Stem Cell-Based Therapies, Remyelination, and Repair Promotion in the Treatment of Multiple Sclerosis

The main challenges in the treatment of multiple sclerosis (MS) are eradication of autoimmunity and repair of the damaged central nervous system (CNS). Stem cells, due to their innate ability to replace damaged cells and cross-talk with the MS microenvironment, have been proposed as powerful tools to achieve at least one or both of such ambitious therapeutic goals. Autologous hematopoietic stem cell transplantation is indeed effective in severe forms of MS in halting inflammation but has no effect on CNS regeneration. On the other hand, preclinical studies with mesenchymal stem cells and neural precursor cells have shown that they exert neuroprotection but surprisingly only marginally through cell replacement and mostly via bystander immunomodulatory and trophic mechanisms.