Friday, 24 November 2017

Searching for the Miracle Cure. MS in the Media

Last night we had a programme in the UK on  someones journey to Israel to examine the effect of mesenchymal stem cells.



It was dubbed a "Search for a Miracle Cure" and was on Channel 4, but there was no evidence presented to suggest it was a cure.


The investigators have developed a culture-based method for inducing mesenchymal stem cells (MSCs) to secrete neurotrophic factors.

These have been used in motor neuron disease and it is clear it is not a cure.

Sensibly at the end of the programme they said the "study was not currently recruiting, so they will not get inundated with requests as it could look like advert for the trial.

They planned to treat with autologous mesenchymal bone marrow stem cells in active and progressive multiple sclerosis. The trial (NCT02166021) requires 36 people and will involve injection of mesenchymal stem cells into the intrathecal space, in the blood or in both intrathecal and intravenous routes. The participants required are non PPMS, progressive MS, EDSS 3.0-6.5 in people who have failed DMT and are showing activity.

In the programme, which followed the journey of someone with MS travelling to Israel. One could see ring enhancing gadolinium lesions on the brain scan shown, indicating that disease was active.

However, if you enter being active, due to natural healing you could get better and this is called "regression to the mean".

I had telecom midway through so will have to watch on catch-up.

However the person in the film had reported return of function in their arm within a couple of hours. So is it remyelination or immunosuppressive I doubt it, as the effect is so quick. 

However some anti-inflammatories (NSAIDS) obvious do work within this time frame. But maybe there is a growth factor produced the stem cells.

So it is a placebo effect or maybe there is a symptomatic benefit

Maybe one of the neurotrophic factors produced could promote nerve conduction. In many animal studies transplanted cells are dead within a few day so by the time I finished on the phone the beneficial effect had waned, so it does not appear to be a cure that reverts you back to health. I would not expect treatments to do this

However, would it have some effect stopping future disease?

Without the total data it will not be possible to say.

Therefore, a sensational title, that would leave me more deflated by the reality.

However, as it is supposedly blinded we have no idea what the person/people in the film was/were taking.

I asked the PI of the study whether they wanted to do a "Guest Post" to give the grounded view of the study..but no response so far.

19 comments:

  1. "I asked the PI of the study whether they wanted to do a "Guest Post" to give the grounded view of the study.."

    Nice Md

    You could do more of that in the future

    Obrigado

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  2. Thanks so very much for the prompt post on last nights program.
    I think I've understood the summary you've provided, except as to how a placebo effect could be so profound, or how any possible positive impact, such as NF promoting nerve conduction could happen so fast?
    Also if you wouldn't mind explaining 'But maybe there is growth factor produced the stem cells'

    Thanks as always MD for your facilitation of our comprehension of all the research and studies - as I've said before: especially for those of us who don't possess a single scientific cell anywhere!

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  3. bronwen_salway@hotmail.comFriday, November 24, 2017 4:48:00 pm

    At least the programme served to continue raising awareness in the public of one of the disabling features MS; No bad thing.

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  4. The claim for these stem cells is that they produce factors to facilitate nerve survival growth etc.
    If the cells are alive and growing they will be pumping out these goodies. So imagine one of the factors can facilitate nerve signalling movement comes back, but as I said in many animal studies these cells are dead in a week they don't become new nerves and so any positive symptomatic effect is gone. If true you find out what the factors is and go and try something new.

    Can a placebo effect have a profound effect...it has ruined some of my bright ideas.

    ReplyDelete
    Replies
    1. Grateful for the addition to your post.
      Have a good weekend.

      Delete
  5. Stem cell research is literally everywhere, from heart diseases to skin ones. It seems to have a lot of potential, probably for neurological conditions too. It is just probably too soon to have an effective application and the buzz is pushed to bring funds to the researchers, supported by the general hype. The fact that it is not the miracle that is promoted doesnt mean its a scam. It is just a procedure that is more clinical, so pharma is not backing the mistakes and promote the benefits.
    This one or another one, it will be a thing of the future. The one that gets the funds first, wins the race.

    ReplyDelete
    Replies
    1. Mesencymal stem cells may or may not turn themselves into to something you want within the CNS

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  6. It didn't look like the LP was ultrasound guided and procedure looked very painful.

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    Replies
    1. As I tweeted, this was not a good advert for a lumbar puncture as I agree it sounded painful and there were I think 6 attempts made.

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    2. I had repeated failed epidural attempts in 2 pregnancies and 6 failed LP attempts. They are incredibly painful. I feel silly saying it but I still get flashbacks to the LP attempts, feeling it all over again, I am glad I didn't watch the programme.

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  7. Without the ablation such as chemotherapy in HSCT, stem cell research in MS is of limited efficacy (as was shown in the documentary).

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    Replies
    1. This is a very different type of therapy to HSCT where the object is to replace the immune system. Mesenychmal stem cells are not going to replace the immmune system, in animlas the immunosuppressive effect of mesenchymal stem cells is modest compared to DMT.

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  8. The solicitor reads this post .

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    Replies
    1. I hope that anyone reading the post, thinks it is a a fair representation of the programme, if not let me know what you feel is wrong and I will re-watch and adjust.

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  9. Mesenchymal stem cells may not be a cure but it sure seems to have better potential than any of the current DMDs in progressive MS, which only delay the inevitable decline of a progressive MS patient.

    MSCT actually appears to remyelinate via growth factors released and IMPROVES MS patient's clinically, including EDSS. Here is some published data in well respected journals and youtube link from one of the researchers.

    http://www.sciencedirect.com/science/article/pii/S1474442211703052

    https://jamanetwork.com/journals/jamaneurology/fullarticle/801249

    https://www.youtube.com/watch?v=mcf4rQKpeg8

    It would be great if MS Barts could ask neurologists, Dr. Peter Connick-UK or Dr. Dimitrios Karussis-Israel, to do a guest post.

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    Replies
    1. Regarding your last point, I believe MD has done just that.

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  10. Is this what they are doing at Tische MS with MSC-NP-based cell therapy ?

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  11. All we wait is for a miracle. But we should try to get on work. There are some treatments which are good.One of my friend was a diagnosed with MS and we suggested that he should get multiple sclerosis treatment.

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