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Thread: Comments on stem cell therapies of multiple sclerosis.

  1. #1

    Comments on stem cell therapies of multiple sclerosis.

    > Hello Dr. Young. I just wanted to ask you a couple of questions if you have minute. My mother has Multiple Sclerosis and has recently been confined to a wheel chair. She has many problems related to the MS that you must know all about. The past few days I have been doing a lot of research on stem cell treatment. I have found places on the internet that offer stem cell injections such as Stem Cell Therapy International Inc., The Institute of Cellular Medicine and Stem Cell Biotherapy Inc. as well as lower cost options in China that are talked about on this web site. Is stem cell injections safe at this time? Will it help her? And is it the right move for my mom to get Stem Cells at this point? If so where would you recommend my mother getting the Stem Cell injections. I have read about research projects that use chemotherapy to kill the immune system and then inject the stem cells that have had good results...
    I received this email and wanted to post my answers here for more general discussion. I stripped various information form the original email in case the writer wants to retain anonymity.

    Many therapies that have been reported to be beneficial for MS but stem cell therapies have not been shown convincingly to do so yet. I know that there are many places claiming beneficial effects of stem cells but I don't think that any of these have data that show that their treatments are effective. Many such places are charging for experimental therapies. I do not recommend these places. There are clinical trials that are testing various cell transplant therapies and let me summarize some of these:

    Many cell transplants have been shown to remyelinate axons in the brain and spinal cord. These include Schwann cells, oligodendroglial precursor cells obtained from embryonic stem cells or fetal neural stem cells, and even olfactory ensheathing glia. In addition, animal studies have shown that transplanted bone marrow stem cells improve recovery in rats that have had demyelination.

    Unfortunately, with the exception of Schwann cells grown from one's own peripheral nerve, all of these cells, when obtained from other individuals, are usually rejected by the host when transplanted. While some scientists claim that embryonic stem cells and mesenchymal stem cells are immunologically privileged and even some claims that the cells are anti-immune in some way, most observers of the field believe that the progeny of the cells are not immunologically privileged and will eventually be rejected.

    In multiple sclerosis, there is several additional factors to consider. It is an autoimmune disease. In other words, no matter what one does in terms of remyelination, the disease may continue to cause demyelination. Thus, it is important to address the autoimmune aspects of the disease before trying to remyelinate. Also, there is evidence that multiple sclerosis is associated with loss of axons. Thus, one may need therapies to regenerate the spinal cord.

    Many anti-immune therapies (such as interferon, high-dose steroids, and even immunization therapies such as copaxone) have been shown to reduce both the incidence and severity of recurrent autoimmune attacks. In fact, one can replace bone marrow and reduce or even eliminate the auto-immunity. However, bone marrow replacement is risky because it involves first ablating the person's bone marrow with chemotherapy because it can be replaced.

    So, while there is a great deal of promise in cell transplant therapies of multiple sclerosis, several major problems still need to be solved. First and foremost, the auto-immune problem must be eliminated. It looks as if bone marrow and umbilical cord blood transplants can achieve this but the procedure is still quite risky. Second, a source of immune-compatible human cells must be obtained for remyelination. Third, regeneration of axons may be necessary for restoring function because many study suggests that multiple sclerosis not only demyelinates but also damages axons.

    So, the direction that one might choose to go depends on the course and status of the multiple sclerosis. If the disease is progressive and the existing therapies have not controlled the progression, one should be looking at bone marrow transplants to replace the immune system. If the disease is stable, one may want to consider remyelination therapy using Schwann cells. Unfortunately, I know of few places in the United States that are doing this. Finally, I would be considering the possibility of transplanting oligodendroglial cells derived from fetal or embryonic stem cells.

    Several companies are working on deriving myelinating cells for multiple sclerosis, including Geron and Advanced Cell Technology. However, none of them have gone to clinical trial yet. If you go to http://clinicaltrials.gov and do a search for multiple sclerosis, you will find a list of all the major legitimate clinical trials that are going on around the world. I would strongly caution against going to overseas clinics that are promising results and charging money for therapies.

    Wise.

    --
    Wise Young, Ph.D., M.D.
    Richard H. Shindell Chair in Neuroscience
    W. M. Keck Center for Collaborative Neuroscience
    Dept. of Cell Biology & Neuroscience
    Rutgers, State University of New Jersey
    Piscataway, New Jersey 08540-8087

  2. #2
    Super Moderator Sue Pendleton's Avatar
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    Wise, if someone has PPMS and is still fairly young, under 40, should they be looking at the bone marrow replacement after treatment to kill off the immune system? Physically a family member of mine is doing "reasonably" well. Mentally she is rapidly losing cognitive functions. I ask because the best matches for bone marrow if something happens to her own when it is stored are siblings. She has 2 brothers now. I realize that stopping the disease will not bring back her cognitive features alone. But the brain is, as we know, amazingly plastic.

