Multiple Sclerosis (MS), a complex autoimmune pathology, impairs the central nervous system through:
The etiology of MS remains partially understood, with prevailing consensus attributing its onset to an interplay of genetic predispositions and environmental triggers. Specifically, inflammation leads to lesion formation in neural tissues; demyelination results from autoimmune assaults on the myelin sheath of nerve fibers; and neuronal damage arises either directly from prolonged inflammatory states or through secondary pathological processes. Clinically, MS manifests in a spectrum of symptoms, including sensory deficits, motor coordination impairment, visual disturbances, fatigue, and cognitive impairments.
In conclusion, MSCs therapy seemed to be an efficacious therapeutic strategy in treating patients with MS, as a majority of patients either improved or remained stable based on the EDSS score. In addition, as no major adverse events were identified, it appeared to be a safe therapeutic strategy in treating MS patients. However, further research, development of new technology, optimisation of MSCs doses, and larger clinical trials are needed to fully evaluate its long-term effectiveness and safety profile.
Emerging therapies such as MSC therapy have shown promising results in treating severe cases of MS. These innovative treatments aim to repair damaged nerve cells and halt disease progression, offering new hope for patients who have not responded well to conventional options.
The current therapeutic approaches for MS include pharmacological interventions, physical therapy, and rehabilitative measures, all directed toward mitigating disease activity, relieving symptomatic burdens, and improving overall patient well-being. Among these, Disease Modifying Therapies (DMTs) are pivotal, primarily functioning to modulate the immune response and curtail inflammatory processes, thus impeding the disease progression (15). DMTs currently encompass a variety of administration routes, including subcutaneous and intramuscular injections, oral formulations, and intravenous infusions, tailored to accommodate the diverse preferences and clinical requirements of individual patients. Despite the advances in DMTs, their application is tempered by challenges related to sustained efficacy, patient-specific response variability, safety profiles, and financial implications (16). Conventional pharmacotherapy encompasses immunomodulators, anti-inflammatory compounds, and immunosuppressive medications, aimed at orchestrating immune system activity to reduce MS progression and ameliorate symptoms. An exemplar of this approach is interferon-β, which emulates endogenous interferons to temper immune hyperactivity, thereby decelerating the disease’s trajectory (17). On the other hand, immunomodulatory agents such as acetate salts function by modulating immune activity, primarily through the suppression of T-cell functionality. Despite their efficacy, there is a risk of patients developing medication resistance over time (18). During acute flare-ups, anti-inflammatory medications like methylprednisolone, a type of glucocorticoid, are utilized to mitigate inflammation; however, their long-term application is associated with adverse effects, including diminished bone density, compromised immune function, and gastrointestinal complications (19).
Beyond pharmacological interventions, holistic treatment regimens, encompassing physical therapy, rehabilitation services, and acupuncture, are employed to improve the quality of individuals with MS (20). While the efficacy of these approaches may vary across patients, the goal of achieving substantial neural regeneration remains elusive. Collectively, current therapeutic strategies can provide symptomatic relief to some degree, yet they are encumbered by various limitations and challenges. Consequently, the exploration of innovative treatments, such as stem cell therapy, represents a promising frontier in the quest for more effective MS management solutions.
In recent advancements, stem cell therapy has been recognized as a frontier with significant potential in the treatment of MS. Stem cells, characterized by their inherent ability for self-renewal and pluripotency, hold promise for regenerating damaged neural tissue, modulating immune responses, and fostering an environment conducive to endogenous repair mechanisms.
Distinct from traditional therapeutic modalities, stem cell therapy entails the transplantation of stem cells capable of differentiating into diverse neural cell types, thereby facilitating tissue regeneration. Moreover, these cells secrete neurotrophic factors that enhance the survival and function of adjacent neural tissue. Critically, stem cells exhibit immunomodulatory effects that attenuate inflammatory processes, offering a novel approach to mitigating the progression of MS lesions.
Empirical studies, including laboratory and animal model research, have demonstrated the therapeutic efficacy of hematopoietic, neural, and embryonic stem cells, indicating substantial therapeutic promise . Preliminary clinical trials have corroborated these findings, signaling a promising horizon for individuals afflicted with MS.
Of the several types of MSCs, UCMSCs are the best option for MS treatment for several reasons. These cells can do a faster self-renewal than other MSCs, can differentiate into three germ layers, and can accumulate in damaged tissue or inflamed areas. They also have their own advantages that makes them the choice of MS therapy. First, the separation of the cells from the UC is easy, painless, and without ethical issues. Second, the amount of stem cells produced per unit area is high. Third, the cost of stem cell transfusion from the UC is not expensive. Fourth, these cells are very safe to use. Based on the studies presented in the section about UCMSCs, these cells would be considered as a safe and alternative option for treatment of the neurological parameters of MS, through results confirmed by EDSS, the nine-hole peg test, the expanded EDSS rating neurologic impairment, and the 25-foot walking time. UCMSCs have also been found to affect the function of the disabled Tregs in MS patients in vitro and revert them to normal conditions; impaired immunoregulatory function of Tregs constitute a main fixture of MS progression as being impaired means they cannot inhibit the proliferation of auto-effector T cells that would attack ODCs and initiate MS. Based on the information presented, it is the author’s recommendation to emphasize the clinical utility of UCMSCs for regenerative medicine and immunotherapy.”
