All three types of adult stem cells (HSCs, MSCs, NSCs) are able to restore self-tolerance, provide immunomodulation and neuroprotection, and promote regeneration in patients with chronic diseases such as multiple sclerosis (MS).
Transplanting stem cells is a potentially effective and safe treatment for MS. Although HSCs and MSCs are more available than NSCs, the latter have the unique capacity of remyelination. Because MS is characterized by damage to the myelin sheath, research surrounding stem cell therapy for MS focuses largely on the therapeutic use of NSCs.
Currently, no studies have directly compared other therapies to stem cell therapies.
According to the National Multiple Sclerosis Society: “In light of the urgent need for more effective treatments for MS, particularly for those with more progressive forms of the disease, we believe that the potential of all types of cell therapies must be explored.”
MSCs (mesenchymal stem cells)
Transplanted MSCs transform into neurons and endothelial cells after induction, and they also secrete factors in vitro and in vivo with various functions such as neurogenesis, inhibition of apoptosis (programmed cell death), neuronal and glial cell survival, expansion of axonal and myelin repair processes, development and protection of nervous tissue and integration, and improvement of local stem cells.
Bone marrow MSCs have the ability to transdifferentiate into (become) neuron-like cells in vitro so they might also have the same ability to deliver cell substitutes to the injured central nervous system.
Treatments using MSCs could be potentially reasonable and advanced way of repairing inflamed and impaired tissue.
MSCs therapy in MS uses either intravenous injection or the intrathecal injection route (into the spinal cord to reach the cerebrospinal fluid). The latter can possibly lead to meningeal irritation, which makes intravenous administration preferable.
HSCs (hematopoietic stem cells)
HSC transplant is different from all other stem cell treatments because its primary goal is to replace and reset the entire immune system. All immune cells are regenerated after destruction of the “old” immune system by radical immunosuppression (chemotherapy and other means significantly suppress or temporarily actually destroy the immune system).
HSCs are able to transdifferentiate into neuronal cells and show development and protection effects. They can be collected directly from the bone marrow and then transplanted back into the patient’s body (autologous HSC transplantation), or transplanted into a different person.
NSCs (neural stem cells) and application for MS treatment
NSCs can provide a source of remyelinating cells with ability to structurally repair the central nervous system.
Experiments have been done in animal models with NSCs injected either intrathecal or intraventricular in order to place the cells into the cerebrospinal fluid compartment (bypassing the blood-brain barrier). This placement has shown to produce beneficial effects in experimental models of neurological diseases such as MS.
The intracerebroventricular route for NSC delivery also bypasses the blood-brain barrier. It is injected directly into the brain in proximity of the ventricular and spinal subarachnoid spaces of the brain’s white matter tracts (bundles of nerve fibers that connect nerve cells) involved in MS. Following injection, cells migrate into the white matter and may get closer to the center of the disease.
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