Multiple sclerosis comes in two forms; the relapsing-remitting form and the progressive form. If, for the first form, there are several treatments available, for the progressive form there are no cures — or rather, there were none until the use of stem cells was tested.
Multiple sclerosis is a neurodegenerative disease that affects the central nervous system. It’s a complex disease and it is estimated that in Italy, there are about 122,000 people affected by multiple sclerosis, and the number of women is almost three times higher than men.
It occurs at any age but is most commonly diagnosed in young adults between 20 and 40 years old. It has a peculiarity that links it to geography; that is, it’s more prevalent in areas far from the equator, particularly Northern Europe, the United States, New Zealand and South Australia.
The three types of Multiple Sclerosis
- Relapsing-Remitting Multiple Sclerosis (RRMS), which accounts for 85% of cases and for which there are several drugs that don’t definitively cure the disease but allow a good quality of life for the patient.
- Secondarily Progressive Multiple Sclerosis (SPMS), is the evolution of the SM-RR form characterized by a persistent disability that progresses gradually over time.
- Primary Progressive Multiple Sclerosis (PPMS), characterized by a worsening of neurological functions since the onset of the first symptoms and represents about 10% of multiple sclerosis patients.
Treatment for Primary Progressive Multiple Sclerosis (PPMS)
It’s the most serious form and unfortunately also the one for which there is no cure. However, in recent years there have been many advances in the use of autologous stem cells. That is, those stem cells that are taken from the patient himself or herself and then re-infused.
The study by the University of Genoa and IRCCS Policlinico San Martino Hospital (Italy)
In October 2020, a study was published in Neurology by a group of researchers from the University of Genoa and IRCCS Policlinico San Martino Hospital, co-funded by The Italian Multiple Sclerosis Society (AISM) through its Foundation.
The study, coordinated by Dr. Mancardi and Dr. Boffa, has analyzed the effectiveness of autologous hematopoietic stem cell transplantation over time.
The procedure involves taking stem cells from the patient, then lowering the inflammation of the nervous system that characterizes multiple sclerosis and then re-injecting the hematopoietic stem cells previously collected from the patient themselves. These cells form a new immune system that is more tolerant and less aggressive — and thus, will reduce the effects of primary progressive multiple sclerosis.
What’s new in this study?
The uniqueness of this study lies in the fact that the data of all patients with an aggressive form of multiple sclerosis undergoing autologous hematopoietic stem cell transplantation (in Italy) from 1998 to 2019 was analyzed.
The study shows that more than 60% of patients who have undergone stem cell transplantation do not have an aggravation of disability 10 years after transplantation and in many cases, there is also a lasting improvement in the neurological picture.
It’s important to emphasize that since patients with primary progressive multiple sclerosis are excluded from clinical trials of new therapies, there are no drugs for them. Therefore, the use of stem cells is the first treatment that has been shown to be effective, and it’s also effective over the long-term, which is very important because multiple sclerosis is a very slow and chronic disease, and long periods of observation are necessary in order to understand the effectiveness of a specific treatment.
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