| خلاصه مقاله | Introduction:
lower urinary tract symptoms (LUTS) are the prevalent but neglected symptoms in multiple sclerosis (MS) patients. This systematic review study assesses both the pre-clinical and clinical studies that evaluate the applications of stem-cell-based therapies (SCT) in MS-related LUTS.
Method:
This study was performed following the PRISMA statement. A systematic search was performed through PubMed and Google Scholar with ((Multiple sclerosis) OR (experimental autoimmune encephalomyelitis)) AND ((Urinary Bladder, Overactive) OR Urodynamics OR (neurogenic bladder) OR (lower urinary tract dysfunction) OR LUTS) AND ((stem cells) OR (cells, cultured) OR (stem cell transplantation) OR (hematopoietic or mesenchymal)) keywords in November 2021 and relevant studies were retrieved.
Result:
Out of 219 results from electronic and hand searches, finally, four records, including one experimental study on mice with experimental autoimmune encephalomyelitis (EAE), two clinical studies, and one clinical trial registry, met our inclusion criteria. Zhibo Jin et. al. intraperitoneally injected the stem-cell factor cytokine and as a result, this treatment could ameliorate the urine retention, micturition frequency and urine output per micturition. Riordan et al. in a 1-year study, assessed the safety and feasibility of umbilical cord mesenchymal stem cells and reported an improvement in bladder function, assessed by Scripps Neurological Rating Scale, after 1 month, but this improvement was not significant after 1-year of intervention.[1] Harris et al. intrathecally administered bone marrow mesenchymal stem cell-derived neural progenitor in three separate doses and all subjects underwent urodynamic testing. Of the 18 study subjects, nine subjects (50%) demonstrated either symptomatic and/or urodynamic improvement in bladder function.[2] Finally, a phase II, double-blinded, placebo-controlled, randomized, cross-over study, tended to assess the degree of bladder dysfunction by urodynamics testing at baseline, Months 13 and 27 after intervention in each group. In this study, Autologous Mesenchymal Stem Cell-derived Neural Progenitors were compared to placebo in patients with progressive MS.[3]
Conclusion:
• Limited efficacy and safety of STC in MS-related LUTS
• Essential future pre-clinical as well as clinical studies
Refrences:
1. Riordan, N.H., et al., Clinical feasibility of umbilical cord tissue-derived mesenchymal stem cells in the treatment of multiple sclerosis. Journal of translational medicine, 2018. 16: p. 1-12.
2. Harris, V., et al., Phase I trial of intrathecal mesenchymal stem cell-derived neural progenitors in progressive multiple sclerosis. EBioMedicine 2018; 29: 23-30. Epub 2018/02/17. PubMed PMID: 29449193.
3. Harris, V.K., et al., Mesenchymal stem cell-derived neural progenitors in progressive MS: Two-year follow-up of a phase I study. Neurology: Neuroimmunology & Neuroinflammation, 2020. 8(1): p. e928. |