Multiple Sclerosis
 

     Multiple Sclerosis is a debilitating neurological disease that is thought to be caused by destruction of the myelin sheaths (fatty protective insulation) around axons of the brain and spinal cord. Loss of myelin impacts the ability of these tissues to conduct signals and the inflammatory process can lead to scarring resulting in a broad range of symptoms. This myelin damage appears to be related primarily to an auto-immune dysfunction, but there also appears to be environmental and genetic factors involved. There is no known cure for the physical and cognitive defects associated with chronic Multiple Sclerosis. Many investigators are looking at using the regenerative properties of cell therapy to mitigate the impact of Multiple Sclerosis on the nervous system.

     Cell Surgical Network has developed a specific SVF deployment protocol that attempts to utilize the immuno-regulatory and anti-inflammatory properties of SVF (rich in mesenchymal stem cells and growth factors). Special measures are taken to optimize transport of the SVF across the blood-brain barrier to improve central nervous system uptake. This is all done as an outpatient at the time of SVF harvesting and procurement. The entire cellular surgical procedure takes approximately three hours.
 

     We care about our Multiple Sclerosis patients at the Cell Surgical Network and take pride in the time we provide to our patients to deploy the best protocols to help our patients achieve their goals. By filling out Confidential Candidate Application, we will answer the questions and concerns you may have about Cell Surgical Network protocols for Multiple Sclerosis.

 
CANDIDATE APPLICATION
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Cell Surgical Network Study for Stromal Vascular Fraction Registered by ClinicalTrials.gov

Rancho Mirage, CA (PRWEB) October 14, 2013

Clinicaltrials.gov, a service of the U.S. National Institutes of Health has registered on their public site an IRB approved safety study from the Cell Surgical Network, Inc.. This study is available for patients with various degenerative and inflammatory conditions to undergo Stromal Vascular Fraction deployment for the evaluation and for the advancement of future stem cell therapy procedures. Stromal Vascular Fraction is rich in autologous adipose derived stem cells and growth factors.

Stromal Vascular Fraction (SVF) is obtained by lipo-harvesting, procurement, and lipo-transfer as a same day operative procedure to provide therapy to patients with various degenerative and inflammatory diseases. Patients must be 16 years or older, male or female and have a degenerative disease or inflammatory disease that meets criteria for treatment under the IRB which includes: Arthritis, Auto-immune disease, COPD, Cardiomyopathy, Peyronies Disease, Interstitial Cystitis, Erectile Dysfunction, and Neurodegenerative disease such as Parkinson’s, ALS, Neuropathy. Patients must be healthy enough to tolerate a local anesthetic, must not have active cancer or infections.

Dr. Elliot Lander, and Dr. Mark Berman, founders of the Cell Surgical Network Inc. will conduct the study: “Ever since our inception, it’s been our goal to maintain transparency during our investigations. With a closed surgical procedure we can provide effective safety studies and evolve good empirical data that will allow us and others to ultimately refine our protocols,” says Dr. Berman.

The purpose of the safety study is to evaluate for any adverse effects that may be related to the administration and reception of autologous adipose derived stromal vascular fraction (SVF). Secondarily, the study monitors the results of subjective and objective findings as it applies to the non-blinded deployment of autologous SVF for various inflammatory and/or degenerative conditions including select orthopedic, neurologic, urologic and cardio-pulmonary conditions. SVF deployments include intra-venous, intra-articular, and soft tissue injections.

Outcome measures will include the number of participants with adverse events related to either SVF deployment or the lipo-harvesting procedure. Interested patients should contact the treatment center by phone: 800-231-0407 or via email: info(at)cellsurgicalnetwork(dot)com

About Cell Surgical Network:

The affiliates of the Cell Surgical Network (CSN) are devoted to advancing access and quality care in the area of adult stem cell regenerative medicine in order to help people suffering from a variety of inflammatory and degenerative conditions. The Cell Surgical Network was founded nearly two years after the formation of the California Stem Cell Treatment Center (founded in 2010). Affiliate members are generally made up of multi-state and international teams of multidisciplinary physicians in order to best assess and provide care for our patients. The Cell Surgical Network emphasizes quality and is highly committed to clinical research and the advancement of regenerative medicine.

