Stem Cells for Multiple Sclerosis Treatment

About Multiple Sclerosis (MS)

Multiple sclerosis (MS) is a neurological disorder, primarily affecting the central nervous system (CNS). The body’s immune system mistakenly attacks the myelin sheath. A process termed as demyelination. Myelin sheath is the protective covering of nerve fibers responsible for insulating nerves and enabling the rapid transmission of electrical impulses in the brain and spinal cord. As the disease spreads, it causes damage to nerve synapses and disrupts communication.

Why Is MS More Common in Females?

MS is approximately three times more common in females than in males. Although the exact cause of this gender disparity remains unclear, research suggests that a combination of hormonal, genetic, and environmental factors may play a role. Studies indicate that women are more susceptible to MS during certain life stages, particularly before puberty and after menopause, when hormonal fluctuations are most significant. Additionally, the presence of two X chromosomes in females might make them more prone to MS than males.

Why is MS called a “Silent Disease”?

MS is often referred to as a “silent” or “invisible disease” because many of its symptoms are not outwardly visible. Individuals may appear healthy while experiencing internal neurological challenges such as pain, numbness, fatigue, or blurred vision. Additionally, the disease can continue to progress even during remission periods, a phenomenon known as “silent progression”. During this phase, the nervous system sustains ongoing damage without clear external signs. This hidden and unpredictable nature of MS contributes to its complexity, as nerve degeneration may advance quietly while physical symptoms temporarily subside.

Current therapeutic interventions for multiple sclerosis (MS) primarily focus on managing symptoms and slowing disease progression. However, many of these treatments are associated with significant adverse effects and may not be effective or suitable for all forms of MS. This limitation has driven the pursuit of advanced therapeutic strategies capable not only of controlling the disease but also of repairing neural damage and promoting functional recovery.

STEM CELL THERAPY has emerged as a promising next-generation approach due to its regenerative and reparative potential. In recent years, this field has rapidly expanded, showing encouraging results in multiple sclerosis.

With technological advancements, personalized stem cell treatments have become possible. These therapies are tailored to each patient’s unique clinical profile and disease characteristics, paving the way for precision medicine. This evolution in therapeutic design offers new hope for MS patients, transforming treatment outcomes and improving quality of life.

Diagnosis

The symptoms of multiple sclerosis (MS) often overlap with those of other neurological conditions, making diagnosis challenging. Currently, no single definitive test exists for MS. Therefore, a comprehensive evaluation that includes a detailed medical history, clinical examination, and multiple diagnostic tests, along with the exclusion of other disorders, is essential for a conclusive diagnosis. The following multiple sclerosis tests are commonly used to evaluate and confirm the disorder:

Neurological Examination: A healthcare provider performs a physical and neurological assessment to evaluate reflexes, muscle strength, coordination, balance, and sensory function. This helps identify areas of the nervous system that may be affected.

Magnetic Resonance Imaging (MRI): MRI uses magnetic fields to produce detailed images of the brain and spinal cord. The presence of two or more lesions in distinct regions of the CNS demonstrates “dissemination in space” (DIS)—a key diagnostic criterion for MS.

“Dissemination in time” (DIT) refers to the occurrence of new lesions or relapses over time, indicating disease progression. MRI follow-up scans and clinical history help establish DIT.

Evoked Potentials (EP): These tests measure electrical activity and nerve conduction in response to visual, auditory, or sensory stimuli. Electrodes placed on the scalp record the time it takes for nerve signals to reach the brain. Abnormalities in these signals suggest delayed nerve conduction, reflecting demyelination and CNS damage.

Cerebrospinal Fluid (CSF) Analysis: Examination of CSF obtained through lumbar puncture may reveal immune cell infiltration, elevated protein concentrations (such as neurofilament light chain or CXCL13), and increased antibodies (including IgG or kappa light chains). These findings support an MS diagnosis.

Blood Tests: Although blood tests cannot diagnose MS directly, they help exclude other neurological and autoimmune conditions. Commonly ordered tests include complete blood count (CBC), thyroid-stimulating hormone (TSH), vitamin B12 levels, erythrocyte sedimentation rate (ESR), and antinuclear antibody (ANA) tests.

Optical Coherence Tomography (OCT): OCT is a non-invasive imaging technique that uses light waves to generate detailed images of the retina. Thinning of the retinal nerve fiber layer detected by OCT may indicate optic nerve damage, an early sign of MS.

Early and accurate multiple sclerosis diagnosis is crucial for initiating prompt treatment, which can slow disease progression, reduce relapses, and delay the onset of disability.

