In this video, I discuss my scepticism of stem cell treatments for multiple sclerosis. I explain why it would be very difficult for stem cells to get to the site of injury and remyelinate. At the end of the video, I offer hope for future improvements.
Research team from Vinmec Research Institute of Stem Cell and Gene Technology in Hanoi, Vietnam. CREDIT AlphaMed Press
Type 2 diabetes patients who are not overweight and who have had the disorder for less than a decade can benefit from stromal stem cells transplanted from their own bone marrow, according to a study published today in STEM CELLS Translational Medicine.
In a randomized clinical trial at Vinmec Research Institute of Stem Cell and Gene Technology in Hanoi, Vietnam, researchers investigated the safety and potential therapeutic value of administering bone marrow stromal stem cells to patients with Type 2 diabetes. In each case, the cells were autologous, or taken from the patients’ own bodies.
A total of 30 adult patients with different body mass indexes whose Type 2 diabetes histories varied from one to 25 years were recruited for the study. Each received two infusions of the cells intravenously or by injection into an artery that supplies blood to the pancreas.
Researchers monitored the patients for 48 hours and re-examined them at one-month, three-month, six-month and one-year intervals. No significant problems were detected in the patients’ health as a result of the treatment and they appeared to benefit equally from both infusion methods.
“Our patients tolerated the procedure well and showed short-term reductions in their blood glucose levels after the treatment,” said Liem Nguyen, the institute’s research director. “We also found that some of them were able to temporarily reduce the dosage of their diabetes medications.”
Some 420 million people worldwide have Type 2 diabetes, a disorder accounting for about 90 percent of all diabetes cases that often leads to disability or death. People with Type 2 diabetes cannot make good use of the insulin their bodies produce. Increased physical activity and a healthy diet can improve the disorder in some people, but many must take insulin or drugs to control their blood glucose levels.
Patients in the Vinmec study were classified into three groups based on the diabetes medicines they were regularly taking before their stem cell infusions. Some were maintaining their blood glucose levels with insulin only. Others were taking drugs but no insulin, and still others were taking a combination of insulin and drugs.
After receiving the treatment, more than half of the patients were able to lower the doses of their diabetes medicines.
“Our trial, the first to link the outcomes of autologous bone marrow stromal stem cell transplantation with body mass index and Type 2 diabetes duration, shows the procedure is safe and opens the way for other clinical trials exploring the potential benefits of this treatment in non-obese patients who have had the disorder less than 10 years,” Nguyen said.
Bone marrow stromal stem cells, also known as mesenchymal stem cells, play a key role in the body’s immune response and can transform into connective tissue cells in any organ. Over the past 50 years, they have emerged as a versatile cell source in the field of regenerative medicine.
“The results of this randomized clinical trial for patients with Type 2 diabetes and the injection of their own bone marrow stromal stem cells is encouraging and potentially may add to the treatment arsenal for this chronic disease that affects so many worldwide,” said Anthony Atala, M.D., Editor-in-Chief of STEM CELLS Translational Medicine and director of the Wake Forest Institute for Regenerative Medicine. “Of special interest is the short-term efficacy in patients with a history of Type 2 diabetes for less than 10 years and a bone mass index of less than 23. This work opens opportunities for future research to further investigate this area of work.”
A new study shows that intense immunosuppression followed by a hematopoietic stem cell transplant may prevent disability associated with multiple sclerosis (MS) from getting worse in 71% of people with relapsing-remitting MS for up to 10 years after the treatment. The research is published in the January 20, 2021, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study also found that in some people their disability improved over 10 years after treatment. Additionally, more than half of the people with the secondary progressive form of MS experienced no worsening of their symptoms 10 years after a transplant.
While most people with MS are first diagnosed with relapsing-remitting MS, marked by symptom flare-ups followed by periods of remission, many people with relapsing-remitting MS eventually transition to secondary progressive MS, which does not have wide swings in symptoms but instead a slow, steady worsening of the disease.
The study involved autologous hematopoietic stem cell transplants, which use healthy blood stem cells from the participant’s own body to replace diseased cells.
“So far, conventional treatments have prevented people with MS from experiencing more attacks and worsening symptoms, but not in the long term,” said study author Matilde Inglese, M.D., Ph.D., of the University of Genoa in Italy and a member of the American Academy of Neurology. “Previous research shows more than half of the people with MS who take medication for their disease still get worse over a 10-year period. Our results are exciting because they show hematopoietic stem cell transplants may prevent someone’s MS disabilities from getting worse over the longer term.”
The study looked at 210 people with MS who received stem cell transplants from 1997 to 2019. Their average age was 35. Of those people, 122 had relapsing-remitting MS and 86 had secondary progressive MS and two had primary progressive MS.
Researchers assessed participants at six months, five years and 10 years after their transplants.
Five years into the study, researchers found that 80% of the people experienced no worsening of their MS disability. At the 10-year mark, 66% still had not experienced a worsening of disability.
When looking at just the people with the most common form of MS, researchers found 86% of them experienced no worsening of their disability five years after their transplant. Ten years later, 71% still experienced no worsening of their disability.
Also, people with progressive MS benefited from stem cell transplants. Researchers found that 71% of the people with this type of MS experienced no worsening of their disability five years after their transplants. Ten years later, 57% experienced no worsening of their disability.
“Our study demonstrates that intense immunosuppression followed by hematopoietic stem cell transplants should be considered as a treatment for people with MS, especially those who don’t respond to conventional therapy,” Inglese said.
Limitations of the study include that it was retrospective, did not include a control group and the clinicians who helped measure participants’ disability were aware that they had received stem cell transplants, so that could have led to bias. Inglese said these limitations will be addressed in future research.
Therapy shown to relieve extreme pain in mice; now moving towards human trials
Researchers at the University of Sydney have used human stem cells to make pain-killing neurons that provide lasting relief in mice, without side effects, in a single treatment.
The next step is to perform extensive safety tests in rodents and pigs, and then move to human patients suffering chronic pain within the next five years.
If the tests are successful in humans, it could be a major breakthrough in the development of new non-opioid, non-addictive pain management strategies for patients, the researchers said.
“We are already moving towards testing in humans,” said Associate Professor Greg Neely, a leader in pain research at the Charles Perkins Centre and the School of Life and Environmental Sciences.
“Nerve injury can lead to devastating neuropathic pain and for the majority of patients there are no effective therapies. This breakthrough means for some of these patients, we could make pain-killing transplants from their own cells, and the cells can then reverse the underlying cause of pain.”
Published today in the peer-reviewed journal Pain, the team used human induced pluripotent stem cells (iPSC) derived from bone marrow to make pain-killing cells in the lab, then put them into the spinal cord of mice with serious neuropathic pain. The development of iPSC won a Nobel Prize in 2012.
“Remarkably, the stem-cell neurons promoted lasting pain relief without side effects,” co-senior author Dr Leslie Caron said. “It means transplant therapy could be an effective and long-lasting treatment for neuropathic pain. It is very exciting.”
John Manion, a PhD student and lead author of the paper said: “Because we can pick where we put our pain-killing neurons, we can target only the parts of the body that are in pain. This means our approach can have fewer side effects.”
The stem cells used were derived from adult blood samples.
The total cost of chronic pain in Australia in 2018 was estimated to be $139.3 billion.
Nicoletta, an MS Reporter representing the MS community, asks Dr Rog whether HSCT will work for people who have secondary progressive MS. MS Reporter: Nicoletta Expert: Dr David Rog, Consultant Neurologist, Salford NHS Trust