 
Stem cell transplants may be more effective than the drug mitoxantrone for people with severe cases of multiple sclerosis (MS), according to a new study published in the February 11, 2015, online issue of Neurology, the medical journal of the American Academy of Neurology.

Provided by American Academy of Neurology.

The study involved 21 people whose disability due to MS had increased during the previous year even though they were taking conventional medications (also known as first-line treatments). The , who were an average age of 36, were at an average disability level where a cane or crutch was needed to walk.

In MS, the body’s immune system attacks its own central nervous system. In this phase II study, all of the participants received medications to suppress immune system activity. Then 12 of the participants received the MS drug mitoxantrone, which reduces immune system activity. For the other nine participants, stem cells were harvested from their bone marrow. After the immune system was suppressed, the stem cells were reintroduced through a vein. Over time, the cells migrate to the and produce new cells that become . The participants were followed for up to four years.

“This process appears to reset the ,” said study author Giovanni Mancardi, MD, of the University of Genova in Italy. “With these results, we can speculate that stem cell treatment may profoundly affect the course of the disease.”

Intense immunosupression followed by stem cell treatment reduced disease activity significantly more than the mitoxantrone treatment. Those who received the stem cell transplants had 80 percent fewer new areas of brain damage called T2 lesions than those who received mitoxantrone, with an average of 2.5 new T2 lesions for those receiving compared to eight new T2 lesions for those receiving mitoxantrone.

For another type of lesion associated with MS, called gadolinium-enhancing lesions, none of the people who received the stem cell treatment had a new lesion during the study, while 56 percent of those taking mitoxantrone had at least one new lesion.

Mancardi noted that the serious side effects that occurred with the stem cell treatment were expected and resolved without permanent consequences.

“More research is needed with larger numbers of patients who are randomized to receive either the or an approved therapy, but it’s very exciting to see that this treatment may be so superior to a current treatment for people with severe MS that is not responding well to standard treatments,” Mancardi said.


Cell-replacement therapy with stem cells in neurodegenerative diseases.

Curr Neurovasc Res. 2004 Jul;1(3):283-9.

Cell-replacement therapy with stem cells in neurodegenerative diseases.

Silani V, Corbo M.

Department of Neurology and Laboratory of Neuroscience – Dino Ferrari Center, University of Milan Medical School – IRCCS Istituto Auxologico Italiano. vincenzo@silani.com

Abstract
In the past few years, research on stem cells has expanded greatly as a tool to develop potential therapies to treat incurable neurodegenerative diseases. Stem cell transplantation has been effective in several animal models, but the underlying restorative mechanisms are still unknown. Several mechanisms such as cell fusion, neurotrophic factor release, endogenous stem cell proliferation, and transdifferentiation may explain positive therapeutic results, in addition to replacement of lost cells. The biological issue needs to be clarified in order to maximize the potential for effective therapies. The absence of any effective pharmacological treatment and preliminary data both in experimental and clinical settings has recently identified Amyotrophic Lateral Sclerosis (ALS) as an ideal candidate disease for the development of stem cell therapy in humans. Preliminary stem transplantation trials have already been performed in patients. The review discusses relevant topics regarding the application of stem cell research to ALS but in general to other neurodegenerative diseases debating in particular the issue of transdifferentiation, endogenous neural stem cell, and factors influencing the stem cell fate.
PMID: 16181078 [PubMed – indexed for MEDLINE]

 
Safety and immunological effects of mesenchymal stem cell transplantation in patients with multiple sclerosis and amyotrophic lateral sclerosis.

