Highlights
- •Stem cells have the potential to cure chronic diseases.
- •MSCs transplantation is a safe and effective therapy for MS.
- •Larger clinical trials are needed to translate the stem cell treatments for MS.
Abstract
Background
Multiple sclerosis (MS) typically arises in early/middle adulthood and is characterized
by a progressive disability of the central nervous system (CNS). Currently approved
therapies do not promote tissue repair or stop disease progression. Emerging data
demonstrate that stem cells present a great potential in regenerative medicine and,
consequently, have also been widely investigated as a potential treatment for MS.
Therefore, the aim of this study was to conduct a systematic review to inquire into
the safety, tolerability, and efficacy of mesenchymal stem cells (MSCs) therapies
in MS.
Methods
Three electronic databases (Web of Science, PubMed, and Cochrane) were searched from
April until June 2019. Clinical trials or case reports with information related to
the effects of MSC therapies in MS patients were considered for this review.
Results
10 manuscripts were selected, namely 7 uncontrolled clinical trials, 2 randomized
controlled clinical trials, and 1 case report. The overall quality of the studies
was considered good. Besides minor adverse events (AEs), it was reported one case
of encephalopathy with seizures and two cases of iatrogenic meningitis, which were
not related to the treatment, but with the administration route. The analyses of the
expanded disability status scale (EDSS) in the uncontrolled clinical trials demonstrated
that 48 patients improved, 39 maintained and 16 worsened their clinical condition.
Regarding the randomized studies, one did not show statistically significant variations
in the mean EDSS score and in the other the mean EDSS score was statistically significantly
lower for the experimental group. The case report also showed an improvement in the
EDSS score.
Conclusions
MSCs transplantation proved to be a safe and tolerable therapy. Their potential therapeutic
benefits were also validated. However, larger placebo controlled blinded clinical
trials will be required to establish the long term safety and efficacy profile of
these therapies for MS. Their translation into the clinical practice can provide a
new hope for the patients of this highly debilitating disease.
Keywords
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Article info
Publication history
Published online: November 18, 2019
Accepted:
November 16,
2019
Received in revised form:
October 29,
2019
Received:
August 6,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
