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PARKINSON'S DISEASE TREATMENT WITH STEM CELL THERAPY

01/May/2019

Introduction

Parkinson’s disease is the second most prevalent disease after Alzheimer’s among progressive disorders that harm the nervous system. It affects mostly elderly patients (1% of people age 60+ and 2-3% age 75+). About 5% of cases are caused by genetically inherited problems, but it is not clear what causes the remaining 95% of cases.

Parkinson’s is characterized by both motor symptoms (tremors, slowed movements, muscle stiffness, balance and posture problems, loss of automatic movements, and difficulties with speech and writing) and non-motor signs and symptoms (anhedonia, depression, anxiety, olfactory deficiency, sleep disorders, and cognitive impairment).

Symptoms of the disease include the loss of a large number of neurons in the area of the brain called the substantia nigra. These neurons produce dopamine, a neurotransmitter that provides signal transduction to the nerve cells. Another identifying feature of this disorder is the emergence of clumps (Lewy bodies) in the brain formed by a protein alpha-synuclein [2, 3].

How stem cell therapy can help treat Parkinson’s disease

Scientists are striving to find treatment for this neurological disorder because the current standard therapy can neither prevent neuronal death nor slow or stop its progression; it is aimed, instead, at maintaining a constant level of dopamine stimulation. Existing medications can improve a patient’s symptoms, but they cannot combat the disease and come with significant disadvantages and side-effects (such as wearing off over time, involuntary movements and dyskinesia, impulsive and compulsive behavior, nausea and vomiting, hallucinations and delusions, heart problems, etc.).

Alternative stem cell therapy approaches have been studied over the past 30-40 years. The results of stem cell therapy with multipotent mesenchymal stromal cells (MMSCs) both on animal models and in clinical trials confirm that such approaches may slow the progression of Parkinson’s disease and reduce symptoms, as well as lower adverse effects of existing medications [4].

Studies of efficacy and the safety of autologous or donor MMSCs when implanted into the specific regions of the brain have been conducted since 2009. About half of the patients showed a positive response within the observation period (from 0 to 36 month) [4], [6]:

• rigidity reduced;
• speech improved;
• minimal tremors;
• no need to increase traditional drug therapy.

It was also noted that patients at an early stage of Parkinson’s disease treated with stem cells often did not experience disease progression and had more pronounced clinical improvement when compared to patients treated at the later stages of the disease [6].

Parkinson's disease. Treatment with stem cells.

Picture 1. Mesenchymal stem cell-based approaches to manage Parkinson’s disease. A. In laboratory settings, MMSCs can be differentiated into dopaminergic neurons by means of various molecular factors. B. Therapeutic application of in vitro developed dopaminergic neurons to treat patients with Parkinson’s disease and screening of small molecules in the cell model of dopaminergic neurons derived from MMSCs. [11].

Expected results

At least part of the participants of the completed studies demonstrated the following improvements [6], [11]:

• Reduced rigidity.
• Improved speech.
• Minimal tremors.
• Ability to do routine activities without much difficulty.
• Ability to walk for longer distances.
• Improved swallowing.
• Reduced involuntary movements.
• Increased independence during daily activities.
• Overall improvement assessed by the unified Parkinson’s disease rating scale (UPDRS) [12].

Results of Swiss Medica patients

Marko Belcanti, patient from Italy:

“A month following treatment, I was able to ride a bicycle for 70 km with 1000-1200 m of altitude difference during my training. This makes me feel very positively about the future.”

Franchesco, patient from Italy:

“I can talk faster, write, walk in the mountains, wash by myself and play football with my grandchildren”.

Patient from Denmark, 10 years with Parkinson’s disease:

“Each tiny thing matters”. His illness started with a little finger trembling and progressed to complete inability to perform daily activities. Now he feels that the progression of the disease has stopped. He can hold a glass and drink, lift his legs, clap his hands and touch his head with his arm.

