Why don’t we use stem cell therapy for MS?

Short answer

Stem cell therapy is already being used to treat MS! Unfortunately, it is a very aggressive treatment with many associated risks. MS is a disease that differs from patient to patient in terms of the exact locations of damage to tissue and the severity of the disease. This means that stem cell therapy does not work equally well for every patient. In patients for whom stem cell therapy would be successful, a less intensive treatment is often already effective. That is why stem cell therapy for MS is still rarely used, although it does happen in special situations!

Longer answer

A short recap: MS (short for multiple sclerosis) is a neurological disease that affects the central nervous system (brain and spinal cord) caused by overactive immune cells. You can read more about this in: “When are we able to solve MS?“.

What is stem cell therapy?

When we talk about stem cells, we mean ‘immature’ cells that can develop into different specialized cells. These ‘immature’ cells can keep dividing, producing both specialized cells and new stem cells. Stem cells are found in the bone marrow and blood, and they make up only a small portion of all the cells in our body. Most of the cells in our body are already specialized and have a specific function (think of muscle cells and skin cells, but also nerve cells).

Stem cell therapy starts with administering certain medications, such as growth factors. As the name suggests, growth factors stimulate (among other things) the growth and multiplication of stem cells. This is necessary to obtain enough of the patient’s own stem cells from their blood, which are then frozen. After that, chemotherapy is used. Through chemotherapy, all immune cells in the circulation of the MS patient are quite drastically destroyed. The frozen stem cells from the blood are then thawed and transplanted back into the body through an IV. These transplanted stem cells can then specialize into different types of cells, including immune cells. In this way, the old defective immune cells are replaced by new ones, giving the patient a kind of ‘hard reset’ of their immune system.

How well does it work?

Stem cell therapy works best in people with the relapsing-remitting form of MS (for an explanation of the types of MS, see also: “When are we able to solve MS?“). In these patients, the treatment can help suppress recurring attacks (or ‘relapses’). Stem cell therapy can stabilize the disease or slow its progression. It is important, however, to put this into perspective! This treatment works mainly in an early phase of the disease, when many immune cells are present and the nerves are still intact. Stem cell therapy does not make stem cells produce new myelin or fully repair the damaged nerve cells. As a result, this treatment does not (yet) work well for people with progressive MS. Unfortunately, this is exactly the group for whom alternative disease-suppressing medications also aren’t very effective (see the answer to the question ‘When can we solve MS?’).

The disadvantages of stem cell therapy

Stem cell therapy is an intense treatment with many associated risks. The treatment can be dangerous because the old immune system is completely shut down, making patients a lotmore vulnerable to infections. Other side effects of stem cell therapy include fever, fatigue, difficulty sleeping, infertility, and hair loss (because of the chemotherapy).

Because of all these disadvantages, stem cell therapy is only used in special cases and under strict medical supervision. It is mainly applied to relapsing-remitting MS patients with a very active form of the disease (many inflammations in the central nervous system), for whom anti-inflammatory medications are not sufficiently effective. In short, stem cell therapy is not often used, but it is also not completely ruled out. For most patients, the potential benefits do not outweigh the risks and side effects of the treatment. For a small group of patients however, it can provide a solution.