Stem Cell Therapy Reduces Symptoms of Multiple Sclerosis
Posted Feb 03 2009 12:10am
From The Times January 30, 2009 Sam Lister, Health Editor
A group of patients suffering from the early stages of multiple sclerosis have shown significant improvements in their condition after being injected with stem cells, scientists say.
Symptoms were reduced in 17 sufferers in a test group of 21 after they were treated with blood stem cells taken from their bone marrow. These haemopoietic cells, which are the precursors to all the components of blood, were used to replace types of white blood cell that attack the central nervous system in MS sufferers.
About 85,000 people in Britain suffer from MS, which is incurable. It weakens the body’s nervous system and, in most cases, causes gradual and irreversible neurological damage.
The research, conducted by doctors at Northwestern University Feinberg School of Medicine, Chicago, involved using drugs to remove the immune system cells (lymphocytes) that were damaging the nervous system and then replacing them with stem cells.
The scientists found that the new lymphocytes formed from the stem cells effectively “reset” the patient’s immune system and no longer caused any nerve damage. This appeared to help the body to rebuild myelin, the sheath that protects nerve fibres from becoming damaged.
Of the 21 patients, 17 showed improvement — regaining balance, having fewer problems walking and suffering less leg weakness — and nerve damage at least stabilised in the other four patients.
Richard Burt, an immunologist at Northwestern University, said that the findings were promising. “It is the first therapy shown to reverse neurological disability in multiple sclerosis and turn the tide of the disease,” he said.
Dr Burt said that further studies involving a larger number of patients were required to confirm his findings, which are published today in The Lancet Neurology.
A control trial, in which patients are randomly assigned the treatment or a placebo, has been approved with 110 patients and research teams in the United States, Canada and Brazil.
The 21 patients, who had an average age of 33, were in the early stage of the disease — known as the relapsing-remitting phase — which is characterised by intermittent symptoms.
Over a period of between 10 and 15 years most patients develop second- phase MS, characterised by gradual and irreversible damage. Available therapies, including steroids and interferons, are effective mainly in the relapsing-remitting phase.
The study showed that 81 per cent of the patients improved by at least one point on the Expanded Standard Disability Status Scale, which grades severity of disability between 1 and 10. No final score was lower than before the stem cell transplantation, while in almost half of cases they improved by two or more points on the scale. The procedure was well tolerated, with only five suffering minor side-effects that improved with treatment.
Dr Burt and colleagues followed up the patients, 11 women and 10 men aged between 20 and 53, for three years. None experienced a relapse.
Writing in an accompanying commentary, Professor Gianluigi Mancardi, of the University of Genova, Italy, said: “The results imply this is a valuable alternative to the transplant conditioning therapies used so far.”
Doug Brown, research manager at the MS Society, said the results were encouraging. “It’s exciting to see that in this trial not only is progression of disability halted, but damage appears to be reversed,” he said. “Stem cells are showing more and more potential in the treatment of MS.”
‘It’s amazing to feel normal’
Multiple sclerosis had left Barry Goudy, a car salesman from Michigan, struggling to work, often unable to climb stairs and needing hospital care after attempting a round of golf (Sam Lister writes).
After suffering the disease for eight years — with aggressive relapses every five or six months — Mr Goudy underwent a stem-cell transplantation in 2003 when he was in his mid-forties. In the five years since, he has not experienced any symptoms of the disease. “I am MS-free — it’s just amazing,” he said. “I used to suffer from all this numbness. I used to have to leave my job to go home and rest. It was terrible.”
After five days of chemotherapy — which effectively removed his immune system — Mr Goudy was injected with the stem cells that reconfigured his white blood cells, halted the fatigue and transformed his life. “I live a normal life,” he said. “I am on no medicine at all.”