Symptoms of Multiple Sclerosis (MS)

The symptoms of multiple sclerosis (MS) vary widely depending on the specific regions of the brain and spinal cord affected. The clinical features of multiple sclerosis can present with a broad spectrum of neurological signs and symptoms, which may fluctuate over time or worsen progressively.

Visual Loss: Visual disturbances are among the most common and often the initial presentation, particularly in relapsing-remitting MS (RRMS). Patients may experience partial or complete vision loss in one eye, often accompanied by pain during eye movement and altered color perception. Although some recovery may occur, visual acuity rarely returns to normal. Other visual manifestations include central blind spots, jerky eye movements, double vision, and optic nerve damage affecting vision.

Motor Symptoms: Motor involvement typically manifests as muscle weakness, stiffness or spasticity, exaggerated reflexes, and tremors. Patients may also experience slurred speech, difficulty swallowing, involuntary eye movements, and severe fatigue, which significantly impact daily functioning.

Sensory Issues: Disruption of nerve signaling in MS often results in abnormal sensations. These may include tingling, numbness, burning, prickling, or “pins and needles” sensations. Some patients report an electric shock-like feeling upon neck flexion (Lhermitte’s sign), a tightness around the trunk or abdomen (the “MS hug”), or loss of facial sensation. There may also be a reduced sense of fine touch, vibration, and joint position.

Balance and Coordination Issues: MS can impair coordination, balance, and posture, leading to vertigo, dizziness, and gait instability. These symptoms increase the risk of falls and can significantly reduce mobility.

Bowel and Bladder Dysfunction: Autonomic involvement may result in urinary incontinence, or difficulty initiating urination. Constipation, diarrhea, and acid reflux are also common gastrointestinal symptoms associated with MS.

Cognitive and Emotional Symptoms: Cognitive impairment in MS may manifest as memory lapses, difficulty concentrating, and reduced problem-solving abilities. Depression, anxiety, sleep disturbances, and sexual dysfunction are also frequently observed and can further impact quality of life.

If any of these symptoms occur, it is essential to consult a healthcare professional promptly to rule out other neurological conditions and facilitate early diagnosis and management of MS.

Available Types of Multiple sclerosis (MS)

Multiple sclerosis (MS) presents in several forms, each with distinct characteristics, symptom patterns, and disease progression. The four primary types of multiple sclerosis are:

Relapsing-Remitting MS (RRMS): RRMS is the most common form, affecting approximately 70–80% of individuals diagnosed with MS. It is characterized by clearly defined relapses (periods of new or worsening symptoms) followed by remission phases, during which symptoms partially or completely subside. Remission may last for months or even years, sometimes without treatment.

Secondary Progressive MS (SPMS): SPMS typically develops 10–15 years after an initial RRMS diagnosis. In this phase, the disease transitions into a more progressive form, marked by a steady worsening of symptoms and functional decline. SPMS can be classified as:

• Active SPMS: involving occasional relapses or evidence of new disease activity.
• Non-active SPMS: with continuous progression but no distinct relapses.

Primary Progressive MS (PPMS): PPMS accounts for about 15–20% of MS cases. Unlike RRMS, this form shows continuous symptom progression from the onset, without distinct relapses or remission periods. Disease progression tends to be gradual but persistent.

Progressive-Relapsing MS (PRMS): The rarest form of MS, PRMS, affects approximately 5% of patients. It involves a gradual worsening of neurological function from the beginning, accompanied by occasional relapses where symptoms temporarily intensify before resuming a progressive course.

Additionally, the following categories are also included within the spectrum of multiple sclerosis:

Clinically Isolated Syndrome (CIS): CIS represents the first clinical episode suggestive of MS, involving a single attack or episode followed by near or complete recovery. Subsequent relapse turns it into definite MS.

Radiologically Isolated Syndrome (RIS): RIS refers to the presence of MRI findings consistent with MS, such as characteristic brain or spinal cord lesions, without any clinical symptoms.

What Causes Multiple Sclerosis (MS)?

The exact multiple sclerosis causes remains unclear; however, research suggests that it arises from a complex interplay of genetic, environmental, and inflammatory factors. Based on previous studies, the potential causes and risk factors associated with MS include:

Genetic Predisposition: Individuals with a family history of multiple sclerosis disease are at a higher risk of developing the disease. Having a first-degree relative with MS increases the risk of the disorder to approximately 2–4%. Certain genetic polymorphisms, particularly those affecting immune regulation, vitamin D metabolism, and central nervous system function, have been linked to a slightly elevated susceptibility to MS.

