Thursday, 18 October 2012

Stem Cell Trial


Despite updating knowledge and a growing number of medications for multiple sclerosis (MS), no definite treatment is available yet for patients suffering from progressive forms of the disease. Autologous bone marrow derived mesenchymal stem cell (BM-MSC) transplantation is a promising method proposed as a therapy for MS. Although the safety of these cells has been confirmed in haematological, cardiac and inflammatory diseases, its efficacy in MS treatment is still under study. Patients with progressive MS (expanded disability status scale score: 4.0 - 6.50) unresponsive to conventional treatments were recruited for this study. 

Twenty-five patients [f/m: 19/6, mean age: 34.7±7] received a single intrathecal injection of ex-vivo expanded MSCs (mean dose: 29.5 106 cells). We observed their therapeutic response for 12 months. Associated short-term adverse events of injection consisted of transient low-grade fever, nausea /vomiting, weakness in the lower limbs and headache. No major delayed adverse effect was reported. 3 patients left the study for personal reasons. The mean (SD) expanded disability status scale (EDSS) score of 22 patients changed from 6.1 (0.6) to 6.3 (0.4). Clinical course of the disease (measured by EDSS) improved in 4, deteriorated in 6 and had no change in 12 patients. In MRI evaluation, 15 patients showed no change, whereas 6 patients showed new T2 or gadolinium enhanced lesions (1 lost to follow-up). It seems that MSC therapy can improve/stabilize the course of the disease in progressive MS in the first year after injection with no serious adverse effects. Repeating the study with a larger sample size, booster injections and longer follow-up using a controlled study design is advised.

This is an open study and  tells us that the procedure of delivering stem cells into the brain appears safe so far. It tells us little about efficacy but does suggest that this is no wonder cure. What we need to know is how long the cells survived and what did they become, because surely this is all about promoting repair. The problem is how do you measure it

5 comments:

  1. http://biotheorist.files.wordpress.com/2011/11/why-stem-cells-do-not-work-for-everybody-nov-22-2011.pdf

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  2. http://www.cbsnews.com/video/watch/?id=7419362n

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  3. The video link above is about stem cell fraud and whilst there are many chancers and con-artists.

    There should be now inference that the study above is related to the scam artists but it is an example to show it has yet to be a wondercure.

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  4. How to measure it? Label stem cells, inject intrathecally into some cute little 'beasties' and then see what happens to the stem cells. Has this been not been done? Feel sure someone must have tried this.

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  5. I know how to do that in beasties and what you said is spot on but sticking labelled cells in humans is more problematical as you don't kill them, at least I hope you don't, so you can see where they go.

    You can load cells up with tracers but any one that says you have the resolution to detect individual cells with any scanners is telling porkies and then have now way of knowing if they are an oligodendrocyte astrocyte neuron or dead cell is the problem. Electrophysiology can help but maybe better to target the visualpathway.

    In beasties this has been done and whilst cells can make myelinating cells I think improvements need to be made

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