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Review Article


Stem cells used for the treatment of Multiple Sclerosis


Lysander Borrero Romero


Abstract


Multiple sclerosis (MS) is a degenerative disease caused by the immune system. In MS the T cell

attacks the myelin sheath around the axon making it very difficult for a patient to move his

appendages. The type of MS that causes fewer problems, in long-term conditions, is the Benign

multiple sclerosis. The deadliest type of MS is called Marburg Variant that can cause even death.

Embryonic stem cells are found in mammal embryos and adult stem cells are present in various

organs of a mammal. Stem cell treatments are mostly autologous. It is usually done by extracting

stem cells from the bone marrow and injecting them into the affected area. The purpose of this

paper is to identify how the stem cells can be used for the improvement of this disease. The

outcome of this investigation is expected to be that stem cells can reduce the effects of multiple

sclerosis, but not cure it completely.


Introduction                                         cell is none other than a lymphocyte, also

                                                     called white blood cell, from the immune
Multiple sclerosis is a degenerative disorder
                                                     system that matures in the thymus. The
in the nervous system. This is an
                                                     infiltration of these cells causes the
autoimmune disease meaning that your own
                                                     destruction of myelin. Myelin is present in
immune system is attacking itself. This
                                                     the neuron and it is a kind of lipid-
disease is caused by the infiltration of T
                                                     containing fiber wrapped around the axon. It
cells into the central nervous system. A T
                                                     acts like an insulator and facilitates the


                                                 1
transmission of nerve signals. This review         and Marburg Variant. Benign multiple

paper will be about how multiple sclerosis         sclerosis is when a patient can expect little

can be treated with stem cells, reducing the       or no progress since its first attack, and

effects of demyelination.                          generally they can remain fully functional.

                                                   Relapsing Remitting Multiple sclerosis
  There have been many studies showing
                                                   (RRMS) is the most common form of the
that women are more affected by multiple
                                                   disease; the patient can suffer a series of
sclerosis than men. For example, studies
                                                   attacks and then there is a complete or
published in the Campbell Biology book
                                                   partial remission stage. Secondary
indicate that gender, genetics, and the
                                                   Progressive Multiple sclerosis can start as
environment could influence the
                                                   the RRMS but has no complete or partial
susceptibility to autoimmune diseases. In
                                                   remission stage, with just a break in the
addition, women are two to three times more
                                                   duration of the attacks. Primary Progressive
likely to suffer from multiple sclerosis and
                                                   Multiple sclerosis is mostly found in men
other diseases than men. They also mention
                                                   and it has no distinct or real periods of
that there is still no concrete evidence of
                                                   remission. Progressive Relapsing Multiple
why do women develop more autoimmune
                                                   sclerosis is a very rare form of MS, and it
diseases than men, and why there is more
                                                   produces acute attacks with no relief.
frequency of autoimmune diseases in
                                                   Marburg Variant, or Malignant Multiple
industrialized countries (Reece et al 2011).
                                                   sclerosis, is the rarest form of MS and after
  Types of MS
                                                   the initial attack can usually kill in months

  There are various types of MS like               or even weeks.

