The availability of multiple disease-modifying medications with regulatory approval to treat multiple sclerosis illustrates the substantial progress made in therapy of the disease. However, all are only partially effective in preventing inflammatory tissue damage in the central nervous system and none directly promotes repair. Cell-based therapies, including immunoablation followed by autologous haematopoietic stem cell transplantation, mesenchymal and related stem cell transplantation, pharmacologic manipulation of endogenous stem cells to enhance their reparative capabilities, and transplantation of oligodendrocyte progenitor cells, have generated substantial interest as novel therapeutic strategies for immune modulation, neuroprotection, or repair of the damaged central nervous system in multiple sclerosis. Each approach has potential advantages but also safety concerns and unresolved questions. Moreover, clinical trials of cell-based therapies present several unique methodological and ethical issues. We summarize here the status of cell-based therapies to treat multiple sclerosis and make consensus recommendations for future research and clinical trials.

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基于细胞的多发性硬化症治疗策略

经监管部门批准的多种疾病缓解药物可用于治疗多发性硬化症，这说明该疾病的治疗取得了实质性进展。但是，所有这些都只能部分有效地预防中枢神经系统的炎性组织损伤，而且都不能直接促进修复。基于细胞的疗法，包括免疫切除，自体造血干细胞移植，间充质和相关干细胞移植，内源性干细胞的药理处理以增强其修复能力以及少突胶质祖细胞的移植，已经引起了人们的广泛兴趣，作为新的治疗策略免疫调节，神经保护或修复多发性硬化症中受损的中枢神经系统。每种方法都有潜在的优势，但也有安全隐患和未解决的问题。此外，基于细胞的疗法的临床试验提出了一些独特的方法论和伦理学问题。我们在这里总结了用于治疗多发性硬化症的基于细胞的疗法的现状，并对未来的研究和临床试验提出了共识性建议。