• Stem cell therapy is an emerging area of treatment that may hold promise for people with multiple sclerosis (MS).
• Currently, stem cell treatments for MS are in early experimental phases and not widely available.
• Several types of stem cells are under investigation for their potential benefits for MS.
• Hematopoietic stem cell therapy, which uses blood stem cells, has received the most focus and may show the greatest opportunity for treating various types of MS.

Nearly 1 million people in America have multiple sclerosis (MS). Different types of MS progress differently, and some cases prove challenging to treat. MS currently has no cure. None of the available treatments for multiple sclerosis are effective for everyone, and none can halt or reverse the disease. Stem cells present hope for more effective treatment options. In the future, stem cell therapies could provide options for people with treatment-resistant or rapidly progressing types of MS.

What Are Stem Cells?

Stem cells are the building blocks of the human body. They’re the foundation of “us” — from our skin to our neurons (nerve cells). Stem cells are also a major part of the body’s ability to repair itself. They have unique and important therapeutic potential because stem cells are self-regenerating, meaning they make copies of themselves through a process called replication. Stem cells also have the ability to differentiate and develop into the specialized cells that make up the body’s organs and tissues.

Embryonic stem cells are present in the early embryo phase. Embryonic cells are self-renewing (can replicate themselves). Known as pluripotent stem cells, embryonic stem cells can become all the myriad, specialized cell types found in a fully developed human.

Somatic stem cells, or adult stem cells, exist in our bodies all our lives. Somatic stem cells are specific to the tissues or organs they come from and mature into certain cell types. For instance, skin stem cells can’t develop into brain cells, and vice versa.

Somatic stem cells are multipotent stem cells. Like pluripotent cells, multipotent stem cells can become different types of cells. Multipotent stem cells, however, are specific to a certain tissue type or organ. For example, blood stem cells can produce all the different cell types comprising the blood. Blood stem cells cannot develop into liver cells.

Types of Stem Cells for MS Therapies

There are several different types of stem cells. Not all stem cells have the potential for use in MS treatments. Here are some types of stem cells that have been studied for application in MS.

• Hematopoietic stem cells (HSCs) — These are somatic stem cells found in the bone marrow and blood. HSCs are capable of producing all of the cells that make up the blood, including red blood cells and white blood cells. White blood cells are the immune-system cells involved in MS attacks.
• Mesenchymal stem cells (MSCs) — MSCs are somatic stem cells found throughout the body, which can become bone, fat, or other tissues. MSCs help other stem cells function properly. In some cases, MSCs have the ability to influence how the immune system works.
• Neural stem cells (NSCs) — These cells play a vital role in repairing myelin in the brain. Demyelination and nerve degeneration can lead to progressive disability.

How Are Stem Cells Sourced?

Induced pluripotent stem cells (iPSCs) are engineered from adult somatic cells. Using a lab technique, these cells are reprogrammed to become pluripotent cells, hence the description “induced.” Their use is only in research settings at this time.

Neural stem cells can be derived from other types of stem cells, such as mesenchymal cells. Embryonic stem cells are grown from cells that are extracted from donated embryos. Stem cells can also be harvested from healthy umbilical cord blood.

How Can Stem Cells Be Used in MS Treatment?

Much of the stem cell research for MS focuses on creating specialized cells that can modify the immune system in a person with MS. Scientists are also exploring ways stem cells can be used to repair nerve cells. Stem cell treatments for MS are in their infancy, and there is a lot to learn.

Immune-Mediating Stem Cell Transplants

In hematopoietic stem cell therapy (HSCT), chemotherapy is used to destroy the immune system. Stem cells are then used to build a new immune system that won’t attack myelin. Hematopoietic stem cells are harvested from a person’s blood or bone marrow before chemotherapy and then infused back into the blood after chemotherapy is complete. The process takes from a few days to several weeks, and full recovery can vary from three to six months.

In studies, HSCT was shown to slow MS progression in 70 percent to 80 percent of participants by four to five years. HSTC may be used to treat relapsing-remitting MS (RRMS) that is not responding to the best disease-modifying treatments. HSTC is an aggressive treatment that can have dangerous side effects, so its use for MS is currently restricted to clinical trials.

