(MS) Multiple sclerosis in India is a long-lasting disabling disease that affects the brain, spinal cord (central nervous system) and the optic nerves in eyes. It causes a wide range of symptoms such as problems with vision, muscle control and sensation or balance. In milder cases involves numbness in the limbs while severe cases may involve vision loss or paralysis. It is not possible to predict progression rate multiple sclerosis (MS) for any individual. The effects are often different for everyone who has the disease. Some people show mild symptoms and don’t need treatment while others will have trouble getting around and doing daily activities.
In MS, the immune system targets the protective sheath (myelin) which covers nerve fibers and causes communication problems between the brain and the rest of the body. Eventually, the disease leads to permanent damage or deterioration of the nerves.
Major symptoms of MS include fatigue, vision problems, such as blurred vision, difficulty walking, numbness or tingling in different parts of the body, problems controlling the bladder, problems with balance and coordination, problems with thinking, learning and planning and muscle stiffness and spasms.
More than 400,000 people in the United States have MS, and approx. 10,000 new cases are diagnosed every year. It is 2 to 3 times more common in women compared to men, and diagnosis usually occurs between the ages of 20 and 50 years.
Treatment for Multiple Sclerosis in India
There is no cure for MS. Treatment usually focuses on speeding recovery from attacks, slowing down the progression of the disease and managing symptoms. Some people showed mild symptoms that no treatment is necessary.
Treatments for MS attacks
* Corticosteroids
* Plasma exchange (plasmapheresis)
Treatments to modify progression
* Ocrelizumab (Ocrevus) (FDA-approved disease-modifying therapy)
Treatment options for relapsing-remitting
Injectable medications
* Beta interferons
* Glatiramer acetate (Copaxone, Glatopa)
Oral treatments
* Fingolimod (Gilenya)
* Dimethyl fumarate (Tecfidera)
* Teriflunomide (Aubagio)
Infusion treatments
* Ocrelizumab (Ocrevus)
* Natalizumab (Tysabri)
* Alemtuzumab (Campath, Lemtrada)
* Mitoxantrone
Treatments for MS signs and symptoms
* Physical therapy
* Muscle relaxants
* Medications to reduce fatigue
* Medication to increase walking speed
Usage of Stem Cells for Multiple Sclerosis
Mesenchymal stem cells (MSCs) are multipotent stem cells that possess the potential ability to differentiate into cells of connective tissue lineages such as bone, cartilage, muscle and fat. Their distinctive characteristics of immunomodulation, rapid self-renewal proliferation rate and multipotency distinguish them as advantageous therapeutic tools for application in neurological disorders and immunomodulatory therapy. In addition, other desirable characteristics including, ease in isolation and cryopreservation, stable phenotype, genetic stability, direct us towards MSC-based therapies as an effective intervention.
In the clinical area, mesenchymal stem cells (MSCs) can be administered directly without pre-treatment or genetic modification. Pointedly, no moral objection or ethical-religious controversies are associated with MSCs, unlike embryonic or fetal stem cells. MSCs exert neuroprotection essentially by secretion of several neurotrophic and immunomodulatory factors. In this manner, MSCs enable the recruitment of endogenous stem cells to stimulate regeneration and via decreasing B cells, T cells and NK cells of the immune system. Because of these significant properties, MSCs are highly preferred candidates for clinical trials for several neurologic diseases.
Clinical trials utilizing MSCs are ongoing for several diseases such as multiple sclerosis (MS), Parkinson’s disease (PD), stroke, Alzheimer’s disease (AD), Huntington’s disease (HD) and systemic autoimmune diseases. Numerous researchers evaluate the potential of MSCs for the treatment of MS.
Considerable progress has been made using human mesenchymal stem cells (hMSCs) for the treatment of MS. The study conducted by Li et al. demonstrated that human umbilical cord blood derived MSCs (hUCB‐MSCs) administered into MS patients were able to improve disease symptoms and decrease relapse occurrence. The immunomodulatory positive outcome was evident as a shift in peripheral blood cytokine expression toward a Th2 response.
Immunomodulation was also noted following human bone marrow derived MSCs (hBM‐MSCs) transplantation in MS. Peripheral blood monocyte analysis 24 hours after transplantation showed an increase in the proportion of immunosuppressive CD4+ CD25+ regulatory T cells and a reduction in the proportion of proinflammatory myeloid dendritic cells. Expanded disability status scale scores of hBM‐MSCs‐treated MS patients exhibited functional improvement six months following transplantation.
Similarly, research done by Mohajeri et al. has also stated a similar immunomodulatory effect following autologous transplantation of hBM‐MSCs in 6 MS patients. In another clinical study, Connick et al. administered autologous hBM‐MSCs intravenously to ten patients with secondary progressive MS with clinical indication of optic nerve involvement. After transplantation, patients exhibited improved visual acuity and an increase in optic nerve area, providing evidence that hBM‐MSCs treatment can affect disease score in progressive MS. In conclusion, a number of clinical studies described the significant outcome of mesenchymal stem cell application in MS. Several clinical trials are ongoing to evaluate the potential of stem cells for the treatment of multiple sclerosis.