How and why stem cells work in treating Parkinson’s disease

MMSCs can produce a wide range of biologically active molecules (cytokines and growth factors), including those with neuroprotective and neurodegenerative properties. Also, in vitro studies showed that MMSCs are potentially able to differentiate into various types of cells, including neurons, and form new synapses with neighboring neurons [9]. The therapeutic effect is provided also by the immunomodulating effect of MMSCs due to the neuroinflammatory nature of Parkinson’s disease [10].

Parkinson's disease. Stem cell therapy.

Picture 2. Through the secretion of neuroregulatory molecules, MMSCs are able to influence processes such as neurogenesis, gliogenesis, remyelination, and neural plasticity.

Stem cell sources

MMSCs can be obtained both from the patient’s own tissues (bone marrow, adipose tissue, peripheral blood or gingiva) or from donor sources (placenta, umbilical cord or bone marrow). The source of cells is selected based on the patient’s condition, disease state, the presence of contraindications to the collection the patient’s own cells (tolerance to anesthesia, risk of bleeding, etc), and also the combined use of donor and patient’s own cells in a personal treatment program.

What the therapy involves

The treatment procedure, when autologous cells are used, involves the following stages:

1. Cells harvesting from one of the source of MMSCs;
2. Creating the cell product – processing and cultivation to obtain the required number of MMSCs (this is the most time-consuming step which lasts about 4 weeks);
3. MMSC injection.

When donor cells are used for treatment, the second step is excluded: cultivated and cryopreserved in advance stem cells (own or donated) may be ready for use within 24 hours.

Preliminary procedures

Prior to the procedure, a Swiss Medica doctor will examine you to determine the current state of your health and individual characteristics, and to collect information from your medical history to determine your eligibility for receiving stem cell therapy with MMSCs. Laboratory and/or instrumental tests are performed at this time. The specialist will choose the most suitable source of autologous MMSCs (bone marrow, adipose/fat tissue or gingival tissue) or recommend treatment with donor stem cells.

To extract autologous MMSCs, the doctor will first prepare your skin by cleaning it with an antiseptic in the operating room and then will administer a local or general anesthesia. A sample of the biological material is then extracted.

The bone marrow samples are usually collected from the top ridge of the back of a hipbone or sometimes from the front of the hip. Adipose tissue is harvested in the area of the anterior abdominal wall, side surfaces of the waist, loins, buttocks, or the outer side of the hips. When cells are collected from the gingival tissue, the doctor takes a small part (3-4 mm3) of the gum.

All of the above-listed methods of sampling biological material to obtain stem cells are almost painless and well tolerated.

If you have any questions regarding treatment procedures, contact a Swiss Medica Medical Advisor for detailed information and conditions.

Duration

Bone marrow collection takes about an hour on average.

Harvesting of adipose-derived SVF cells takes about 30 minutes and varies depending upon the amount of tissue aspirated from the patient.

Collecting cells from gingival tissue only takes about 5-15 minutes.

The patient is monitored after collection MMSCs to ensure his or her safety.

Your comfort during the procedures

You may feel some pain similar to the sensations from ordinary syringe injections while the doctor introduces the local anesthetic during autologous cell harvesting and during local cell product injections.

Safety of stem cell therapy

The procedures are usually well tolerated in the majority of patients. Clinical trial results confirmed the safety of local injections and treatment with MMSCs from the perspective of tumor formation after a follow-up period [6]. Individual intolerance (short-term fever), while rare, cannot be excluded. Swiss Medica specialists will monitor your condition for safer and more beneficial results.

Recovery after treatment

You may feel a slight soreness in the place where stem cells were injected. Discomfort may occur for a few days after harvesting the biomaterial. During this period, you may also feel some weakness.

To understand the effectiveness of stem cell treatment and create a follow-up procedure plan, patients undergo a routine examination several weeks after the stem cell injection. The results of the treatment are observed 3-6 months after the procedure and the treatment plan is adjusted for the patient’s unique needs.

