Cell therapy in demyelinating diseases

Abstract

Multiple sclerosis presents particular and serious problems to those attempting to develop cell-based therapies: the occurrence of innumerable lesions scattered throughout the CNS, axon loss, astrocytosis, and a continuing inflammatory process, to name but a few. Nevertheless, the limited and relatively focused nature of damage to oligodendrocytes and myelin, at least in early disease, the large body of available knowledge concerning the biology of oligodendrocytes, and the success of experimental myelin repair, have allowed cautious optimism that therapies may be possible. Here, we review the clinical and biological problems presented by multiple sclerosis in the context of cell therapies, and the neuroscientific background to the development of strategies for myelin repair. We attempt to highlight those areas where difficulties have yet to be resolved and draw on a variety of more recent experimental findings to speculate on how remyelinating therapies are likely to develop in the foreseeable future.

FIG. 1.

Questions to be considered in the development of reparative cell therapy.

FIG. 2.

Cultured Schwann cells, stained with S100.

FIG. 3.

Adult human olfactory glia in vitro.

FIG. 4.

Adult human brain-derived neural stem cells differentiated into oligodendrocyte progenitors and stained with NG2.

FIG. 5.

Adult human mesenchymal stem cells in culture.