2-3 million people globally are diagnosed with multiple sclerosis (MS)
. Most of them are adult patients in their 20s-40s. Currently, the
treatment for multiple sclerosis remains a challenge as there is no
medication that can combat the disease completely. Management of
multiple sclerosis includes disease-modifying therapy, drugs to treat
acute relapses, and symptomatic treatment. There is also a range of
complementary and alternative therapies . Researchers are focused
on finding new targets for drug therapy and effective therapeutic
substances along with innovative approaches such as stem cell
Picture 1. Multiple sclerosis is characterized by chronic
inflammation in the nervous system due to damage to the neuron
Mechanisms of Multiple Sclerosis Development and Its Symptoms
sclerosis is a chronic disease that is characterized by inflammation
in the nervous system (the spinal cord and/or the brain). The
inflammation is caused by immune system activation. Its specific
cells damage the coating of nerve fibers (myelin), leading to
impaired conduction of impulses from the brain to other parts of the
body and the development of a variety of neurological symptoms. The
manifestation of the disease is individual and depends on the
location of the neuronal damage. However, the following complaints
may be highlighted that are common in most patients:
weakness and numbness in limbs
spasticity and tremors
bladder and bowel problems
video demonstrates how nerves work and what happens to them when the
disease occurs .
the exact causes of multiple sclerosis are still unknown, it was
shown that the interaction of both hereditary and environmental
factors (stress, viruses, vitamin D deficiency, etc.) contributes to
the development of the disease .
Multiple Sclerosis Treatment Strategies
cure for multiple sclerosis has not yet been found. Several types of
drugs have been shown to combat neuroinflammation and slowdown
neuronal damage [5, 6]. Therapy with these medications is called
disease-modifying treatment. Usually, additional therapy includes
treatment of acute attacks and symptom management. Exercises and
physical therapy also play a key role in comprehensive management of
Disease Modifying Medications
medications reduce both the frequency and severity of relapses and
slow down the development of damage in the brain and/or spinal cord
and the accumulation of disability. They are available in several
forms depending on the route of administration.
Beta interferons have been used for the treatment of relapsing
multiple sclerosis since the 90s. They are injected either under the
skin or into a muscle by the patient.
Glatiramer acetate is a moderately effective drug. It is also
administered under the skin or into a muscle. This is a synthetic
molecule resembling the myelin – the protein that surrounds nerve
fibers. It deludes immune cells thus preventing myelin from their
Teriflunomide suppresses the immune system by inhibiting the
division of cells, which are responsible for relapses of multiple
Fingolimod prevents immune cells (lymphocytes) to enter the central
nervous system by attaching to them. Lymphocytes with bonded
fingolimod are seized in the lymph glands and cannot cause
inflammation and damage to the neurons.
Dimethyl fumarate is a drug whose mechanism of action is not yet
completely clear. It is assumed to modulate the immune system
without suppressing it.
Cladribine was approved in 2019 in the USA and 1-2 years earlier in
EU countries for the treatment of multiple sclerosis. This is a
chemotherapeutic agent being used for the treatment of certain types
of blood cancer. It reduces two types of immune cells involved in
the deterioration of the central nervous system.
Siponimod is the latest medication approved by the FDA. It has not
yet been approved in Europe. Like fingolimod, it prevents
penetration of immune cells into the central nervous system.
Alemtuzumab induces the death of immune cells responsible for
neurodegeneration in multiple sclerosis.
Mitoxantrone prevents the division of immune cells.
Ocrelizumab suppresses the immune system. Its approval may be
terminated if the manufacturer does not provide results of
additional safety studies on this drug.
Natalizumab prevents the penetration of immune cells from blood into
the central nervous system.
than a dozen other medications have shown promising preliminary
results in their current clinical studies*:
MD1003, or high-dose biotin
years are required to conduct more extensive research in a larger
number of participants. However, some drugs from the list –
rituximab, simvastatin, ozanimod, phenytoin, laquinimod, ponesimod –
may have more clear results available as soon as 2020-2023.
Picture 2. Scientists are searching for new treatment approaches to Multiple Sclerosis
of multiple sclerosis is always an art of balance between efficacy
and safety. Disease-modifying drugs provoke serious side effects, and
the more effective the drug is, the more severe the reaction it may
cause. National regulatory agencies, such as the FDA in the US and
EMA in Europe, monitor new data on safety and may deny a drug due to
safety reasons (as it was in 2018 when EMA banned daclizumab for risk
of serious and potentially fatal immune reactions affecting the
brain, liver and other organs) . In April 2019, EMA initiated a
review of alemtuzumab due to new reports of immune-mediated
conditions and problems with the heart and blood vessels for patients
on this medicine, including fatal cases, and more common side effects
that significantly impacted the patient’s quality of life. Summary
of data on the efficacy of disease modifying treatments’ abilities
to postpone relapses and safety of licensed medications for multiple
sclerosis is compiled in Table 1 [5, 8].
