Neuroimmune diseases: are autoimmune diseases that occur in the nervous system, including multiple sclerosis (MS), neuromyelitis optica, inflammatory demyelinating polyneuropathy, and myasthenia gravis. It can lead to clinical symptoms such as abnormal mental behavior, repeated epileptic seizures, and cognitive impairment.
In recent years, researchers in the industry have deepened their understanding of the spectrum of autoimmune diseases in the nervous system and the spectrum of autoantibodies in the nervous system, and found that mesenchymal stem cells (MSCs) have self-renewal, multi-directional differentiation potential, immune regulation and tissue repair. Secreting cytokines, regulating T cells, etc. to play an immunomodulatory role, has become one of the emerging treatment options for immune diseases of the nervous system.
The mechanism of action of stem cells in the nervous system
①Cell migration: When tissue is damaged in the body, MSCs migrate directionally to the damaged tissue or organ microenvironment to maintain or remodel their cell function. This process involves a variety of cytokines and cell signaling pathways.
②Immune regulation: MSCs can inhibit the proliferation of T cells, regulate the ratio of Th2/Th1 cells, block the cell cycle of B cells, and inhibit cell proliferation and antibody production.
③ Cell differentiation: MSCs can be differentiated into neurons, astrocytes, oligodendrocytes and other cells. After infusion of MSCs, they can migrate to the damaged nerve area and replace damaged resident cells, repair damaged neurons, and improve clinical symptoms.
Stem Cell Therapy for Multiple Sclerosis (MS)
MS is characterized by inflammatory demyelinating lesions of the central nervous system white matter, with sporadic, adult susceptibility, recurrent, and poor prognosis.
Riordan et al. observed and reported the clinical efficacy of stem cells in 20 patients with MS, of which 15 patients were diagnosed with relapsing-remitting MS, 4 patients with primary progressive MS, and 1 patient with secondary progressive MS at the time of enrollment. Follow-up showed that all patients The clinical symptoms of the patients were relieved, the EDSS score was significantly improved, and there was no recurrence or deterioration.
Stem cell therapy for neuromyelitis optica (NMO) spectrum disease
NMO spectrum disorder is an acute or subacute demyelinating neuroimmune disorder in which the optic nerve and spinal cord are involved simultaneously or sequentially.
Fu et al. reported the situation of 15 patients with NMO spectrum disease who received bone marrow MSCs treatment. About 1.0 × 108 autologous bone marrow MSCs were intravenously injected into the patients and followed up for 2 years. Among them, 13 patients had no clinical recurrence. And the EDSS score has been improved.
Another study included 12 cases of NMO treated with autologous MSCs. After clinical treatment and careful nursing, the condition of 12 patients improved and was discharged from hospital, of which 2 patients fully recovered.
Stem Cell Therapy for Myasthenia Gravis (MG)
MG is an autoimmune disease involving the neuro-muscular junction. The clinical features are mainly fluctuating muscle weakness, and the muscle weakness is aggravated by activity, relieved by rest, and heavy in the morning and evening.
Bryant et al. reported 7 patients with MG who received autologous stem cell transplantation, of which 6 were primary MG and 1 was secondary MG after follicular lymphoma. All 7 patients achieved significant clinical symptom relief. One case was associated with immune-related graft-versus-host disease, but no other serious stem cell-related clinical adverse reactions occurred.
Stem cell therapy for autoimmune encephalitis (AE)
AE generally refers to a type of encephalitis mediated by autoimmune mechanisms. The main clinical manifestations are multifocal or diffuse brain damage such as abnormal mental behavior, epileptic seizures, and recent memory impairment.
Yang et al. showed that adult NSCs can stimulate the high expression of IL-10 in an animal model of experimental autoimmune encephalomyelitis, with strong immune regulation and remyelination, and immunofluorescence showed that NSCs could further differentiate into neurons and oligodendrocytes. Dendritic cell population.
Summary: The above studies have found that stem cells have great clinical application value in the treatment of neuroimmune diseases, and have achieved good results in the treatment of MS, NMO, MG, AE, etc. Although there are few clinical cases in some diseases, their safety Both performance and effectiveness have been verified.