Benign MS, RRMS, SPMS, PPMS, PRMS,




                                               2
Stem Cells                                          high-dose immunosuppression with

                                                    peripheral blood stem cell transplantation
  There are two types of stem cells,
                                                    (SCT) in selected patients (Openshaw 2000).
embryonic and adult stem cells. Embryonic
                                                    In this investigation they are trying to see
stem cells are the stem cells found in the
                                                    how the body will react to the
developing embryo of a mammal. Adult
                                                    immunosuppressive drugs. They need to use
stem cells, also called somatic stem cells,
                                                    immunosuppression, which is lowering the
are present in different organs like bone
                                                    intensity of protection of the immune
marrow, liver, peripheral blood, brain, and
                                                    system, in order for the body to accept the
heart. Stem cells help repair the body of any
                                                    stem cells. They are autologous stem cells,
kind of disease. There has been treatment
                                                    meaning from your own body, but since they
even for cancer using stem cells. In recent
                                                    are extracted and preserved the immune
studies scientists have extracted stem cells
                                                    system could mistake them for a pathogen
from the bone marrow as a treatment for
                                                    and destroy them.
multiple sclerosis. They are trying to use
                                                      Eighty-five patients with progressive
autologous stem cells. Autologous stem cells
                                                    Multiple sclerosis were treated with
are stem cells from your body but they are
                                                    autologous HSCT (hematopoietic stem cell
extracted and preserved in a laboratory.
                                                    transplantation) in 20 centers and reported to
They are preserved in a laboratory with the
                                                    the autoimmune disease working party of
objective that they can be taken out when
                                                    the European Group for Blood and Marrow
you need a stem cell transplant.
                                                    Transplantation (Fassas et al 2002). Fifty-
  Stem Cell Treatment
                                                    two of these patients representing 61% of
  Multiple sclerosis (MS) is an immune-
                                                    the subjects in the study were females
mediated disease that may be amenable to


                                                3
between the ages of 20 and 58 years old.            achieve immunosuppression even if it is an

The outcome of the study was 7 deaths, 5            autologous stem cell transplantation. The

due to toxicity and 2 of neurological               use of intensive stem cell transplantation

deterioration. Neurological deterioration was       offers an opportunity to deliver maximally

observed in 22 patients during the                  tolerated immunosuppression (Nash et al

transplant. The study showed that there was         2003).Once the immunosuppression is done,

more progression in patients with primary           they can proceed with the insertion of stem

progressive MS than patients with secondary         cells in the brain and spinal cord. The stem

progressive or relapsing-remitting MS.              cells would be used for the regeneration of

                                                    myelin sheath around the axon. This
Conclusion
                                                    regeneration will help the patient have a
 Among patients with multiple sclerosis,
                                                    better movement of his appendages. The
relapses do not significantly influence the
                                                    stem cells would even slow down the
progression of irreversible disability
                                                    process of multiple sclerosis.
(Confavreux 2000). The scientists must




                                                4
References

Confavreux C, Vukusic S, Moreau T,                    and others. High-dose immunosuppressive

Adeleine P. 2000. Relapses and Progression            therapy and autologous peripheral blood

of Disability in Multiple Sclerosis [Internet].       stem cell transplantation for severe multiple

N Engl J. [16 Nov 2000]. Volume 343(20).              sclerosis. Journal Of The American Society

Available at:                                         of Hematology[Internet]; [2003 October 1].

http://www.nejm.org/doi/full/10.1056/NEJ              Doi:10.1182/blood-2002-12-3908 .Vol.

M200011163432001#t=abstract                           102:[approximately 10 p.] Available at:

                                                      http://bloodjournal.hematologylibrary.org/co
Fassa AS, Passweg JR, Anagnostopoulos A,
                                                      ntent/102/7/2364.full.pdf+html
Kazis A, Kozak T, Havrdova E, Carreras E,

Graus F, Kashyap A, Openshaw H, and                   Openshaw H, Lund BT, Kashyap A,

others. 2002. Hemapoietic stem cell                   Atkinson R, Sniecinski I, Weiner LP,

transplantation for multiple sclerosis A              Forman S. 2000. Peripheral Blood Stem

retrospective multicenter study(Abstract).            Cell Transplantation in Multiple Sclerosis

Journal of Neurology [Internet]; [2002 Feb            With Busulfan and Cyclophosphamide

4; 2002 Feb 6]. DOI: 10.1007/s00415-002-              Conditioning: Report of Toxicity and

0800-7. Volume 249(8). Available at                   Immunological Monitoring. American

http://www.springerlink.com/content/1b19ld            Society for Blood and Marrow

gyecqvny3w/                                           Transplantation [Internet]; [2000 Jun 13].

