So no benefit found so far. I personally think stem cells are moon shots and should only be attempted after much other more realistic research is accomplished. Ask your doctor how many thousands of stroke research needs followup with human testing and how close they are to completion. I'm not paid to keep track of this stuff, your doctor supposedly is, so ask them.
Safety and Clinical Efficacy of Mesenchymal Stem Cell Treatment in Traumatic Spinal Cord Injury, Multiple Sclerosis and Ischemic Stroke – A Systematic Review and Meta-Analysis
Christopher Elnan Kvistad1*, 
Torbjørn Kråkenes1, Cecilie Gjerde2, 
Kamal Mustafa2, Tiina Rekand1,3 and Lars Bø1,4- 1Department of Neurology, Haukeland University Hospital, Bergen, Norway
- 2Tissue Engineering Group, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- 3Institute for Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- 4Department of Clinical Medicine, University of Bergen, Bergen, Norway
Background: Mesenchymal stem cells (MSCs) is an attractive candidate in regenerative research and clinical trials have assessed their therapeutic potential in different neurological conditions with disparate etiologies. In this systematic review, we aimed to assess safety and clinical effect of MSC treatment in traumatic spinal cord injury (TSCI), multiple sclerosis (MS) and ischemic stroke (IS).
Methods: A systematic search was performed 2021-12-10 in MEDLINE, EMBASE, Web of Science and Cochrane where clinical studies assessing MSC treatment in TSCI, MS or IS were included. Studies without control group were excluded for efficacy analysis, but included in the safety analysis. For efficacy, AIS score, EDSS score and mRS were used as clinical endpoints and assessed in a meta-analysis using the random effects model.
Findings: Of 5,548 identified records, 54 studies were included. Twenty-six studies assessed MSC treatment in TSCI, 14 in MS and nine in IS, of which seven, seven and five studies were controlled, respectively. There were seven serious adverse events (SAEs), of which four were related to the surgical procedure and included one death due to complications following the implantation of MSCs. Three SAEs were considered directly related to the MSC treatment and all these had a transient course. In TSCI, a meta-analysis showed no difference in conversion from AIS A to C and a trend toward more patients treated with MSCs improving from AIS A to B as compared to controls (p = 0.05). A subgroup analysis performed per protocol, showed more MSC treated patients improving from AIS A to C in studies including patients within 8 weeks after injury (p = 0.04). In MS and IS, there were no significant differences in clinical outcomes between MSC treated patients and controls as measured by EDSS and mRS, respectively.
Interpretation: MSC-treatment is safe in patients with TSCI, MS and IS, although surgical implantation of MSC led to one fatal outcome in TSCI. There was no clear clinical benefit of MSC treatment, but this is not necessarily a proof of inefficacy due to the low number of controlled studies. Future studies assessing efficacy of MSC treatment should aim to do this in randomized, controlled studies.
Introduction
For neurological diseases affecting the central nervous system (CNS), there are no available therapies that may repair and thereby reverse neurological disability. So far, this has been the common denominator in CNS injury, regardless the cause.
Mesenchymal stem cells (MSCs), also known as mesenchymal stromal cells, are heterogeneous cells with self-renewal potential and multipotent properties that can be found in all postnatal tissues (1). MSCs do not have a unique cell marker, but are defined according to international guidelines by the presence and absence of different cell surface proteins and tri-lineage differentiation potential in vitro (2).
Recent studies have highlighted the systemic role of MSCs in tissue repair (3–5). In this setting, MSCs have been shown to possess regenerative capabilities, also for conditions affecting the CNS. Animal studies have revealed that MSCs can migrate toward sites of injury (6) and promote repair of myelin and neurons, thus leading to improved functional outcomes in models of central nervous diseases (7, 8). This effect is likely mediated through different mechanisms, such as the paracrine stimulation of endogenous progenitor- and stem cells through the MSC secretome (9), mitochondria donations (10), immunomodulation (11) and transdifferentiation toward neural cell lines (12).
MSCs can be obtained from different tissues, such as bone marrow (BM), adipose tissue and umbilical cord, and expanded ex vivo. The use of autologous or allogeneic MSCs represent no ethical concerns as compared to other stem cell therapies based on embryonal or fetal stem cells. This, along with the promising results from animal studies, have made MSCs an attractive candidate for regenerative human studies.
Numerous studies have been performed the last years assessing MSC treatment in neurological conditions. As injury to the human CNS may be caused by different mechanisms, an important question is whether MSC treatment is safe and whether it possesses a neuroregenerative effect across separate etiologies. In this systematic review and meta-analysis, we aimed to assess safety and clinical effect of MSC treatment in traumatic spinal cord injury (TSCI), multiple sclerosis (MS) and ischemic stroke (IS).
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