The immunomodulatory properties of mesenchymal stem cells (MSCs) coupled with their isolation from several sources ranging from bone marrow to adipose tissue to umbilical cord to placenta to dental pulp, and even menstrual fluid makes them attractive options for use in cell-based therapy.
According to the National Institute of Environmental Health Sciences, autoimmune diseases affect more than 24 million people in the United States. Research points out the interactions between genetic and environmental factors with the involvement of ethnicity and gender. These diseases are a leading ability of disability in the world.
An example of an autoimmune disease is multiple sclerosis (MS): according to the GBD 2016 Multiple Sclerosis Collaborators, the prevalence of this disease increased by around 10% in 2016 from the figures in 1990. The need of the hour is a clinically effective treatment option for this disease. A 2012-published clinical trial explored the use of autologous bone-marrow-derived mesenchymal stem cells for multiple sclerosis (ClinicalTrials.gov: NCT00395200). 10 patients with secondary progressive multiple sclerosis from the East Anglia and North London regions of the UK were administered 1·6×106 cells per kg body weight of the stem cells. The safety was shown by a lack of serious adverse effects from up to 20 months before treatment until up to 10 months after the infusion. Additionally, the optic nerve area was increased with the improvement in visual functions and an overall improvement in the progression of disability as evidenced by lowered expanded disability status scale (EDSS) scores. Thus, MSCs were shown to exert neuroprotective effects in diseases such as MS.
A common and fatal autoimmune disease is systemic lupus erythematosus (SLE): scientists Sun and team (2014) reported the safety and efficiency of the umbilical cord (UC)–derived mesenchymal stem cells (MSCs) in a multicenter clinical trial (ClinicalTrials.gov identifier: NCT01741857). 40 patients from China received allogeneic UC MSC transplantation on days 0 and 7 intravenously. 13 patients showed a major clinical response (MCR) while 11 showed a partial clinical response (PCR) during 12 months of follow up. There were no adverse effects of the MSC transplantation noted. There was a significant reduction in the clinical indices: Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score over 12 months and British Isles Lupus Assessment Group (BILAG) score at 3 months of follow-up showing the potential of MSCs in autoimmune disease treatment.
The likely healing effects of MSCs are attributed to modulation of inflammation, secretion of paracrine factors (growth factors, cytokines and chemokines) as well as their homing ability. The treatment of autoimmune diseases that plague several people across the globe sees light in the horizon in the form of mesenchymal stem cell-based therapies.
Fernando E. Figueroa, FlavioCarrión, Sandra Villanueva, MarounKhoury.Mesenchymal Stem Cell treatment for autoimmune diseases: a critical review. Biol Res 45: 269-277, 2012.
GBD 2016 Multiple Sclerosis Collaborators. Global, regional, and national burden of multiple sclerosis 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol(2019): 18 (3): 269-285
Connick P, Kolappan M, Crawley C, et al (2012) Autologous mesenchymal stem cells for the treatment of secondary progressive multiple sclerosis: an open-label phase 2a proof-of-concept study. Lancet Neurol 11(2):150-156.
Wang, D., Li, J., Zhang, Y., Zhang, M., Chen, J., Li, X., Hu, X., Jiang, S., Shi, S., & Sun, L. (2014). Umbilical cord mesenchymal stem cell transplantation in active and refractory systemic lupus erythematosus: a multicenter clinical study. Arthritis research & therapy, 16(2), R79.