the delivery of oxygen and nutrients to damaged tissues, helping the remaining neurons survive.
India has an advanced medical infrastructure and a highly skilled medical workforce. The country has been making strides in advanced medical research and development. Along with the cutting-edge medical services, India is also renowned for offering high-quality medical treatment at affordable costs, as compared to Western countries. These factors collectively have contributed to India becoming a hub for stem cell therapies.
Stem Cell Therapy for ALS is still under trial and experimental stage across the world, various renowned hospitals and clinics in India are providing this treatment to ALS patients. The expert medical setups are approaching this treatment by particularly utilising mesenchymal stem cells (MSCs) from umbilical cord tissue and bone marrow for extracting the stem cells.
From a regulatory point of view, India is approaching these advancements with a progressive mindset. The regulatory bodies in India — the Indian Council of Medical Research (ICMR) and the Department of Biotechnology (DBT) — work to oversee the ethical and scientific use of stem cells. At present, India offers several clinical trials and stem cell therapies for ALS, with a key focus on mesenchymal stem cells (MSCs), induced pluripotent stem cells (iPSCs), and neural stem cells (NSCs).
FAQs
Stem cells are the cells present in human immune system. These have the capacity to develop into different cell types.
This therapy uses stem cells to repair or replace the damaged tissues, cells, and neurons present in a patient’s body. This helps in the regeneration of new cells and slows down the growth.
What is ALS disease?
ALS (Amyotrophic Lateral Sclerosis) is a progressive neurodegenerative disease that primarily affects motor neurons surrounding the brain and spinal cord. ALS causes muscle weakness, loss of motor control, and respiratory failure, eventually causing paralysis and death.
How does stem cell therapy help ALS patients?
With the help of stem cell therapy, new and healthy stem cells are ingested in the patient’s body, which increases the possibility of the following:
- Replace damaged motor neurons
- Protect existing healthy neurons
- Minimize inflammation
- Potentially help restore the motor function
Can stem cell therapy completely cure ALS?
No, stem cell therapy is a potential option for curing ALS, which is at trial stage and aims at minimizing the symptoms, slowing down the disease progression, and helping improve the life quality of the patients.