If you have any questions about the treatments and using stem cells to manage Parkinson’s disease, please contact our Swiss Medica Medical Advisor. They’ll be able to connect you with a specialist from our clinic to discuss your individual case.

– Published on May 1, 2019 by

Eremin Ilya Igorevich,

Vice Director for Science and Research,

MD, PhD;

Senior Research Associate at the Laboratory for Cellular Biology and Developmental Pathology at the Institute of General Pathology and Pathophysiology;

Associate Professor of the Department of Regenerative Medicine and Biomedical Technology at A.I. Yevdokimov Moscow State University of Medicine and Dentistry;

Member of the Department of Plastic and Reconstructive Surgery, Cosmetology and Cellular Technologies (Pirogov Russian National Research Medical University);

Member of International Federation for Adipose Therapeutics and Science (IFATS);

Member of International Society of Plastic & Regenerative Surgeons (ISPRES);

Member of Cell Society;

Member of International Placenta Stem Cells Society (IPLASS);

Author and co-author of more than 120 scientific articles, and co-author of 6 patents of invention.

List of literature references:

[1]. De Lau, L.M., and Breteler, M.M. 2006. Epidemiology of Parkinson’s disease. Lancet Neurol 5, 525-535.

[2]. Rocha, E.M., De Miranda, B., and Sanders, L.H. 2017. Alpha-synuclein: Pathology, mitochondrial dysfunction and neuroinflammation in Parkinson’s disease. Neurobiol Dis.

[3]. Wakabayashi, K., Tanji, K., Mori, F., and Takahashi, H. 2007. The Lewy body in Parkinson’s disease: molecules implicated in the formation and degradation of alpha-synuclein aggregates. Neuropathology 27, 494-506.

[4]. Mendes Filho D et al., Therapy with Mesenchymal Stem Cells in Parkinson Disease: History and Perspectives. Neurologist. 2018 Jul;23(4):141-147.

[5]. Autologous Mesenchymal Stem Cell Transplant for Parkinson’s Disease.

[6]. Venkataramana NK et al., Bilateral transplantation of allogenic adult human bone marrow-derived mesenchymal stem cells into the subventricular zone of Parkinson’s disease: a pilot clinical study. Stem Cells Int. 2012;2012:931902.

[7]. Outcomes Data of Adipose Stem Cells to Treat Parkinson’s Disease.

[8]. Allogeneic Bone Marrow-Derived Mesenchymal Stem Cell Therapy for Idiopathic Parkinson’s Disease.

[9]. Glavaski-joksimovicA, BohnMC. Mesenchymal stem cells and neuroregeneration in Parkinson’s disease. Exp Neurol. 2013;247:25–38.

[10]. Tansey MG, Goldberg MS. Neuroinflammation in Parkinson’s disease: its role in neuronal death and implications for therapeutic intervention. Neurobiol Dis. 2010;37:510–518.

[11]. Venkatesh K, Sen D1. Mesenchymal Stem Cells as a Source of Dopaminergic Neurons: A Potential Cell Based Therapy for Parkinson’s Disease. Curr Stem Cell Res Ther. 2017;12(4):326-347.

[12]. Unified Parkinson’s Disease Rating Scale (UPDRS).

[13]. Antonio J. Salgado et al. Mesenchymal stem cells secretome as a modulator of the neurogenic niche: basic insights and therapeutic opportunities. Front Cell Neurosci. 2015 Jul 13;9:249.

Patient's results of treatment
at Swiss Medica

Parkinson's disease
Autism
Lyme disease
Dementia
Multiple Sclerosis
Osteoarthritis
Diabetes type 2
Alzheimer
Kidney Disease

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About Swiss Medica clinic

Our primary task is to make your own cells treat your own body. We use advanced technology to activate mesenchymal stem cells derived from adipose tissue, bone marrow, etc. Donated cells can also be used. Introduced to the patient’s body, these cells help to regenerate damaged tissue. Symptoms become less obvious and/or disappear.

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