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Stem Cell Therapies for Progressive Multiple Sclerosis

Journal

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fcell.2021.696434

Keywords

progressive multiple sclerosis; neural stem cell; regenerative neuroimmunology; mesenchymal stem cell; stem cell therapy; clinical trial

Funding

  1. National MS Society (United States) [RG-1802-30200]
  2. Italian Multiple Sclerosis Association (AISM) [2018/R/14]
  3. United States Department of Defense (DoD) Congressionally Directed Medical Research Programs (CDMRP) [MS-140019]
  4. Bascule Charitable Trust [RG 75149, RG 98181]
  5. Wellcome Trust [RG 79423]
  6. Fondazione Italiana Sclerosi Multipla (FISM) [2017/B/5]
  7. '5 per mille' public funding
  8. Cambridge Trust [10468562]
  9. Canadian Scholarship Trust Foundation
  10. MNI-Cambridge Douglas Avrith Graduate Studentship
  11. Rosetrees Trust [A1850]
  12. ECTRIMS Postdoctoral Research Fellowship Exchange Program [G104956]
  13. Medical Research Council Doctoral Training Partnership (MRC DTP) award [RG86932]

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Multiple sclerosis is a chronic inflammatory disease of the central nervous system characterized by demyelination and axonal degeneration. While current treatments for progressive MS are limited, stem cell transplantation shows promise in providing neurotrophic support, immunomodulation, and cell replacement to combat chronic neuroinflammation.
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterized by demyelination and axonal degeneration. MS patients typically present with a relapsing-remitting (RR) disease course, manifesting as sporadic attacks of neurological symptoms including ataxia, fatigue, and sensory impairment. While there are several effective disease-modifying therapies able to address the inflammatory relapses associated with RRMS, most patients will inevitably advance to a progressive disease course marked by a gradual and irreversible accrual of disabilities. Therapeutic intervention in progressive MS (PMS) suffers from a lack of well-characterized biological targets and, hence, a dearth of successful drugs. The few medications approved for the treatment of PMS are typically limited in their efficacy to active forms of the disease, have little impact on slowing degeneration, and fail to promote repair. In looking to address these unmet needs, the multifactorial therapeutic benefits of stem cell therapies are particularly compelling. Ostensibly providing neurotrophic support, immunomodulation and cell replacement, stem cell transplantation holds substantial promise in combatting the complex pathology of chronic neuroinflammation. Herein, we explore the current state of preclinical and clinical evidence supporting the use of stem cells in treating PMS and we discuss prospective hurdles impeding their translation into revolutionary regenerative medicines.

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