New Multiple Sclerosis Treatment Trial Compares Stem Cell Transplantation to Best Available Drugs

The clinical study launched in the United States is of undoubted value and importance, conducted with scientific rigour by prestigious institutions.
It is part of scientific research on possible new therapeutic fields for the treatment of diseases with autoimmune aetiology.
In fact, multiple sclerosis is a disease caused by an abnormal immune response against tissues of the nervous system that causes a progressive reduction in function.
Starting from the principle that in the human organism the immune response is activated and regulated by a particular category of white blood cells (T lymphocytes and B lymphocytes), it is hypothesized the possibility of replacing the patient's T lymphocytes, which are responsible for recognizing a foreign antigen by presenting it to the B lymphocytes and stimulating them to produce antibodies. In the case of an autoimmune disease, due to an alteration of their genetic material, they recognize as foreign the patient's own cells and tissues, with T lymphocytes that do not show this alteration. These "healthy" T lymphocytes may be those of the patient himself collected at a time when the disease was not present, or T lymphocytes of the patient undergoing genetic manipulation to make them unable to develop an autoimmune disease.
Such a therapeutic approach is based on the experience and practice already widespread for years of hematopoietic stem cell transplantation.
(AHSCT). The T lymphocytes that this study considers are present in the blood and originated, such as red blood cells and hematopoietic stem cell platelets. AHSCH is a therapy, today widespread and in many cases of choice for a number of onco-haematological and other blood cell diseases.
Experimental studies based on the use of an autologous haematopoietic stem cell transplantation in a patient with multiple sclerosis have already been presented but always on a small number of patients and not yet with a comparative study between such a therapy and the currently accepted standard pharmacological therapies. Hence the interest in this study.
From such a therapeutic approach derives the growing interest in having a patient's "healthy" haematopoietic stem cells in order to be able to expand and transplant them to the patient after eliminating his "sick" lymphocytes.
These "healthy" lymphocytes can be collected by the patient during a period of absence of the disease, with the doubt that, even if the patient has no symptoms of disease, his lymphocytes are already altered, or use the stem cells of the umbilical cord collected at birth.
In conclusion, this study participates in indicating the growing interest in cellular and genetic therapies based on the use of blood cells or other tissues. The results are promising and the interest of the rapidly growing medical-scientific world is growing.
It will be very interesting to know the results of the study on the reported treatment of multiple sclerosis.

Automatic translation - original language: Italian

Dott. Damiano Castelli MD


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