Arch Neurol. 2010 Oct;67(10):1187-94.
Safety and immunological effects of mesenchymal stem cell transplantation in patients with multiple sclerosis and amyotrophic lateral sclerosis.
Karussis D, Karageorgiou C, Vaknin-Dembinsky A, Gowda-Kurkalli B, Gomori JM, Kassis I, Bulte JW, Petrou P, Ben-Hur T, Abramsky O, Slavin S.
Department of Neurology, Hadassah-Hebrew University Hospital, Ein Karem, Jerusalem IL-91120, Israel. karus@cc.huji.ac.il
Abstract
OBJECTIVE: To evaluate the feasibility, safety, and immunological effects of intrathecal and intravenous administration of autologous mesenchymal stem cells (MSCs) (also called mesenchymal stromal cells) in patients with multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS).
DESIGN: A phase 1/2 open-safety clinical trial. Patients Fifteen patients with MS (mean [SD] Expanded Disability Status Scale [EDSS] score, 6.7 [1.0]) and 19 with ALS (mean [SD] Amyotrophic Lateral Sclerosis Functional Rating Scale [ALSFRS] score, 20.8 [8.0]) were enrolled. Intervention After culture, a mean (SD) of 63.2 × 10(6) (2.5 × 10(6)) MSCs was injected intrathecally (n = 34) and intravenously (n = 14). In 9 cases, MSCs were magnetically labeled with the superparamagnetic iron oxide ferumoxides (Feridex).
MAIN OUTCOME MEASURES: The main outcome measure was the recording of side effects. Follow-up (≤25 months) included adverse events evaluation, neurological disability assessment by means of the EDSS, magnetic resonance imaging to exclude unexpected pathologies and track the labeled stem cells, and immunological tests to assess the short-term immunomodulatory effects of MSC transplantation.
RESULTS: Twenty-one patients had injection-related adverse effects consisting of transient fever, and 15 reported headache. No major adverse effects were reported during follow-up. The mean ALSFRS score remained stable during the first 6 months of observation, whereas the mean (SD) EDSS score improved from 6.7 (1.0) to 5.9 (1.6). Magnetic resonance imaging visualized the MSCs in the occipital horns of the ventricles, indicating the possible migration of ferumoxides-labeled cells in the meninges, subarachnoid space, and spinal cord. Immunological analysis revealed an increase in the proportion of CD4(+)CD25(+) regulatory T cells, a decrease in the proliferative responses of lymphocytes, and the expression of CD40(+), CD83(+), CD86(+), and HLA-DR on myeloid dendritic cells at 24 hours after MSC transplantation.
CONCLUSION: Transplantation of MSCs in patients with MS and ALS is a clinically feasible and relatively safe procedure and induces immediate immunomodulatory effects. Trial Registration clinicaltrials.gov Identifier: NCT00781872.
PMID: 20937945 [PubMed – indexed for MEDLINE]

 
Pilot trial of intravenous autologous culture-expanded mesenchymal stem cell transplantation in multiple sclerosis.

2017 Apr 1:1352458517703802. doi: 10.1177/1352458517703802.

Cohen JA, Imrey PB, Planchon SM, Bermel RA, Fisher E, Fox RJ, Bar-Or A, Sharp SL, Skaramagas TT, Jagodnik P, Karafa M, Morrison S, Reese Koc J, Gerson SL, Lazarus HM.

Abstract
BACKGROUND:

Mesenchymal stem cells (MSCs) exhibit immunomodulatory, tissue-protective, and repair-promoting properties in vitro and in animals. Clinical trials in several human conditions support the safety and efficacy of MSC transplantation. Published experience in multiple sclerosis (MS) is modest.

OBJECTIVE:

To assess feasibility, safety, and tolerability and explore efficacy of autologous MSC transplantation in MS.

METHODS:

Participants with relapsing-remitting multiple sclerosis (RRMS) or secondary progressive multiple sclerosis (SPMS), Expanded Disability Status Scale score 3.0-6.5, disease activity or progression in the prior 2 years, and optic nerve involvement were enrolled. Bone-marrow-derived MSCs were culture-expanded and then cryopreserved. After confirming fulfillment of release criteria, 1-2 × 106 MSCs/kg were thawed and administered IV.

RESULTS:

In all, 24 of 26 screened patients were infused: 16 women and 8 men, 10 RRMS and 14 SPMS, mean age 46.5, mean Expanded Disability Status Scale score 5.2, 25% with gadolinium-enhancing magnetic resonance imaging (MRI) lesions. Mean cell dosage (requiring 1-3 passages) was 1.9 × 106 MSCs/kg (range, 1.5-2.0) with post-thaw viability uniformly ⩾95%. Cell infusion was tolerated well without treatment-related severe or serious adverse events, or evidence of disease activation.

