Karussis Dimitrios, Kassis Ibrahim
Department of Neurology, Laboratory of Neuroimmunology, Hadassah-Hebrew University Center, Jerusalem, Ein-Karem, IL-91120, Israel.
Expert Rev Neurother. 2007 Sep;7(9):1189-201. doi: 10.1586/14737175.7.9.1189.
The reported evidence of neurodegeneration in multiple sclerosis (MS) may explain the lack of efficacy of the currently used immunomodulating modalities and the irreversible axonal damage, which results in accumulating disability. To date, efforts for neuroprotective treatments have not been successful in clinical studies in other CNS diseases. Therefore, for MS, the use of stem cells may provide a logical solution, since these cells can migrate locally into the areas of white-matter lesions (plaques) and have the potential to support local neurogenesis and rebuilding of the affected myelin. This is achieved both by support of the resident CNS stem cell repertoire and by differentiation of the transplanted cells into neurons and myelin-producing cells (oligodendrocytes). Stem cells were also shown to possess immunomodulating properties, inducing systemic and local suppression of the myelin-targeting autoimmune lymphocytes. Several types of stem cells (embryonic and adult) have been described and extensively studied in animal models of CNS diseases and the various models of MS (experimental autoimmune encephalomyelitis [EAE]). In this review, we summarize the experience with the use of different types of stem cells in CNS disease models, focusing on the models of EAE and describe the advantages and disadvantages of each stem cell type for future clinical applications in MS.
多发性硬化症（MS）中报道的神经退行性变证据，可能解释了目前使用的免疫调节方法为何无效以及不可逆的轴突损伤，而这种损伤会导致残疾不断累积。迄今为止，在其他中枢神经系统疾病的临床研究中，神经保护治疗的努力尚未取得成功。因此，对于MS而言，使用干细胞可能提供一个合理的解决方案，因为这些细胞可以局部迁移到白质病变（斑块）区域，并有可能支持局部神经发生以及受损髓鞘的重建。这可以通过支持中枢神经系统内源性干细胞储备以及使移植细胞分化为神经元和产生髓鞘的细胞（少突胶质细胞）来实现。干细胞还被证明具有免疫调节特性，可诱导对靶向髓鞘的自身免疫淋巴细胞的全身和局部抑制。在中枢神经系统疾病的动物模型以及各种MS模型（实验性自身免疫性脑脊髓炎 [EAE]）中，已经描述并广泛研究了几种类型的干细胞（胚胎干细胞和成体干细胞）。在这篇综述中，我们总结了在中枢神经系统疾病模型中使用不同类型干细胞的经验，重点是EAE模型，并描述了每种干细胞类型在MS未来临床应用中的优缺点。
