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Neurological Efficacy and Safety of Mesenchymal Stem Cells (Mscs) Therapy in People With Multiple Sclerosis (Pwms): An Updated Systematic Review and Meta-Analysis Publisher Pubmed



Vaheb S1 ; Afshin S2 ; Ghoshouni H1 ; Ghaffary EM1 ; Farzan M3 ; Shaygannejad V1, 4 ; Thapa S5 ; Zabeti A6 ; Mirmosayyeb O1, 4
Authors
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Authors Affiliations
  1. 1. Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Neurology, School of Medicine, Hormozgan University of Medical Sciences, Bandarabbas, Iran
  3. 3. Students Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
  4. 4. Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Jacobs School of Biomedical Sciences, University of Buffalo, Department of Neurology, Buffalo, United States
  6. 6. University of Cincinnati, Cincinnati, OH, United States

Source: Multiple Sclerosis and Related Disorders Published:2024


Abstract

Background: Current therapeutic strategies for multiple sclerosis (MS) aim to suppress the immune response and reduce relapse rates. As alternative treatments, mesenchymal stem cells (MSCs) are being explored. MSCs show promise in repairing nerve tissue and reducing autoimmune responses in people with MS (pwMS). Objective: This review delves into the literature on the efficacy and safety of MSC therapy for pwMS. Methods: A comprehensive search strategy was employed to identify relevant articles from five databases until January 2024. The inclusion criteria encompassed interventional studies. Efficacy and safety data concerning MSC therapy in relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), and primary progressive MS (PPMS) groups were extracted and analyzed. Results: A comprehensive analysis encompassing 30 studies revealed that individuals who underwent intrathecal (IT) protocol-based transplantation of MSCs experienced a noteworthy improvement in their expanded disability status scale (EDSS) compared to the placebo group. Weighted mean difference (WMD) was -0.28; 95 % CI -0.53 to -0.03, I2 = 0 %, p-value = 0.028); however, the intravenous (IV) group did not show significant changes in EDSS scores. The annualized relapse rate (ARR) did not significantly decrease among pwMS (WMD = -0.34; 95 % CI -1.05 to 0.38, I2 = 98 %, p-value = 0.357). Favorable results were observed in magnetic resonance imaging (MRI), with only 19.11 % of pwMS showing contrast-enhanced lesions (CEL) in the short term and no long-term MRI activity. The most common complications in both short-term and long-term follow-ups were infection, back pain, and gastrointestinal symptoms. Conclusions: The study highlights the safety potential of MSC therapy for pwMS. While MRI-based neural regeneration shows significant treatment potential, the effectiveness of MSC therapy remains uncertain due to study limitations and ineffective outcome measures. Further research is needed to establish efficacy and optimize evaluation methods for MSC therapy on pwMS. © 2024 Elsevier B.V.
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