CONCLUSION:

Autologous MSC transplantation in MS appears feasible, safe, and well tolerated. Future trials to assess efficacy more definitively are warranted.

KEYWORDS: Multiple sclerosis; clinical trial; disability measures; mesenchymal stem cells; quantitative MRI; safety
PMID: 28381130
DOI: 10.1177/1352458517703802
 
The transplantation of mesenchymal stem cells derived from unconventional sources: an innovative approach to multiple sclerosis therapy.

2017 Mar 25. doi: 10.1007/s00005-017-0460-z.

Giacoppo S, Bramanti P, Mazzon E.

Abstract

In recent years, in the effort to find a potential innovative therapy for multiple sclerosis (MS), researchers focused on transplantation of mesenchymal stem cells (MSCs) due to their well-recognized ability to suppress inflammatory/autoimmune responses and exert neuroregenerative properties. MSCs are a heterogeneous subset of pluripotent non-hematopoietic stromal cells that can be isolated from many different adult tissues, characterized by the capability to differentiate into various cell lineages, and to translocate into damaged areas, providing immunomodulatory effects. To date, several encouraging results were obtained mainly from the use of MSCs derived from the bone marrow (BM-MSCs) in experimental models of MS as well as in clinical trials. However, their use in clinic is limited due to the invasive collecting procedure and the low yield of viable stem cells. Consequently, these restrictions have prompted researchers to look for alternative tissue sources for stem cells such as adipose tissue, fetal annexes, and dental tissues that could represent a novel therapeutic option for MS treatment. Here, we provide an overview of the current knowledge about the most explored BM-MSCs in MS treatment in experimental and clinical studies. Moreover, we propose that unconventional sources of stem cells, which show characteristics similar to that of BM-MSCs, and being less invasive for removal, could be considered an excellent alternative to BM-MSCs and thus could be a promising innovative approach for MS treatment.

KEYWORDS:

Adipose tissue; Bone marrow; Dental tissues; Fetal annexes; Mesenchymal stem cells; Multiple sclerosis

PMID: 28342084
DOI: 10.1007/s00005-017-0460-z
 
 
 
Allogeneic Adipose-Derived Mesenchymal Stromal Cells Ameliorate Experimental Autoimmune Encephalomyelitis by Regulating Self-Reactive T Cell Responses and Dendritic Cell Function.

2017;2017:2389753. doi: 10.1155/2017/2389753. Epub 2017 Jan 30.

Anderson P, Gonzalez-Rey E, O'Valle F, Martin F, Oliver FJ, Delgado M.

Abstract

Multipotent mesenchymal stromal cells (MSCs) have emerged as a promising therapy for autoimmune diseases, including multiple sclerosis (MS). Administration of MSCs to MS patients has proven safe with signs of immunomodulation but their therapeutic efficacy remains low. The aim of the current study has been to further characterize the immunomodulatory mechanisms of adipose tissue-derived MSCs (ASCs) in vitro and in vivo using the EAE model of chronic brain inflammation in mice. We found that murine ASCs (mASCs) suppress T cell proliferation in vitro via inducible nitric oxide synthase (iNOS) and cyclooxygenase- (COX-) 1/2 activities. mASCs also prevented the lipopolysaccharide- (LPS-) induced maturation of dendritic cells (DCs) in vitro. The addition of the COX-1/2 inhibitor indomethacin, but not the iNOS inhibitor L-NAME, reversed the block in DC maturation implicating prostaglandin (PG) E2 in this process. In vivo, early administration of murine and human ASCs (hASCs) ameliorated myelin oligodendrocyte protein- (MOG35-55-) induced EAE in C57Bl/6 mice. Mechanistic studies showed that mASCs suppressed the function of autoantigen-specific T cells and also decreased the frequency of activated (CD11c+CD40high and CD11c+TNF-α+) DCs in draining lymph nodes (DLNs). In summary, these data suggest that mASCs reduce EAE severity, in part, through the impairment of DC and T cell function.

PMID: 28250776
PMCID: PMC5303870
DOI: 10.1155/2017/2389753
 
 
 
 
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