محققین کانادایی با بکارگیری سلولهای بنیادی موفق به درمان بیماری ام اس شدند.
ایرکانیوز – 14 جون 2016- 25 خرداد 95
Breakthrough in MS treatment at Ottawa Hospital uses stem cells
محققین دانشگاه Ottawa کانادا با انجام آزمایشات بالینی متوجه شدند که باز تقویت سیستم ایمنی بدن منجر به درمان ام اس می شود.
دکتر فریدمن و دکتر هری اتکینز توانستند در شیوه درمانی موسوم به IAHSCT ابتدا محققین کانادایی سیستم ایمنی بدنی که بیمار شده بود را با بکارگیری دوز بالای داروهای شیمی درمانی هدف قرار داده و آن را از بین بردند.
سپس با استفاده از سلول های بنیادی Hematopoietic که قبلا از خون بیمار تهیه شده بود دوباره آن را به بدن فرد مبتلا به ام اس پیوند زدند.
نتیجه آن منجر به شکل گیری سیستم ایمنی جدید برای بدن به وسیله این سلول های بنیادی شد که حافظه ای برای حمله به سیستم عصبی بدن نداشتند. با بکارگیری این تکنیک ۲۴ بیمار که از ام اس شدید رنج می بردند، درمان شدند.
جنیفر ملسون در 21 سالگی به ام اس مبتلا شده بودو می گوید نجات پیدا کردم .
همچنین در فرآیند بعد از درمان نیز گزارشی از بازگشت ام اس ثبت نشد و در ۳۲۷ اسکن انجام گرفته از بیماران ام اس در دوره بعد از درمان، نشانه ای از ضایعه مغزی مشاهده نشد ضمن اینکه دیگر نیازی به استفاده از داروهای خاص ام اس برای جلوگیری از پیشرفت بیماری نبود.
بر اساس برآوردهای انجام گرفته، سالانه در حدود ۲.۳ میلیون نفر در سرتاسر جهان مبتلا به بیماری ام اس می شوند که علت آن هدف قرار گرفتن سیستم عصبی بدن از سوی سیستم ایمنی به طور اشتباه است.
این بیماری با علائمی نظیر خستگی و تار شدن دید ظاهر و به فلج جزیی تا کامل منجر می شود. در بین 24 بیمار 15 تا ی انها که این شیوه بر روی انها اعمال شده است خوب شده اند . تحقیق 6.7 میلیون دلاری توسط بنیاد ام اس پرداخت شده بود .
نتیجه این تحقیق در نشریه The Lancet منتشر شده است.
Dr. Mark S. Freedman was a senior resident at a multiple sclerosis clinic in the 1980s when he met a former colleague with the disease. The patient asked Freedman if he planned to do research.
“Just look at me’” the man said. “Do something for this dreaded disease.”
That challenge planted a seed in Freedman that fully matured this week with a breakthrough in the treatment of MS that one patient says has “given me my life back.”
The treatment, pioneered by Freedman and Dr. Harry Atkins of The Ottawa Hospital and University of Ottawa, involves wiping out a patient’s immune systems and then generating a new one using the patient’s own blood stem cells.
The complex procedure was performed on 24 patients who were followed for up to 13 years to confirm the results. One participant died of liver failure due to the treatment (which has since been modified to make it less toxic to the liver) and another required intensive care for liver complications.
But of those who successfully received the treatment, the study found that not a single participant experienced a clinical relapse, there were no new active inflammatory brain lesions that could be detected, not a single participant required drugs to control the disease and, crucially, 70 per cent of participants experienced a complete stop in disease progression.
It was the first clinical trial to show the “complete, long-term suppression of all inflammatory activity in people with MS,” says Atkins.
The results were published in the medical journal The Lancet on Thursday.
Jennifer Molson was 21 in 2002 when she received a stem cell transplant as part of the trial at The Ottawa Hospital. She had been diagnosed with MS six years earlier and the disease had progressed rapidly.
By the time she received the transplant, the formerly active young woman was receiving 24-hour care at The Ottawa Hospital Rehabilitation Centre. She couldn’t feed herself, blow dry her hair, shower or dress without help.
Today, Molson is symptom free, relapse free, skiing, driving, working and living life as if she had never had MS.
“I got my life back,” she says.
Molson’s is the kind of success story that has led MS patients from around the world who have heard about the therapy to write to the Ottawa researchers involved begging them for the same treatment. Freedman says it is “almost a daily occurrence” that he receives an email from someone asking to be treated. He has even had a wealthy person offer to build a new centre for the treatment. But Freedman says treating patients from around the world is not a possibility.
“We are not in the business of making money. We are in business to help our patients in Canada. Our health care system will not allow us to start taking in patients from around the world.”
The treatment is not for everyone. It comes with risks and some limitations.
When Molson had the transplant, she was told the risk of death was one in 10 (the researchers say it is less than that due to medical advances). She also knew she would never be able to conceive children. Those were risks she was willing to take, she says, because of the rapid progression of her disease.
More than a decade after the procedure, Molson says she has actually improved, rather than simply stabilizing. It has changed her life.
“It sounds corny, but I have a whole new appreciation for life. I don’t take anything for granted.”
Freedman says that kind of feedback is rewarding, especially given the damage MS causes.
“It has got to be one of the most satisfying things to be able to actually help people.”
There are currently about 10 licensed drugs to treat MS and treatment is getting better, but with most of those drugs, says Atkins, MS will usually “break through” at some point, which can mean relapses or further progression of disabilities caused by the disease.
Patients whose disease is advanced and with accumulated progressive disabilities are not good candidates for the procedure, say the researchers. It is intended for patients with early, aggressive MS that cannot be well controlled by drugs.
Since the initial trial of 24 patients, about 15 more procedures have been performed. With advances in drugs and technology, all of them have done well.
Freedman says he would like to see this procedure done in other centres across Canada and around the world. A key, he says, is not only completely wiping out patients’ immune systems before the transplant, but the careful care and monitoring patients receive afterward.
The $6.47-million trial was funded by the MS Society of Canada.
Molson says the results not only offer hope for other MS patients but illustrate that donations to charities can make a real difference.
“I wouldn’t be here if not for the MS Society.”