Saturday, 29 November 2014

Stem cells inhibiting inflammatory attack

Epub: Li et al. The potential of human umbilical cord-derived mesenchymal stem cells as a novel cellular therapy for multiple sclerosis. Cell Transplant. 2014.

Background: MS is a complex disease of neurological disability, affecting more than 300 out of every one million people in the world. 
Aim: The purpose of the study was to evaluate the therapeutic effects of human umbilical cord-derived mesenchymal stem cell (hUC-MSC) transplantation in MSers. 
Methods: 23 MSers were enrolled in this study and 13 of them were given hUC-MSC therapy at the same time as anti-inflammatory treatment, whereas the control patients received the anti-inflammatory treatment only. Treatment schedule included 1,000 mg/kg of methylprednisolone i.v. daily for 3 days and then 500 mg/kg for 2 days, followed by oral prednisone 1mg/kg/day for 10 days. The dosage of prednisone was then reduced by 5mg every two weeks until reaching a 5mg/day maintenance dosage. Intravenous infusion of hUC-MSCs was applied three times in a 6 week period for each patient. The overall symptoms of the hUC-MSC treated patients improved compared to patients in the control group. Both the EDSS scores and relapse occurrence were significantly lower than those of the control patients. Inflammatory cytokines were assessed, and the data demonstrated a shift from Th1 to Th2 immunity in hUC-MSC treated patients. Our data demonstrated a high potential for hUC-MSC treatment of MS

There you have it. Stem cells seem to have benefit but based on most data I have seen they do not really turn into anything and dies within a few days but that may make enough growth factors to promote repair

LACTRIMS presentation on teriflunomide and alemtuzumab

Questions to ask yourself when interpreting the alemtuzumab phase 3 trial data. #LACTRIMS #MSBlog #MSResearch

"As promised are the slides from the Genzyme symposium presented yesterday at LACTRIMS. The presentations were very data heavy and to help the attendees digest the data in their own time my co-presenter Professor Flavia Nelson has agreed for her slides to be uploaded with mine; thank you."

"To make a data heavy alemtuzumab presentation clinically relevant I tried to present the data in the context of the following questions:

  1. How early is early?
  2. What about the patient wanting to have children?
  3. Is it realistic to expect improvement in disability?
  4. How durable is the treatment response to alemtuzumab?
  5. Do you tell your patients about brain atrophy (end-organ damage)?
  6. Can you de-risk alemtuzumab treatment; how to deal with infusion reactions, infections and secondary autoimmunity?
It is reassuring to note that most LATAM neurologists have, or soon will have, access to alemtuzumab to treat their patients."

"I would like to thank my Peruvian hosts;  such hospitable people with a truly amazing history and culture."

CoI: multiple; attendance at LACTRIMS sponsored by Genzyme.