Stem Cell Transplantation to Treat Multiple Sclerosis

Atkins, Harold L.

doi:10.1001/jama.2018.20777

Cited by 11 publications

(9 citation statements)

References 18 publications

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“…Compared with ongoing repeated treatments with modern DMTs, aHSCT is a 'one-off' treatment, for which, therapeutic benefits last for many years in appropriately selected patients. Favourable cost-effectiveness ratio in MS patients showing a sustained response to HSCT over some DMTs has been reported [139][140][141]. However, for accurate and upto-date evaluations, health economic evaluation should be combined with prospective clinical trials.…”

Section: Public Health System Delivery Of Hsct In Ms and Immune-mediamentioning

confidence: 99%

Autologous haematopoietic stem cell transplantation and other cellular therapy in multiple sclerosis and immune-mediated neurological diseases: updated guidelines and recommendations from the EBMT Autoimmune Diseases Working Party (ADWP) and the Joint Accreditation Committee of EBMT and ISCT (JACIE)

Sharrack

Saccardi

Alexander

et al. 2019

Bone Marrow Transplant

189

276

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These updated EBMT guidelines review the clinical evidence, registry activity and mechanisms of action of haematopoietic stem cell transplantation (HSCT) in multiple sclerosis (MS) and other immune-mediated neurological diseases and provide recommendations for patient selection, transplant technique, follow-up and future development. The major focus is on autologous HSCT (aHSCT), used in MS for over two decades and currently the fastest growing indication for this treatment in Europe, with increasing evidence to support its use in highly active relapsing remitting MS failing to respond to disease modifying therapies. aHSCT may have a potential role in the treatment of the progressive forms of MS with a significant inflammatory component and other immune-mediated neurological diseases, including chronic inflammatory demyelinating polyneuropathy, neuromyelitis optica, myasthenia gravis and stiff person syndrome. Allogeneic HSCT should only be considered where potential risks are justified. Compared with other immunomodulatory treatments, HSCT is associated with greater short-term risks and requires close interspeciality collaboration between transplant physicians and neurologists with a special interest in these neurological conditions before, during and after treatment in accredited HSCT centres. Other experimental cell therapies are developmental for these diseases and patients should only be treated on clinical trials.

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Section: Public Health System Delivery Of Hsct In Ms and Immune-mediamentioning

confidence: 99%

Autologous haematopoietic stem cell transplantation and other cellular therapy in multiple sclerosis and immune-mediated neurological diseases: updated guidelines and recommendations from the EBMT Autoimmune Diseases Working Party (ADWP) and the Joint Accreditation Committee of EBMT and ISCT (JACIE)

Sharrack

Saccardi

Alexander

et al. 2019

Bone Marrow Transplant

189

276

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“…Mesenchymal stem cells (MSCs) are multipotent cells that can be self-renewing, including human umbilical cord mesenchymal stem cells, bone marrow mesenchymal stem cells and adiposederived stem cells. Recently, stem cell therapy has been a promising strategy for diseases, such as liver disease (Zhao L. et al, 2018), multiple sclerosis (Muraro et al, 2017;Atkins, 2019), leukemia (Shem-Tov et al, 2020) and diabetic retinopathy (Gaddam et al, 2019). However, whether stem cell transplantation contributes to the emergence of tumors remains unknown.…”

Section: Mesenchymal Stem Cells-derived Exosomes In Insulin Resistancementioning

confidence: 99%

Exosomes and Obesity-Related Insulin Resistance

Lei

Lin

et al. 2021

Front. Cell Dev. Biol.

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Exosomes are extracellular vesicles, delivering signal molecules from donor cells to recipient cells. The cargo of exosomes, including proteins, DNA and RNA, can target the recipient tissues and organs, which have an important role in disease development. Insulin resistance is a kind of pathological state, which is important in the pathogeneses of type 2 diabetes mellitus (T2DM), gestational diabetes mellitus and Alzheimer’s disease. Furthermore, obesity is a kind of inducement of insulin resistance. In this review, we summarized recent research advances on exosomes and insulin resistance, especially focusing on obesity-related insulin resistance. These studies suggest that exosomes have great importance in the development of insulin resistance in obesity and have great potential for use in the diagnosis and therapy of insulin resistance.

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“…The rationale behind AHSCT is to stop the inflammatory CNS attack by ablation of the patient’s autoreactive immune system, followed by replacement with an autologous naïve immune system that will no longer attack the CNS. 9,10 The procedure has two phases: first, mobilization and collection of the patient’s hematopoietic stem cells (HSCs), and second, immune ablation by the transplant conditioning regimen followed by reinfusion of the autologous HSC. 11…”

Section: Ahsct Methodologymentioning

confidence: 99%

Autologous hematopoietic stem cell transplantation for multiple sclerosis: A current perspective

et al. 2020

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The most effective treatment at halting inflammation in patients with highly active multiple sclerosis (MS) is immune ablation followed by autologous hematopoietic stem cell transplantation (AHSCT). Better patient selection and supportive management, as well as advances in conditioning regimens have resulted in improved safety with AHSCT. However, which comorbidities or prior therapies increase the risks associated with AHSCT still need to be determined. In addition, there is still debate as to which AHSCT conditioning regimen offers the best balance of long-term efficacy and safety. New studies comparing AHSCT with highly effective disease-modifying therapies will help to inform on the ideal placement of AHSCT in the treatment algorithm. Currently, many centers are experienced and use AHSCT to treat select patients with MS, contributing to ongoing registries and clinical trials which will help answer these questions.

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Stem Cell Transplantation to Treat Multiple Sclerosis

Cited by 11 publications

References 18 publications

Autologous haematopoietic stem cell transplantation and other cellular therapy in multiple sclerosis and immune-mediated neurological diseases: updated guidelines and recommendations from the EBMT Autoimmune Diseases Working Party (ADWP) and the Joint Accreditation Committee of EBMT and ISCT (JACIE)

Autologous haematopoietic stem cell transplantation and other cellular therapy in multiple sclerosis and immune-mediated neurological diseases: updated guidelines and recommendations from the EBMT Autoimmune Diseases Working Party (ADWP) and the Joint Accreditation Committee of EBMT and ISCT (JACIE)

Exosomes and Obesity-Related Insulin Resistance

Autologous hematopoietic stem cell transplantation for multiple sclerosis: A current perspective

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