Regeneration, repair and stem cell therapy for MSSaturday, October 01, 2005, 08:50 - 09:10
Future neuroprotective treatments for MS: focus on bone marrow stromal cell transplantationD. Karussis (Jerusalem, IL)
It is increasingly recognized that during MS progression, in addition to demyelination, a substantial irreversible damage and loss of neurons takes place, leading to atrophy and chronic disability. Potential therapeutic strategies to prevent the irreversible changes and induce neuroprotection and promote regeneration, have been extensively tried in models of degenerative CNS diseases or stroke, but the subsequent application in human diseases was of limited success. In EAE and MS it seems preferable to combine immunomodulation with neuroprotective modalities to achieve maximal clinical benefit. A promising method to induce neuroregeneration is with transplanation of stem cells.
It was previously shown in our laboratory, that neuronal embryonic stem cells can suppress EAE by exerting direct in situ immunomodulating effects, in addition to their ability to provide a potential source for remyelination and neuro-regeneration.
Another therapeutic strategy involves the use of bone marrow derived stem cells. Both hematopoetic and non-hematopoetic, stromal cells can differentiate under certain circumstances into cells from various neuronal and glial type lineages. Bone marrow stromal cells offer significant advantages over "conventional" embryonic neuronal stem cells: a. they can be obtained even from the adult bone marrow; b. they can be easily cultured and expanded in vitro; c. the patient himself could be the donor of stromal cells and therefore there is no need for any additional imunosuppression for the prevention of rejection.
In a chronic model of EAE we have recently shown that intravenous or intracerebral/intraventricular injection of bone marrow derived stromal cells (either as a crude inoculum or purified) could differentiate in different neuronal/glial cells and could suppress the clinical disease.
Both bone marrow and neuronal stem cells have a therapeutic potential in various neurodegenerative diseases. Specifically bone marrow stromal cells may provide a feasible and practical way to remyelination and regeneration in multiple sclerosis.