Clinical neurorestorative progress in amyotrophic lateral sclerosis

Abstract

Amyotrophic lateral sclerosis is a progressive and fatal neurodegenerative disease characterized by progressive paralysis and motor neuron death. In addition to symptomatic managements such as ventilation and nutritional support, neurorestorative therapies have demonstrated anti-neurodegenerative potential and may improve quality of life for patients. Currently, clinical neurorestorative strategies include pharmacological management (granulocyte colony stimulating factor), neuromodulatory intervention (repetitive transcranial magnetic and cortical stimulation), cell transplantation (bone marrow stromal cells, olfactory ensheathing cells, granulocyte colony stimulating factor-mobilized peripheral blood stromal cells, hematopoietic stem and progenitor cells, neural stem/progenitor cells, CD133 + cells and CD34 + cells), bioengineering and tissue engineering therapy, and combined neurorehabilitative treatment. In this review, we describe the latest progress in clinical neurorestorative management of amyotrophic lateral sclerosis and discuss the underlying evidence base.

Clinical Cell Therapy Guidelines for Neurorestoration (IANR/CANR 2017)

“…The clinical guidelines presented in this document apply more to mature/functionally differentiated cell therapy. To date, clinical trials of treatments based on those categories of cells have been carried out in over 40 countries with documented safety and functional neurological improvement for patients with CNS diseases and damage 74 – 114 .…”

Progress and challenges with clinical cell therapy in neurorestoratology

“…Cell therapies have been shown to stabilize or improve neurological functioning and quality of life in patients with amyotrophic lateral sclerosis to some extent for a period of time according to the Amyotrophic Lateral Sclerosis Functional Rating Scale assessment standard. [16][17][18] Farge et al 19 reported that autologous hematopoietic stem cell transplantation is capable of inducing sustained remissions for more than 5 years in patients with severe autoimmune diseases, in particular those with multiple sclerosis, with similar results being shown in other studies. 13,[20][21][22][23][24][25] Although not providing a cure, such therapy may lead to prolonged disease stabilization and attenuate the aggressive course of multiple sclerosis.…”