March 20, 2024

Advanced cell therapy for progressive MS with Dr Stefano Pluchino | S6E06

37 minutes

Welcome to Living Well with MS, where we are pleased to welcome Dr Stefano Pluchino as our guest! Dr Pluchino is a Professor of Regenerative Neuroimmunology at Cambridge University and has been researching stem cell therapy for progressive MS. In this episode, Dr Pluchino speaks to Geoff about what advanced cell therapy is, the success of his phase one trial and what the future of DMTs looks like indicating what people with MS may experience.

Watch this episode on YouTube here. Keep reading for the key episode takeaways.

Topics and Timestamps:

01:31 Dr Pluchino’s background and research into stem cell therapy for progressive MS.

02:52 The difference between types of MS.

05:09 Navigating DMT options for progressive MS.

08:40 Dr Pluchino’s advanced cell therapy research trial: The success of phase one and plans for phase two.

21:05 How advanced cell therapy compares to HSCT or bone marrow transplants.

26:02 What it means for the future of DMTs.

33:39 How you can be part of groundbreaking MS research and trials.

Selected Key Takeaways:

There are nuances in types of MS beyond ‘relapsing’ or ‘progressive’.

04:23 "It is becoming more complex between active and non-active types of primary and secondary progressive MS where activity is attributed to other episodes. Clinical episodes of disease or radiologically evident episodes of disease, which can be identified by the use of contrast agents at the time of the MRI. So, they are very complex very heterogenous types of disease, with or without activity, which inevitably undergo accumulation of neurological deficits.”

The next generation of DMTs will target progression rather than relapses.

06:39 “What's becoming very interesting is that [over the last] few years, there is a general worldwide consensus that progressive MS is becoming and has become a clinical unmet need. The old MS world is concentrating on financing, funding and efforts towards stopping MS through the development of a new generation of DMDs which will eventually target progression rather than relapses.”

The future of advanced cell therapy research will look at remyelination, reduction of inflammation and neuroprotection.

19:10 "There is space for assessing whether a proportion of the injected cells [can] differentiate in vivo into new myelin-forming cells. There is a space to assess whether some of the cells [can] increase the survival of neurons in the brain. There is space to assess whether the transplanted cells [can] reduce the type of inflammation which characterises progressive MS, which is what we call a smouldering inflammation.

These highly diffuse homogeneous, low-level activations of microglia (immune cells of the central nervous system) and astrocytes (star-shaped cells that hold nerve cells in place) might be reduced by means of advanced cell therapy and the reason why I am specifically alluding to these three major biological mechanisms of disease, remyelination, reduction of inflammation and neuroprotection is because we have managed to identify each of these mechanisms in clinically relevant animal disease models in the last 25 years. So, there is [an] expectation that a clinical trial designed in a way that will allow us to establish the efficacy of the treatment will reveal what we have established already in one of these models.”

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