Repair, Reset, Reimagine: Stem Cell Therapies for Multiple Sclerosis

Stem cells have the extraordinary ability to transform into different types of cells and renew themselves—offering new hope in the treatment of multiple sclerosis. One of the most advanced approaches—autologous hematopoietic stem cell transplantation (AHSCT)—involves collecting a patient's own bone marrow stem cells, using chemotherapy to wipe out their faulty immune system, and then reinfusing the stem cells to help rebuild it. A more aggressive "myeloablative" approach can effectively halt relapses and new MRI activity but carries serious risks, including life-threatening infections. A gentler "immunoablative" method reduces these risks but allows for a return of MS activity in up to 25% of patients. AHSCT is typically reserved for younger individuals with aggressive relapsing disease and moderate or milder disability. Mesenchymal stem cells—derived from fat, bone marrow support tissue, or dental pulp—have shown mixed results. A large international trial found no benefit when delivered intravenously, although the treatment was safe. However, a smaller study using repeated injections into the spinal fluid showed disease stabilization in most participants. New research is now exploring neural stem cells, which may help protect and repair the brain and spinal cord. A recent Phase 1 trial involving 15 people with secondary progressive MS found reduced inflammation in blood and spinal fluid markers and less brain shrinkage on MRI scans following neural stem cells given into the spinal fluid spaces of the brain. Tune in as we unpack the science, the risks, and the exciting future of stem cell therapies in MS. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Stefano Pluchino MD PhD, Clinical Professor of Regenerative Neuroimmunology, Honorary Consultant in Neurology, University of Cambridge, UK Mark Freedman MD, Professor of Medicine in the field of neurology, University of Ottawa, and Director of the Multiple Sclerosis Research Unit, Ottawa Hospital, Canada