Multiple Sclerosis (MS) is a chronic condition that tends to affect the nervous system (both spinal cord and brain) and optic nerves. In this disease, our immune system acts against the body by attacking the myelin sheath, which is the layer around the nerves for protection and fast transport. Multiple Sclerosis causes temporary lesions and inflammation of the cells. It can also cause permanent lesions and scars, making it difficult for the brain to transmit signals in the body. 

According to the NINDS (National Institute for Neurological Disorders and Stroke), more than 350,000 patients suffer from MS in the United States. However, according to the estimate of the National Multiple Sclerosis Society, this number will cross even one million patients in the US. 

According to the pathology of the disease, there are four distinct types of Multiple Sclerosis:

- PPMS (Primary Progressive Multiple Sclerosis)

- RRMS (Relapse-remitting MS)

- SPMS (Secondary progressive MS)

- CIS (Clinically isolated syndrome)

The main reason for Multiple Sclerosis is the autoimmune attacks the body. These destructions can cross the blood-brain barrier and cause damage to the protective layer of the myelin sheath of the nerve fibres. 

Demyelination causes remission of the nerve fibres (formation of new myelin), but the inflammation of the nerve tissue leads to the formation of scar tissues. These scar tissues can result in neurological impairment of the involved nerve and the area. 

In general, there is no single standard factor or cause of Multiple Sclerosis. Several factors and a combination of triggering stimuli give rise to abnormalities in the immune system to act against its function. 

The most common risk factors of MS are:

• Age and gender: People in their young age group are more prone to developing this disease. Most Multiple Sclerosis diagnosed patients are in their 20-40 years of age. However, in terms of gender, females are more affected by this disease than males.

• Infections: Exposure to deadly viruses such as EBV (Epstein-Barr) or Mononucleosis can increase a person's risk of developing MS. Other viruses such as Mycoplasma Pneumonia, and HHV6 (Human Herpesvirus Type-6) can also play a vital role in triggering the immune system.

• Nutrient deficiency: Essential vitamins such as Vitamin D and B-12 are vital for the body's normal functioning. The deficiency of these nutrients can cause abnormalities in the functioning of the immune system, leading to neurological conditions such as Multiple Sclerosis.

• Smoking and toxins exposure: Chronic smokers are two times more likely to develop this disease than non-smokers. This population has more brain shrinkage and lesions than healthy individuals. However, genetic and environmental factors can cause mutations in the genetic makeup. The alterations and modifications of genetic components cause an increased risk for MS.

MS is a disease of the Central Nervous System. 

CNS controls all the functions and parts of the body. Therefore, MS can affect almost any and every part of the body. 

The most vital and common symptoms of MS are:

• Muscular weakness due to nerve damage and less frequent use of muscles

• Tingling sensation and numbness

• Bowel and bladder problems in emptying the bladder, urge incontinence, and loss of voluntary bladder control

• Vertigo and dizziness causing balance and coordination issues

• Muscle spasms and spasticity are an early sign of MS, which shows the damage of nerve fibers in the brain and spinal cord

• Tremors and uncontrolled involuntary movements

• Vision-related issues due to damage to the optic nerve myelination. It can even lead to partial or complete loss of vision in these patients.

• Mobility and gait pattern changes

• Sexual dysfunction

• Confusion, learning problems, memory dysfunction, and pain

In terms of medicines and drugs, a few potent options are:

• Cladribine (mavenclad)

• Aubagio (teriflunomide)

• Tecfidera (dimethyl fumarate)Lemtrada (alemtuzumab)

• Tysabri (natalizumab)

• Novantrone (mitoxantrone)

• Siponimod (mayzent)

• Rebif and Avonex (interferon beta 1-a)

*All of these medications are only effective for the initial stages of the disease. All of these medications and treatments aren’t the absolute solution or cure of the disease.

According to the emerging data and pieces of evidence, Stem Cells Therapy has great potential for regenerating myelin sheath and reversing MS. Stem Cells Therapy provides a modified alternative to the treatment regimens for Multiple Sclerosis.

1. Mesenchymal Cells for the MS: Mesenchymal Cells are the mature Stem Cells present in the umbilical cord, adipose tissue, and bone marrow. These cells are the anti-inflammatory, multipotent, and regenerative agents for the human body. Mesenchymal Cells, which are derived from the umbilical cord, have a few advantages over other procedures as they can:

   • Provide more ethical validation

   • Be less invasive 

   • Provide low immunogenicity

   • Provide high capacity for proliferation

   • Provide an advanced capability for differentiation in the body

     
     *Several clinical pieces of research have used the MSC to treat different diseases such as Multiple Sclerosis, Alzheimer’s disease, and Type-1 Diabetes. 

Neurological Diseases have a high rate of fatality and incapacitation, which prevents the proper functioning of different parts of the brain. Stroke, Parkinson's disease, and Alzheimer's disease are the most common neurological disorders, which can cause severe damage to brain tissues and cells. The traditional treatment of these diseases consists of endovascular thrombectomy (ET), IV-tPA (intravenous tissue plasminogen activator), and other medications. 

One of the modern treatment techniques for neurological disorders is the use of Exosomes along with Stem Cell Therapy. According to the research data, exosomes can improve angiogenesis, ischemic boundary zone neurogenesis, neurite remodeling, and synaptic plasticity. Many researchers claim that the conjunction of Stem Cell Therapy and Exosomes can upgrade the functional, tissue levels, and even cellular recovery in individuals with neurological diseases and damages. 

Intravenous Mesenchymal Stem Cells, along with Exosomes administration, can help with improved white matter integrity by inducing different responses post-stroke as:

• Oligodendrogenesis

• Remyelination

• Axonal sprouting

Moreover, Exosomes also enhance the expression of microRNAs such as miR-133b, miR-210, miR-184, and miR-17-92 clusters. These microRNAs have neuroprotective properties, which aid in the good prognosis of the disease.