Mesenchymal stem cells and conditioned media in the treatment of multiple sclerosis patients: Clinical, ophthalmological and radiological assessments of safety and efficacy

Abstract

SummaryAimsThis open‐label prospective phase I/IIa clinical study used autologous bone marrow‐derived mesenchymal stromal cells (BM‐MSCs) followed by mesenchymal stromal cells conditioned media (MSC‐CM) for the first time to treat multiple sclerosis (MS) patients. The primary goal was to assess the safety and feasibility and the secondary was efficacy. The correlation between the MSC‐CM content and treatment outcome was investigated.MethodsTen MS patients who failed conventional therapy were enrolled. Adverse events were recorded to assess safety. The Expanded Disability Status Scale (EDSS) was the primary efficacy measurement, the secondary included clinical (25WFT, 9‐PHT), cognitive (MMS), ophthalmology (OCT, VEP), and radiological (MRI lesion and volume) tests. The MSCs‐CM concentration of 27 inflammatory biomarkers was investigated.ResultsThe treatment protocol was well tolerated by patients. There was an overall trend of improvement in all the tests, except the lesion volume which increased significantly. A decrease of 4 and 3.5 points on the EDSS was achieved in two patients. We report a correlation between a decreased lesion number at baseline and higher IL‐6, IL‐8, and VEGF MSC‐CM content.ConclusionThe used protocol was safe and feasible with possible efficacy. The addition of MSC‐CM could be related to the magnitude of EDSS improvement observed.

Conditioned media derived from mesenchymal stem cell cultures: The next generation for regenerative medicine

“…It was shown that the BMSCs and BMSC‐CM can be safely used for treatment, and it also demonstrated the importance of IL‐6. IL‐8 and VEGF present in the CM for the treatment of multiple sclerosis (Dahbour et al, ).…”

Potential of mesenchymal stem cells alone, or in combination, to treat traumatic brain injury

“…The preclinical data on MSCs both alone and in conjunction with other treatment strategies are promising. These cells have entered at least Phase I (safety) clinical trials for multiple nervous system diseases and injuries, most notably cerebral ischemia, multiple sclerosis, Alzheimer's disease, and TBI . While we have a better understanding of the pathologic cascades triggered after TBI and the mechanisms by which MSCs repair the brain and improve functional outcomes, we are still years away from realizing an effective regenerative medicine therapy for TBI that is widely available to patients.…”

Stem cell therapy for neurological disorders

“…The most recent report using bone marrow-derived MSCs for multiple sclerosis also included follow-up administrations of MSC-conditioned medium. [57] MSC-conditioned medium, i.e. the same cell culture medium used to expand MSCs, contains a range of cytokines, chemokines and growth factors which are postulated to further promote neuronal regeneration.…”