Stem cells Twenty plus strikes and You’re Out!

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We are in the middle of trials on microbiome and have had a fair few on vitamin D and then we have Stem cells.

People have clamoured for trials to take place and the academic community has complied with this wish over and over again.

In this meta analysis there have been 18 and the conclusion is more trials are needed.

How many times do we have to repeat an idea. For cannabis it was one and that’s it …it failed….even when it may not have, but for mesenchymal stem cell transplantation we keep going back,again and again. I have to say if you take a step back to look at the studies in animals, they have not shown a great effect and is often not better than could be achieved with fingolimod, which can work very well in animals

Zeng L, Yu G, Yang K, Xiang W, Li J, Chen H. Efficacy and Safety of Mesenchymal Stem Cell Transplantation in the Treatment of Autoimmune Diseases (Rheumatoid Arthritis, Systemic Lupus Erythematosus, Inflammatory Bowel Disease, Multiple Sclerosis, and Ankylosing Spondylitis): A Systematic Review and Meta-Analysis of Randomized Controlled Trial. Stem Cells Int. 2022 Mar 24;2022:9463314. doi: 10.1155/2022/9463314. 

Objective: To evaluate the efficacy and safety of mesenchymal stem cell (MSC) transplantation in the treatment of autoimmune diseases.

Methods: The Chinese and English databases were searched for clinical research on the treatment of autoimmune diseases with mesenchymal stem cells. The search time range is from a self-built database to October 1, 2021. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted data, and evaluated the bias of the included studies. RevMan 5.3 analysis software was used for meta-analysis.

Results: A total of 18 RCTs involving 5 autoimmune diseases were included. The 5 autoimmune disease were rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), inflammatory bowel disease, ankylosing spondylitis, and multiple sclerosis. For RA, the current randomized controlled trials (RCTs) still believe that stem cell transplantation may reduce disease activity, improve the clinical symptoms (such as DAS28), and the percentage of CD4+CD 25+Foxp3+Tregs in the response group increased and the percentage of CD4+IL-17A+Th17 cells decreased…………For multiple sclerosis, the current research results are still controversial, so more RCTs are needed to amend or confirm the conclusions. No obvious adverse events of mesenchymal stem cell transplantation were found in all RCTs.

Conclusion: MSCs have a certain effect on different autoimmune diseases, but more RCTs are needed to further modify or confirm the conclusion.

However should this be nineteen

Berard JA, Freedman MS, Marrie RA, Marriott JJ, Atkins HL, Szwajcer D, Courtman DW, Thebault S, Walker LAS. Mesenchymal stem cell therapy and cognition in MS: Preliminary findings from a phase II clinical trial. Mult Scler Relat Disord. 2022 Mar 27;61:103779.

Background: Mesenchymal stem cell (MSC) therapies are being evaluated in multiple sclerosis (MS) for possible neural repair. To date, the potential benefits on cognition have received little attention. The objective of the current study was to comprehensively evaluate cognition before and after MSC therapy in those with MS as part of a double-blind, phase II clinical trial.

Methods: Twenty-eight individuals with a confirmed diagnosis of MS were randomly assigned into two study arms. Cognition was evaluated using an expanded Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) battery. The battery was administered at Week 0, Week 24, and Week 48 and results were analysed at the group and individual level.

Results: No detectable effect of MSC-mediated neural repair was noted in the short-term with respect to cognition, although some cognitive stability or improvement was observed. Decline was noted in some cognitive areas immediately following the procedure at Week 24; though these were temporary with performance returning to baseline levels at Week 48.

Conclusions: While MSC therapy does not lead to improvement in cognition, at least in the short-term, neither does the procedure have lasting deleterious effects. The current findings lend support to the safety and feasibility of MSC therapy as a potentially viable treatment option for individuals with MS.

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MouseDoctor

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  • For clarity: these are not the same as aHSCT but are the type where athletes etc will have them injected in and around injury sites?

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