                                                      Available at:
Nash RA, Bowen JD, McSweeney PA,
                                                      http://mmserver.cjp.com/gems/bbmt/6.5a.Op
Pavletic SZ, Maravilla KR, Park M, Storek
                                                      enshaw.pdf.
J, Sullivan KM, Al-Omaishi J, Corboy JR,


                                                  5
Reece JB, Urry LA, Cain ML, Wasserman

SA, Minorsky PV, Jackson RB. 2011.

Biology. 9th Ed. San Francisco (CA):

Pearson Benjamin Cummings. 947 p.




                                        6

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Review paper ms 1 revised2

  • 1. Review Article Stem cells used for the treatment of Multiple Sclerosis Lysander Borrero Romero Abstract Multiple sclerosis (MS) is a degenerative disease caused by the immune system. In MS the T cell attacks the myelin sheath around the axon making it very difficult for a patient to move his appendages. The type of MS that causes fewer problems, in long-term conditions, is the Benign multiple sclerosis. The deadliest type of MS is called Marburg Variant that can cause even death. Embryonic stem cells are found in mammal embryos and adult stem cells are present in various organs of a mammal. Stem cell treatments are mostly autologous. It is usually done by extracting stem cells from the bone marrow and injecting them into the affected area. The purpose of this paper is to identify how the stem cells can be used for the improvement of this disease. The outcome of this investigation is expected to be that stem cells can reduce the effects of multiple sclerosis, but not cure it completely. Introduction cell is none other than a lymphocyte, also called white blood cell, from the immune Multiple sclerosis is a degenerative disorder system that matures in the thymus. The in the nervous system. This is an infiltration of these cells causes the autoimmune disease meaning that your own destruction of myelin. Myelin is present in immune system is attacking itself. This the neuron and it is a kind of lipid- disease is caused by the infiltration of T containing fiber wrapped around the axon. It cells into the central nervous system. A T acts like an insulator and facilitates the 1
  • 2. transmission of nerve signals. This review and Marburg Variant. Benign multiple paper will be about how multiple sclerosis sclerosis is when a patient can expect little can be treated with stem cells, reducing the or no progress since its first attack, and effects of demyelination. generally they can remain fully functional. Relapsing Remitting Multiple sclerosis There have been many studies showing (RRMS) is the most common form of the that women are more affected by multiple disease; the patient can suffer a series of sclerosis than men. For example, studies attacks and then there is a complete or published in the Campbell Biology book partial remission stage. Secondary indicate that gender, genetics, and the Progressive Multiple sclerosis can start as environment could influence the the RRMS but has no complete or partial susceptibility to autoimmune diseases. In remission stage, with just a break in the addition, women are two to three times more duration of the attacks. Primary Progressive likely to suffer from multiple sclerosis and Multiple sclerosis is mostly found in men other diseases than men. They also mention and it has no distinct or real periods of that there is still no concrete evidence of remission. Progressive Relapsing Multiple why do women develop more autoimmune sclerosis is a very rare form of MS, and it diseases than men, and why there is more produces acute attacks with no relief. frequency of autoimmune diseases in Marburg Variant, or Malignant Multiple industrialized countries (Reece et al 2011). sclerosis, is the rarest form of MS and after Types of MS the initial attack can usually kill in months There are various types of MS like or even weeks. Benign MS, RRMS, SPMS, PPMS, PRMS, 2