Environmental Factors: Several environmental triggers have been implicated in the onset of MS, including smoking, vitamin D and B12 deficiencies, dietary habits, and insufficient exposure to ultraviolet (UV) radiation. Some foreign antigens may share structural similarities (molecular mimicry) with myelin components, such as proteolipid protein, myelin basic protein, and myelin-associated glycoprotein, potentially leading to an autoimmune attack on the myelin sheath.

Inflammatory Mechanisms: Two primary hypotheses explain the inflammatory processes underlying MS. The “outside-in” hypothesis suggests that peripheral immune activation occurs due to a foreign antigen. In contrast, the “inside-out” hypothesis proposes that intrinsic CNS abnormalities initiate inflammation and subsequent tissue damage.

Age and Gender: MS most commonly develops in young adults aged 15–40 years and is three times more prevalent in women than in men. Hormonal differences may cause this gender bias.

Throughout the course of multiple sclerosis disease, lesions (plaques) form in waves due to localized inflammation. These plaques are characterized by myelin loss, edema, and axonal injury, which collectively contribute to progressive neurological impairment.

Stem Cells for Multiple Sclerosis (MS) Treatments

Current therapeutic interventions for multiple sclerosis (MS) primarily aim to control the immune response directed against the myelin sheath. While these treatments can effectively manage symptoms and slow disease progression, they are often associated with long-term adverse effects and may lose efficacy over time as patients develop resistance.

These limitations have prompted the search for more effective and restorative multiple sclerosis therapy. Among emerging approaches, stem cell therapy has gained significant attention for its potential to repair neural damage and restore function, rather than merely managing symptoms. Research has revealed several mechanisms through which stem cell therapy may benefit individuals with MS.

• Stem cells reduce pro-inflammatory T cells and enhance anti-inflammatory T cells, thereby suppressing neuroinflammation.
• They secrete neurotrophic factors such as brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and neurotrophin-3 (NTF3), which help prevent neurodegeneration and support neuronal survival.
• Stem cells promote the M2 macrophage phenotype, which facilitates tissue repair, while reducing the M1 phenotype, responsible for inflammation.
• They activate regulatory T cells (Tregs), which modulate immune responses through the secretion of prostaglandin E2 (PGE2), transforming growth factor-β1 (TGFβ1), interleukin-10 (IL10), and soluble human leukocyte antigen-G (sHLA-G).
• Transplanted stem cells inhibit demyelination and simultaneously stimulate remyelination, aiding the regeneration of the myelin sheath around damaged nerve fibers.
• By producing hepatocyte growth factor (HGF), stem cells encourage the formation of tolerogenic dendritic cells, which help maintain immune tolerance and prevent further autoimmune attacks.
• Stem cells increase the number of oligodendrocyte lineage cells (OLCs) in lesion sites. These cells play a crucial role in enhancing nerve impulse conduction and preserving axonal integrity.

Collectively, these pathways address the underlying disease mechanisms and induce repair, contributing to functional recovery.

Frequently Asked Questions

Q1. Can stem cells cure multiple sclerosis?

Stem cell therapy is not a definitive cure, but it represents one of the most promising regenerative approaches under active research. It offers hope for long-term remission and functional improvement, especially when administered under expert medical supervision and combined with rehabilitation and supportive care. Additional clinical research and treatment optimization might provide a definitive answer to the curative ability of stem cells.

Q2. Which Type of Stem Cells Are Most Effective?

Among different stem cell sources studied for MS treatment, mesenchymal stem cells (MSCs) have shown the most promise due to their immunomodulatory properties. MSCs can be derived from various tissues, including umbilical cord, bone marrow, and adipose (fat) tissue. In a comparative analysis, umbilical cord MSCs demonstrated an improvement rate of approximately 56.7%, as opposed to a 38.5% rate seen in bone marrow-derived MSCs.

Q3. When Can I Expect to See Results?

The timeline for improvement following stem cell therapy varies between individuals. As per clinical data, patients may notice changes within 3 to 6 months, while more significant neurological and functional improvements may take up to a year. The response time depends on several factors, including severity and duration of MS, type of stem cells, dose and route of administration, age, and overall health status of the patient, etc. Consistent rehabilitation, physiotherapy, and lifestyle management following treatment can further enhance recovery outcomes.

Q4. What Are the Possible Side Effects?

Stem cell therapy for MS is generally considered safe and well-tolerated, particularly when conducted in accredited medical centers with quality-assured stem cells. However, like any medical procedure, mild and temporary side effects may occur, such as fever, headache, fatigue or mild body aches, and injection site discomfort. Therefore, it is vital to undergo therapy at a licensed and reputable stem cell center utilizing premium-quality stem cells that follow safety, regulatory, and ethical standards.