    She started out on beta seron when diagnosed at 19 while it was in clinical trials and is now on Copaxone once a week, I believe. There is no way her brothers would attempt an overseas trial that was not proven to also restore her brain to its former state.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  3. #3
    Quote Originally Posted by Sue Pendleton
    Wise, if someone has PPMS and is still fairly young, under 40, should they be looking at the bone marrow replacement after treatment to kill off the immune system? Physically a family member of mine is doing "reasonably" well. Mentally she is rapidly losing cognitive functions. I ask because the best matches for bone marrow if something happens to her own when it is stored are siblings. She has 2 brothers now. I realize that stopping the disease will not bring back her cognitive features alone. But the brain is, as we know, amazingly plastic.

    She started out on beta seron when diagnosed at 19 while it was in clinical trials and is now on Copaxone once a week, I believe. There is no way her brothers would attempt an overseas trial that was not proven to also restore her brain to its former state.
    Sue,

    If she is losing cognitive function, I think that it may be warranted. Doug Kerr has an NIH grant to do such a trial. You should talk to him.

    wise.

    http://clinicaltrial.gov/ct2/show/NC...lerosis&rank=3

  4. #4
    Super Moderator Sue Pendleton's Avatar
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    Thanks Wise. It's about time I talked to him again in any case. Just wish they had more facilities involved. She lives down south. Funny I didn't see this in the newsletters.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  5. #5

    stem cell injections

    Mr. Young my husb and is incomplete t 12 spinal cord injury 3 months ago , we are interested in stem cell injections, who and where do u reccommend that we go? please contact asap , we were discharged 12/13/07, after rehab and will start outpt, he is set on doing this so where ever we have to go we will and asap,
    Last edited by Wise Young; 12-17-2007 at 09:36 PM.

  6. #6
    Super Moderator Sue Pendleton's Avatar
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    Lawana it's not a good idea to put phone numbers on your posts. Dr Young can get private messages, emails by clicking on his name or just post here and he will answer as soon as he can. You have a couple days to edit your post and remove your number if you wish.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  7. #7
    Quote Originally Posted by lawana patterson
    Mr. Young my husb and is incomplete t 12 spinal cord injury 3 months ago , we are interested in stem cell injections, who and where do u reccommend that we go? please contact asap , we were discharged 12/13/07, after rehab and will start outpt, he is set on doing this so where ever we have to go we will and asap,
    Lawana, I removed your phone number and email address because it is not a good idea to post them in a public forum such as this.

    In my opinion, there is no stem cell injection anywhere in the world that has been shown to be effective. I strongly recommend that you be patient and wait until a stem cell therapy has been shown to be effective. The claims by doctors who say that they have an effective stem cell therapy are not supported by credible evidence.

    If you do get cell transplants, you should choose a place that is conducting a legitimate clinical trial. Such clinical trials would be committed to examining your husband carefully and following up the results for a year or more, to find out whether the treatment is effective. They should not be charging for experimental therapy.

    Wise.

  8. #8
    Dr. Wise Young: my wife has autosomal dominant leukodystrophy which is a demeylinization of the white matter in the brain. NIH has an ongoing study but there is no known cause other than to say its genetic. Are there any medical trials going on that might some day lead to treatment to either slow down, stop or repair demeylinization. I know something about 4AP or fampridine.

  9. #9
    Quote Originally Posted by Mickpeek
    Dr. Wise Young: my wife has autosomal dominant leukodystrophy which is a demeylinization of the white matter in the brain. NIH has an ongoing study but there is no known cause other than to say its genetic. Are there any medical trials going on that might some day lead to treatment to either slow down, stop or repair demeylinization. I know something about 4AP or fampridine.
    You should look at http://clinicaltrials.gov/ct2/result...leukodystrophy for clinical trials.

    Wise.

  10. #10
    Here are the details of a research study on patients with auto-immune diseases, including multiple sclerosis. The study is seeking participants. The study involves an autologous stem cell transplant.

    I actually had the opportunity to speak with a nurse involved with these treatments. The transplant does not cure the MS. However, it can, in effect, reset the immune system thereby stopping the progression of the MS.

    John
    "Hope is like a road in the country; there was never a road, but when many people walk on it, the road comes into existence." Lin Yutang

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