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  4. Mesenchymal stem cell-based therapies for treating well-studied neurological disorders: a systematic review

Mesenchymal stem cell-based therapies for treating well-studied neurological disorders: a systematic review

Frontiers in Medicine, 2024 · DOI: 10.3389/fmed.2024.1361723 · Published: March 27, 2024

Regenerative MedicineNeurology

Simple Explanation

This systematic review investigates the use of mesenchymal stem cells (MSCs) to treat neurological conditions like ALS, Parkinson’s Disease, Multiple Sclerosis, Spinal Cord Injury, and Traumatic Brain Injury. It focuses on the safety, tolerability, and effectiveness of MSC therapies based on published clinical trials. The review analyzed 43 clinical trials using MSCs derived from various sources, including the patient's own bone marrow or tissue, or from umbilical cords. The MSCs were administered through different routes, such as intravenous infusion or injection into the spinal cord. The study found that MSC transplantation is generally safe and tolerable, with common adverse events being mild, such as fever or pain at the injection site. However, some studies reported deaths attributed to the progression of the underlying disease, not the treatment.

Study Duration
Most studies followed-up for at least 6–12 months, with the shortest follow-up period being just 14 days and two studies had follow-up period of 7 and 9 years.
Participants
43 studies were included in this systematic review. The patients in these clinical studies ranged in age from 18 to 80.
Evidence Level
Systematic Review of clinical trials (30 being phase I, seven being phase II, and six being phase I/II)

Key Findings

  • 1
    The review of 43 studies showed that MSC transplantation is generally considered safe and tolerable, with the most common adverse events being mild, such as fever, headache, or pain at the injection site.
  • 2
    Three studies reported a 100% improvement rate, but the sample sizes were small (10 or fewer patients). Thirteen other studies had an improvement rate higher than or equal to 50%, but with the same limitation of low sample size.
  • 3
    Eight studies showed no improvement, and 13 studies did not mention improvement scores, focusing solely on the safety and tolerability of cell administration.

Research Summary

This systematic review assesses the safety, tolerability, and efficacy of mesenchymal stem cell (MSC) therapies for neurological disorders like ALS, Parkinson’s Disease, Multiple Sclerosis, Spinal Cord Injury, and Traumatic Brain Injury. The review includes 43 clinical trials using MSCs from various sources and administration routes, finding that MSC transplantation is generally safe and tolerable, with mild adverse events. While some studies showed promising improvement rates, many had small sample sizes or focused solely on safety. Larger, well-designed clinical trials with longer follow-up periods are needed to determine the true efficacy of MSC therapies for neurological disorders.

Practical Implications

Clinical Trial Design

Future studies should focus on larger sample sizes and longer follow-up periods to better assess the efficacy and long-term effects of MSC therapies.

Administration Route

Further research is needed to determine the optimal administration route for MSCs in treating neurological disorders, comparing intravenous infusion, intrathecal administration, and direct injection.

Personalized Medicine

Consider patient-specific factors, such as age, disease stage, and source of MSCs, to optimize treatment outcomes and address the heterogeneity observed in current studies.

Study Limitations

  • 1
    Small sample sizes in many included studies.
  • 2
    Short follow-up periods in several studies, limiting assessment of long-term effects.
  • 3
    Heterogeneity of research methods across different studies, making it challenging to draw definitive conclusions.

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