  • 3. Stem Cells high-dose immunosuppression with peripheral blood stem cell transplantation There are two types of stem cells, (SCT) in selected patients (Openshaw 2000). embryonic and adult stem cells. Embryonic In this investigation they are trying to see stem cells are the stem cells found in the how the body will react to the developing embryo of a mammal. Adult immunosuppressive drugs. They need to use stem cells, also called somatic stem cells, immunosuppression, which is lowering the are present in different organs like bone intensity of protection of the immune marrow, liver, peripheral blood, brain, and system, in order for the body to accept the heart. Stem cells help repair the body of any stem cells. They are autologous stem cells, kind of disease. There has been treatment meaning from your own body, but since they even for cancer using stem cells. In recent are extracted and preserved the immune studies scientists have extracted stem cells system could mistake them for a pathogen from the bone marrow as a treatment for and destroy them. multiple sclerosis. They are trying to use Eighty-five patients with progressive autologous stem cells. Autologous stem cells Multiple sclerosis were treated with are stem cells from your body but they are autologous HSCT (hematopoietic stem cell extracted and preserved in a laboratory. transplantation) in 20 centers and reported to They are preserved in a laboratory with the the autoimmune disease working party of objective that they can be taken out when the European Group for Blood and Marrow you need a stem cell transplant. Transplantation (Fassas et al 2002). Fifty- Stem Cell Treatment two of these patients representing 61% of Multiple sclerosis (MS) is an immune- the subjects in the study were females mediated disease that may be amenable to 3
  • 4. between the ages of 20 and 58 years old. achieve immunosuppression even if it is an The outcome of the study was 7 deaths, 5 autologous stem cell transplantation. The due to toxicity and 2 of neurological use of intensive stem cell transplantation deterioration. Neurological deterioration was offers an opportunity to deliver maximally observed in 22 patients during the tolerated immunosuppression (Nash et al transplant. The study showed that there was 2003).Once the immunosuppression is done, more progression in patients with primary they can proceed with the insertion of stem progressive MS than patients with secondary cells in the brain and spinal cord. The stem progressive or relapsing-remitting MS. cells would be used for the regeneration of myelin sheath around the axon. This Conclusion regeneration will help the patient have a Among patients with multiple sclerosis, better movement of his appendages. The relapses do not significantly influence the stem cells would even slow down the progression of irreversible disability process of multiple sclerosis. (Confavreux 2000). The scientists must 4
  • 5. References Confavreux C, Vukusic S, Moreau T, and others. High-dose immunosuppressive Adeleine P. 2000. Relapses and Progression therapy and autologous peripheral blood of Disability in Multiple Sclerosis [Internet]. stem cell transplantation for severe multiple N Engl J. [16 Nov 2000]. Volume 343(20). sclerosis. Journal Of The American Society Available at: of Hematology[Internet]; [2003 October 1]. http://www.nejm.org/doi/full/10.1056/NEJ Doi:10.1182/blood-2002-12-3908 .Vol. M200011163432001#t=abstract 102:[approximately 10 p.] Available at: http://bloodjournal.hematologylibrary.org/co Fassa AS, Passweg JR, Anagnostopoulos A, ntent/102/7/2364.full.pdf+html Kazis A, Kozak T, Havrdova E, Carreras E, Graus F, Kashyap A, Openshaw H, and Openshaw H, Lund BT, Kashyap A, others. 2002. Hemapoietic stem cell Atkinson R, Sniecinski I, Weiner LP, transplantation for multiple sclerosis A Forman S. 2000. Peripheral Blood Stem retrospective multicenter study(Abstract). Cell Transplantation in Multiple Sclerosis Journal of Neurology [Internet]; [2002 Feb With Busulfan and Cyclophosphamide 4; 2002 Feb 6]. DOI: 10.1007/s00415-002- Conditioning: Report of Toxicity and 0800-7. Volume 249(8). Available at Immunological Monitoring. American http://www.springerlink.com/content/1b19ld Society for Blood and Marrow gyecqvny3w/ Transplantation [Internet]; [2000 Jun 13]. Available at: Nash RA, Bowen JD, McSweeney PA, http://mmserver.cjp.com/gems/bbmt/6.5a.Op Pavletic SZ, Maravilla KR, Park M, Storek enshaw.pdf. J, Sullivan KM, Al-Omaishi J, Corboy JR, 5
  • 6. Reece JB, Urry LA, Cain ML, Wasserman SA, Minorsky PV, Jackson RB. 2011. Biology. 9th Ed. San Francisco (CA): Pearson Benjamin Cummings. 947 p. 6