Immunomodulatory Effects of Stem Cell Therapy in Multiple Sclerosis

Multiple sclerosis (MS) is increasingly recognized as a serious, worldwide public health concern. Statics indicate that globally 2.5 million people suffer from MS. It’s a chronic inflammatory condition of the central nervous system which is followed by autoreactive lymphocytes.The first serious discussions of MS treatment emerged during the 1990s with disease-modifying therapy (DMT); however, there wasn’t enough evidence of improvement in patients treated this way. In the recent decade, immune reconstitution therapies have beenidentified, one type of which is autologous hematopoietic stem cell transplantation (AHSCT). AHSCT therapy is an immunoablative therapy and induces immune reconstitution by hematopoietic stem cells. The way to treat autoimmunity, what exactly happens in MS, isthat immunoablative therapy suppresses autoreactive immune cells and allows stem cells to produce a new, self-tolerant, cluster. In the last 15 years, AHSCT has been demonstrated as an effective approach. Therapeutic trials indicated that transplantation can lead to diseaseremission, relapse prevention and recovery enhancement from paresis. AHSCT restores the regulatory T-cell network, reduces pro-inflammatory IL-17 response, normalizes microRNA expression and gene expression profiles. Despite compelling evidence that supports thistreatment, the exact mechanism of its efficacy remains unclear. Little is known about how AHSCT limits or controls autoreactive lymphocytes. This indicates a necessity to further studies to address some biomarkers of clinical response to AHSCT in autoimmunity in orderto clarify its function. Moreover, the disease reactivates in some patients due to reasons not yet understood. For this reason, also, further researches are essential to improve or sustain the therapeutic efficacy of AHSCT in autoimmunity.