A potential cure for multiple sclerosis: the promising role mesenchymal stem cells play in the reparative process

Background: Mesenchymal stem cells (MSCs) are multipotent stem cells derived primarily from bone marrow (BM). They exert neurotrophic and immunomodulatory effects. Understanding laboratory and patient-related factors that affect MSC biology will optimise their use as a potential multiple sclerosis (MS) treatment. Methods: Eleven patients with relapsing forms of MS were enrolled in an ongoing Phase 1 trial, having met eligibility criteria (adult between 18 and 55, relapsing form of MS, currently on standard treatment, visual involvement, T2 hyperintense lesions on MRI). BM-derived MSCs were isolated, cultured and subsequently re-infused one time to assess tolerability. A literature review of MSC biology was conducted alongside this Phase I trial in order to examine the role of MSCs in MS therapy. Results: Low concentration foetal bovine serum (FBS) and specific biological factors favour MSC activity. Paracrine activity yields the majority of the therapeutic effects. Faster MSC proliferation rates were observed in cells of individuals in an earlier stage of the disease. Patient age decreases proliferation capacity. The effects of gender, MS type and disease duration are less clear. Discussion/conclusion: MSCs have great potential in MS treatment through their anti-inflammatory and reparative properties, and the trial has thus far shown that autologous MSC transplantation is safe and feasible.