Repairing Nerve Damage

Neural stem cells in the brain naturally try to repair and replace myelin. In people with MS, the immune system attacks the myelin again and again until nerves are damaged and then destroyed. Stem cells may be able to help repair the damaged myelin sheath, remyelinating the nerves and allowing them to function correctly again. This could prevent nerve degeneration and slow down the progression to disability. Ultimately, scientists hope to use stem cells to regenerate or replace nerves that have been destroyed. However, this process is still in the early research stages at this time.

Research

Multiple sclerosis is a complex autoimmune disease. Scientists aren’t sure precisely what causes MS or exactly how it functions. Researchers are using stem cells, including induced pluripotent stem cells, to explore how MS impacts healthy cells. The iPSCs also let researchers examine how a person’s unique biological and environmental factors might impact disease progression.

What Does Research on Stem Cell Therapies in MS Show So Far?

The results of a small study released in February 2020 suggested that autologous hematopoietic stem cell therapy (AHSCT) may be effective for those with severe relapsing-remitting multiple sclerosis (RRMS) as well as some people with secondary progressive multiple sclerosis (SPMS). Forty-two percent of study participants had no signs of progression five years after the stem cell transplant.

Like most treatments for MS, there’s no guarantee that stem cell therapy will work for everyone. “I had a stem cell transplant in 2014 using stem cells harvested from my fat cells, not from marrow,” said a MyMSTeam member. “My fatigue lessened for about two months, then returned.”

When stem cell therapy works, it can have a huge effect on a person’s disease progression and quality of life. “I just had my six-year follow-up MRIs done. Still no new or enhancing lesions. I have not been on any disease modifying drugs (DMDs) in over six years!” said a MyMSTeam member. “Done with those awful side effects!!! My MS is in remission!”

Researchers are exploring different stem cells to learn more about MS and how to prevent or repair myelin damage. IPSCs also present the opportunity to develop new cell lines and study previously inaccessible human cells, such as the nerve cells of the brain.

Challenges of Stem Cell Treatment

While stem cell therapy holds great potential for treating MS, there are several hurdles to overcome and a great deal more research to be done before stem cells can be regularly used in therapies for people with MS. While the HSCT procedure is approved by the U.S. Food and Drug Administration (FDA) for treating cancer and other conditions, it is not yet widely available for treating MS.

Stem cell therapy for MS is new and, as such, serious side effects and outcomes can be unpredictable. Regardless of whether the stem cells used are your own (autologous stem cell transplant) or sourced from a donor, HSCT requires the use of immunosuppressive drugs to ensure that your body doesn't reject the transplant. Living with a compromised immune system brings a lot of other potential health issues and risk.

Stem cell treatments for MS are also costly. Many U.S. insurance companies only cover treatments that are FDA approved specifically to treat MS. Several MyMSTeam members seek HSCT treatment abroad, in Mexico, Europe, or Asia. “I had treatment with umbilical cord cells five weeks ago in the Cayman Islands,” shared one MyMSTeams member. “I’m building muscle and my balance has greatly improved. It is a game changer!”

Do your research and “buyer beware” if you’re thinking of going abroad for stem cell therapy. Stem cell therapy clinics of varying reputability are popping up worldwide, which offer cost savings but also come with a variety of risks. Treatments at clinics may be unproven and unregulated.

Participating in clinical trials studying stem cell treatment for MS may be one way to gain access to this therapy. Talk to your doctor to find out if a clinical trial for stem cell therapy may be an option for you.

MyMSTeam Members Discuss Stem Cell Treatment for MS

Stem cell therapy is a medical advancement that shows great promise for people living with MS, especially for those whose MS hasn’t responded to traditional disease-modifying drugs. Further research is necessary, but MyMSTeam members often discuss stem cell therapy.

Have you undergone stem cell therapy? What was it like, and has it made a difference in your MS? Comment below or post your experiences on MyMSTeam.