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Brain. 2017 Nov 1;140(11):2776-2796. doi: 10.1093/brain/awx154.

Cell-based therapeutic strategies for multiple sclerosis.

Author information

1
Department of Neurology, University of Bristol Southmead Hospital, Bristol BS10 5NB, UK.
2
Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI 53226, USA.
3
Scientific and Clinical Research Associates, LLC, Salisbury, CT 06068, USA.
4
Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

Abstract

The availability of multiple disease-modifying medications with regulatory approval to treat multiple sclerosis illustrates the substantial progress made in therapy of the disease. However, all are only partially effective in preventing inflammatory tissue damage in the central nervous system and none directly promotes repair. Cell-based therapies, including immunoablation followed by autologous haematopoietic stem cell transplantation, mesenchymal and related stem cell transplantation, pharmacologic manipulation of endogenous stem cells to enhance their reparative capabilities, and transplantation of oligodendrocyte progenitor cells, have generated substantial interest as novel therapeutic strategies for immune modulation, neuroprotection, or repair of the damaged central nervous system in multiple sclerosis. Each approach has potential advantages but also safety concerns and unresolved questions. Moreover, clinical trials of cell-based therapies present several unique methodological and ethical issues. We summarize here the status of cell-based therapies to treat multiple sclerosis and make consensus recommendations for future research and clinical trials.

KEYWORDS:

clinical trials; medical ethics; multiple sclerosis and neuroinflammation; remyelination; stem cells

PMID:
29053779
PMCID:
PMC5841198
DOI:
10.1093/brain/awx154
[Indexed for MEDLINE]
Free PMC Article

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