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Talk on stem cells--2/13/08

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Talk on stem cells--2/13/08
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This is a talk that I gave to a patient group on 2/13/08 about stem cell therapy in multiple sclerosis.  Stem cells are currently a very fashionable research topic in many areas of medicine, including neurology.  They are being investigated for treatment of several different neurologic diseases.  There is no proven use for stem cells currently, and I would not recommend the use of stem cells for anyone outside of a clinical study under the management of a reputable physician.  Stem cells may someday be a useful treatment for MS, but a lot of work will need to be done first. 
The text from the slides follows. 

Stem Cell Therapy in Multiple Sclerosis

J. William Lindsey, MD

Feb. 13, 2008



             Very fashionable area, not my area of research or expertise

             What are the needs for treatment in MS?

             Where stem cells might help

             Background on stem cells

             Research results with stem cells relevant to MS

Treatment Needs in MS

             Stop the disease process and prevent new damage

             Know what causes MS

             Be able to stop the disease process

             Repair damaged tissue

             Repair damaged myelin

             Replace damaged nerve cells

Current Treatment—Interferon

Current Treatment—Glatiramer

What are stem cells?

             Stem cells are undifferentiated cells with the potential to divide indefinitely and differentiate into multiple different types of cell. 

Why Stem Cells?

             Stem cells can grow into any kind of cell

             Stem cells could repair damaged tissues such as myelin in MS

Types of Stem Cells

             Embryonic stem cells—derived from embryos, can become any type of cell

             Mesenchymal stem cells—found in bone marrow, can become some types of cells

             Neural stem cells—found in particular areas of the brain, can become nerve cells or glia

             Artificial stem cells—reprogrammed skin cells

Major Challenges

             If not derived from the person to be treated, they will be rejected as foreign

             Need the right quantity

             Have to get to the right place

             Need the right signals to turn into the right kind of cell

             New nerve cells have to make the right connections

             Need to know when to stop growing

Stem cells in animals

             Neural stem cells from periventricular zone grown in culture

             Injected into blood or ventricles of mice with acute EAE

             Cells migrated to damaged areas and survived

             Saw increase in new myelin and decrease in gliosis and axonal loss

             The mice were not as sick as untreated mice

             Nature 422:688

Other studies in animals

             Repair of chronic EAE with adult neural stem cells

             Transplanted cells secrete cytokines and neurotrophins but don’t differentiate

             Bone marrow derived stem cells may form myelin, or may fuse with myelin forming cells

             Embryonic stem cells cause tumors


Stem cells in humans

             4 Women who had bone marrow transplant from male donor

             Survival about 2 months

             Small numbers of donor-derived cells in the brain, both neurons and glia


             Stem cells may some day be useful for repair of damaged tissues in MS

             The underlying disease process needs to be stopped or stem cells will be futile

             The stem cells should be derived from the recipient

             Presently stem cells are all promise and no substance

J. William Lindsey, MD
University of Texas Multiple Sclerosis Research Group
Houston, Texas

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