Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Laboratory of Anatomy and Histology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Hum Cell. 2024 Jan;37(1):9-53. doi: 10.1007/s13577-023-01006-1. Epub 2023 Nov 21.
Multiple sclerosis (MS) is a chronic inflammatory, autoimmune, and neurodegenerative disease of the central nervous system (CNS), characterized by demyelination and axonal loss. It is induced by attack of autoreactive lymphocytes on the myelin sheath and endogenous remyelination failure, eventually leading to accumulation of neurological disability. Disease-modifying agents can successfully address inflammatory relapses, but have low efficacy in progressive forms of MS, and cannot stop the progressive neurodegenerative process. Thus, the stem cell replacement therapy approach, which aims to overcome CNS cell loss and remyelination failure, is considered a promising alternative treatment. Although the mechanisms behind the beneficial effects of stem cell transplantation are not yet fully understood, neurotrophic support, immunomodulation, and cell replacement appear to play an important role, leading to a multifaceted fight against the pathology of the disease. The present systematic review is focusing on the efficacy of stem cells to migrate at the lesion sites of the CNS and develop functional oligodendrocytes remyelinating axons. While most studies confirm the improvement of neurological deficits after the administration of different stem cell types, many critical issues need to be clarified before they can be efficiently introduced into clinical practice.
多发性硬化症（MS）是一种中枢神经系统（CNS）的慢性炎症性、自身免疫性和神经退行性疾病，其特征是髓鞘脱失和轴突丢失。它是由自身反应性淋巴细胞攻击髓鞘和内源性髓鞘再生失败引起的，最终导致神经功能障碍的积累。疾病修饰剂可以成功地解决炎症性复发，但在多发性硬化症的进行性形式中疗效较低，并且不能阻止进行性神经退行性过程。因此，干细胞替代疗法旨在克服中枢神经系统细胞丢失和髓鞘再生失败，被认为是一种有前途的替代治疗方法。尽管干细胞移植的有益效果的机制尚未完全阐明，但神经营养支持、免疫调节和细胞替代似乎起着重要作用，从而对疾病的病理学进行多方面的对抗。本系统综述主要关注干细胞向中枢神经系统病变部位迁移并分化为功能性少突胶质细胞来修复轴突的能力。虽然大多数研究证实了不同类型的干细胞治疗后神经功能缺损的改善，但在将其有效引入临床实践之前，仍有许多关键问题需要澄清。
