Mesenchymal stem cells and conditioned media in the treatment of multiple sclerosis patients: Clinical, ophthalmological and radiological assessments of safety and efficacy

CNS Neurosci Ther. 2017 Nov;23(11):866-874. doi: 10.1111/cns.12759. Epub 2017 Sep 29.

Abstract

Aims: This open-label prospective phase I/IIa clinical study used autologous bone marrow-derived mesenchymal stromal cells (BM-MSCs) followed by mesenchymal stromal cells conditioned media (MSC-CM) for the first time to treat multiple sclerosis (MS) patients. The primary goal was to assess the safety and feasibility and the secondary was efficacy. The correlation between the MSC-CM content and treatment outcome was investigated.

Methods: Ten MS patients who failed conventional therapy were enrolled. Adverse events were recorded to assess safety. The Expanded Disability Status Scale (EDSS) was the primary efficacy measurement, the secondary included clinical (25WFT, 9-PHT), cognitive (MMS), ophthalmology (OCT, VEP), and radiological (MRI lesion and volume) tests. The MSCs-CM concentration of 27 inflammatory biomarkers was investigated.

Results: The treatment protocol was well tolerated by patients. There was an overall trend of improvement in all the tests, except the lesion volume which increased significantly. A decrease of 4 and 3.5 points on the EDSS was achieved in two patients. We report a correlation between a decreased lesion number at baseline and higher IL-6, IL-8, and VEGF MSC-CM content.

Conclusion: The used protocol was safe and feasible with possible efficacy. The addition of MSC-CM could be related to the magnitude of EDSS improvement observed.

Keywords: conditioned media; expanded disability status scale; magnetic resonance imaging; mesenchymal stem cells; multiple sclerosis; optical coherence tomography; visual evoked potential.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II

MeSH terms

  • Adolescent
  • Adult
  • Brain / diagnostic imaging
  • Cells, Cultured
  • Culture Media, Conditioned*
  • Disability Evaluation
  • Evoked Potentials, Visual
  • Female
  • Follow-Up Studies
  • Humans
  • Immunologic Factors / therapeutic use
  • Magnetic Resonance Imaging
  • Male
  • Mesenchymal Stem Cell Transplantation* / adverse effects
  • Mesenchymal Stem Cells* / metabolism
  • Middle Aged
  • Multiple Sclerosis / diagnostic imaging
  • Multiple Sclerosis / physiopathology
  • Multiple Sclerosis / psychology
  • Multiple Sclerosis / therapy*
  • Spinal Cord / diagnostic imaging
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Young Adult

Substances

  • Culture Media, Conditioned
  • Immunologic Factors