MSCT for multiple sclerosis

Could a new treatment for MS be on the horizon? MS-UK Helpline officer Shaun Barton explains MSCT 

In recent years the use of stem cells to treat multiple sclerosis (MS) has been well documented, particularly in the form of hematopoietic stem cell transplantation (HSCT), which is currently available as a treatment for some people with MS via the NHS in the UK. But did you know that there is another form of stem cell therapy that studies so far have shown could have potential to be an effective treatment for MS and other inflammatory conditions? 

Mesenchymal stem cells (MSCs) play a significant part in modulating our immune system, with the focal role being preventing it from being excessively active. MSC therapies have been approved in some countries across the globe to treat conditions that would benefit from its anti-inflammatory effects, such as Alzheimer’s and Crohn’s disease in Korea and Japan.   

The MSCT procedure

Mesenchymal stem cell therapy (MSCT) involves extracting a sample of MSCs from a patient’s blood stream or bone marrow, multiplying them once in the lab, and then reintroducing the multiplied cells back into their blood or spinal cord fluid, via infusion.  

This differs from HSCT which uses chemotherapy to completely wipe the patient’s immune system before reintroducing the hematopoietic stem cells, leaving the patient vulnerable to infections in the interim.  

You may have heard of HSCT for multiple sclerosis because there have been some high-profile success stories in recent years. American actress Selma Blair has spoken publicly about her positive experience with HSCT, which she underwent in 2019, which has so far caused her MS to be in remission, meaning there is no evidence of progression. But, while there are many success stories from people who have undergone HSCT, the process can be brutal for the body, poses a risk to life, and often requires a lengthy hospital stay. 

In theory, MSCT treatment should therefore be less invasive and pose less risks than HSCT. 

How MSCT works

The premise that underpins MSCT for MS is that the infused cells will help better regulate the immune system, reduce the impact of inflammation on our central nervous system, and possibly influence myelin repair.  

So, what do we know so far? To date, studies have shown that MSCT can play a positive role in the treatment of MS, regarding both efficacy and safety. A recent review of clinical studies that were focused on the impact of MSCT treatment for people with MS concluded that results thus far suggested it could decrease demyelination and inflammation, leading to an improvement of MS symptoms. However, the authors noted that more extensive clinical trials were required to further understanding.  

There was also positive news for people affected by progressive forms of MS, given the results of a recent trial which took place in the United States. 

Hopeful research

Researchers recruited 54 participants who scored at least three points or more on the Expanded Disability Status Scale (EDSS). They were split into two groups, one being a placebo and the other whose members were given MSCT, over a two-year period. Results showed that the MSCT group displayed significantly improved walking ability and muscle strength compared to the placebo. 

Conversely, the MESEMS trial, which took place in centres around the world and involved 144 participants who were affected by MS, concluded that while MSCT is safe and well tolerated by people with the condition, there was little evidence to show that it was effective at reducing inflammation for patients with active forms of MS.  

It is apparent that while studies have shown there could be benefits of MSCT for the management of MS, more extensive clinical trials are required to further understanding, specifically in terms of efficacy and safety.  

As always MS-UK will report on any such findings via our website and social media outlets, whenever significant information is released to the public domain.