Drug Name (International Non-proprietary Name)
Common Side Effects
Possible Serious Side Effects
risk of infections
risk of infection
risk of infection
risk of infection
risk of malignancy
liver function tests
and atrioventricular (AV) conduction delays
reversible encephalopathy syndrome
increase in disability after discontinuation
Table 1. Efficacy and safety of the currently licensed
medications for multiple sclerosis , .
Treatment of Acute Relapses
Two options are available now to manage sudden attacks of the disease (relapses):
corticosteroids (prednisone) to reduce inflammation. Adverse
may be caused by corticosteroids are high blood pressure, weight
gain, sleep disorders, mood changes, swelling,
low infection resistance. High doses of oral or intravenous steroids
may be required for severe relapses.
Exchange (Plasmapheresis). The procedure of replacing
liquid part of blood with a donor’s blood
that is ‘clean’ of the proteins that caused the attack. This
is performed in a hospital or in
unit and may
pose some risks like decreased blood pressure, bleeding, infection,
thrombosis, or allergic reaction.
differences in signs and symptoms of multiple sclerosis, as well as
different tolerances to disease-modifying medications and symptomatic
treatment, require health specialists to find a personalized approach
in each case of multiple sclerosis . Current approaches to
managing symptoms of multiple sclerosis include both drug therapy and
rehabilitation programs. They focus on minimizing disease symptoms
and increasing the quality of life. Regular exercise is another key
factor in effective management of multiple sclerosis.
Approaches for Multiple Sclerosis Management
and alternative therapies are used in addition to conventional
treatment recommended by a physician. They aim to improve the overall
quality of life by allowing the patient to cope with the symptoms of
multiple sclerosis. The following therapies have shown to be
effective in the management of symptoms in patients with certain
types of Multiple Sclerosis :
in various forms.
spasticity and pain
improves urinary frequency.
potentially cause psychopathology
and neurocognitive side effects due to their psychoactive
interact with disease-modifying
studied complementary and alternative therapies, such as bee venom,
low-fat diet with omega-3 fatty acid supplementation, Cari Loder
regimen (Lofepramine combined with L-phenylalanine and vitamin B1
plus mind-body practices) either did not show any benefits compared
to the control group of patients or had insufficient evidence base
Stem Cell Therapy for Multiple Sclerosis
differences in signs and symptoms of multiple sclerosis, as well as
differences in tolerance to disease-modifying medications and
symptomatic treatment, require health specialists to find a
personalized approach in each case of multiple sclerosis .
Picture 3.High efficacy treatments of multiple sclerosis are
usually negated by poor tolerance.
sclerosis treatment strategies, which include both existing and new
drugs to manage disease progression, acute relapses, and symptoms,
can be successfully combined with stem cell therapy for long-lasting
benefits for patients. Leading scientific and industry societies pay
huge attention to the role of regenerative cell biology in the
development of care strategies for multiple sclerosis . An
increasing number of studies show promising results when using stem
cell therapy in addition to other therapies for multiple sclerosis
, . One of them is to re-set the patient’s immune system
through chemotherapy followed by a stem-cell replacement of the
immune system using the patient’s own or donor stem cells .
approach is to use mesenchymal (bone marrow) stem cells sourced from
the patient (autologous) and/or obtained from a donor to cure lesions
in the central nervous system and to recover functional neurological
deficits , , , , . Bone marrow-derived
mesenchymal stem cells have been shown to reduce inflammatory
responses, stimulate neuronal stem cell differentiation, and promote
the regeneration of damaged areas in the central nervous system .
Both strategies show encouraging results in efficacy as well as
safety , , , , .
Shaun Lawrence battled multiple sclerosis for many years before deciding to come to Swiss Medica clinic. Limp on his right leg, urinary and bowel problems were some of the main issues he suffered from. After having a stem cell treatment his life changed completely. He is very satisfied with the experience, as well as the overall results of the treatment.
For me, since I got back after my 2 weeks of having my treatment, within 2 days of being home speaking to friends and family around the world, they all noticed the difference in my speaking, cognitively and I was able to listen and integrate with conversations with my family at home.
A wonderful experience, a wonderful care are these very caring people, yes.
Everything is done naturally and pleasantly here. Actually I do not feel sick, it is the most important thing – during these 12 days I haven’t felt sick.
I didn’t have the impression that I was treated like a patient. I was treated like a normal person, it is true I take medicines, receive infusions and still have some pain, but I never felt like I was in the hospital.
Linda Cole struggled with multiple sclerosis for over 30 years. She decided to give stem cell treatment a try, even though she didn’t expect much from it. She was pleasantly surprised, as her symptoms improved and reversed drastically. Her ability to move, walk and think much better than before assured her she made the right decision by coming to Swiss Medica.