#MultipleSclerosis #MS #CellTherapy
#Immunomodulation #Cytokines #Neuroinflammation
Multiple sclerosis
(MS) is a
chronic,
progressive autoimmune disease of the central nervous
system, primarily affecting young adults. It is characterized by
persistent
inflammation,
demyelination of nerve fibers, and
progressive axonal
degeneration, which lead to a wide range of neurological symptoms. While
relapsing forms of MS benefit from effective immunomodulatory treatments, the
secondary progressive form (SPMS), which appears after several years, remains
challenging to manage.
In SPMS, patients
experience a continuous
worsening of neurological disability without evident
inflammatory relapses,
limiting the effectiveness of standard treatments.
Current approaches mainly target immune response modulation, but
no strategy
has yet succeeded in restoring lost neuronal function or halting disease
progression.
Resistance to existing therapies,
lack of clinical response, and
the
absence of regenerative treatments are major challenges for this patient
population.
In this constrained
therapeutic context,
placenta-derived mesenchymal stem cells (PLMSCs) are
generating
growing interest. Current data suggest they can
modulate immunity,
reduce inflammation, and
promote neuroprotection and possibly repair. These
cells are low in immunogenicity and have demonstrated an excellent safety
profile, making them
a promising and innovative option for progressive forms of
MS.
This study was
launched to
assess the tolerance, safety, and
exploratory clinical, cognitive,
immunological, and
radiological effects following a
single intravenous
injection of PLMSCs. This protocol is a key step in evaluating the feasibility
of a cell-based approach in this advanced and treatment-resistant form of MS.
Cells to awaken
neurons?
In this study,
five
patients with SPMS were selected and followed for
six months, with a
comprehensive assessment protocol that included:
- Clinical (EDSS), cognitive (MACFIMS
battery), and advanced brain imaging (DTI, fMRI) evaluations;
- Analysis of immunological markers (IL-10,
TNFα, IL-6, IL-17) and B-cell subpopulations (CD19/CD20).
No serious adverse
events were reported, except for transient headaches in two patients within
hours of injection.
Neurologically,
clinical improvement was observed, with a significant reduction in EDSS scores
(P < 0.0001).
Cognitively, substantial gains were noted in several
neuropsychological subtests, indicating
improvements in attention, executive
function, and memory. DTI imaging revealed a
significant reduction in radial
diffusivity, suggesting decreased cerebral oxidative stress. Concurrently,
functional MRI showed an
increase in post-injection functional brain
connectivity.
From an immunological
standpoint, a
significant decrease in B-cell CD19/CD20 expression was observed,
accompanied by a
marked increase in the anti-inflammatory cytokine IL-10 and a
notable reduction in pro-inflammatory cytokines IL-6, TNFα, and IL-17—indicating
a shift toward a more regulated and less inflammatory immune profile.
A cellular hope on
the horizon
Secondary progressive
multiple sclerosis is an advanced stage of the disease marked by irreversible
accumulation of disability, for which therapeutic options remain limited. The
main challenge lies in the
ineffectiveness of conventional treatments, the
lack
of strategies for neuronal repair, and the
silent,
uncontrolled progression of
inflammation and axonal degeneration.
In this context, the
study aimed to
evaluate the safety, tolerability, and exploratory clinical,
cognitive, radiological, and immunological effects of a single intravenous
injection of
placenta-derived mesenchymal stem cells in patients with SPMS. The
results suggest that
PLMSCs are well-tolerated, with no serious adverse
effects, and may
positively influence neurological, cognitive, and immune
functions. Advanced MRI data and biomarker evolution hint at a
potential
neuroprotective—and possibly regenerative—effect of PLMSCs in this progressive
form.
Despite these
encouraging findings, the study has several major limitations, justifying
further
clinical trials. Future trials involving
larger cohorts,
long-term
follow-up, control groups, and
evaluation of multiple-injection protocols will
be essential to
confirm the true clinical efficacy of PLMSCs and refine their
future
integration into the management of progressive MS.
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