Stem Cells Therapy
for
Amyotrophic Lateral Sclerosis (ALS)

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Amyotrophic Lateral Sclerosis (ALS), is a neurodegenerative condition that involves the breakdown of motor neurons in the spinal cord and the brain. Patients with ALS may experience weakness in their limbs followed by a quick and progressive paralysis that leads to total paralysis, respiratory failure and death.

The Stem Cells Transplant Institute in Costa Rica, recommends the use of umbilical cord stem cells for the treatment of ALS.

Treatment at the Stem Cells Transplant Institute could help improve the symptoms of amyotrophic lateral sclerosis:

  • Muscle twitches or cramps in the arms, shoulders, legs or tongue (fasciculations)
  • Stiff, tight muscles (spasticity)
  • Muscle weakness or clumsiness in the hands, arms, legs, ankles, neck or diaphragm
  • Slurred speech
  • Difficulty swallowing
  • Difficulty chewing
  • Difficulty walking, tripping, or falling
  • Cognitive and behavioral changes
  • Difficulty breathing
  • Weight loss

What is ALS?

ALS is a progressive neuromuscular disease that damages primarily the nerve cells in the brain and spinal cord, responsible to controlling voluntary muscle movement like chewing, walking and talking.  Damage to the barrier or protective wall between the central nervous system and the blood circulatory system allows harmful substances including immune mediated cells and inflammatory cells to enter both the brain and the spinal cord.

Motor neurons in the brain (upper motor neurons) and motor neurons in spinal cord and motor nuclei of the brain (lower motor neurons) begin to die and no longer send messages to the voluntary muscles in the body. Without signals from the brain and spine the muscles are no longer able to function and they become weak and begin to die. Initially the muscles weaken and begin to twitch but eventually they atrophy or die and the body loses its ability to control voluntary movement.

Who is at Risk of Developing ALS?

In 2016 the Centers for Disease Control and Prevention estimated that between 14,000 – 15,000 Americans have ALS.  ALS usually strikes people between the ages of 40 and 70, and for unknown reasons, military veterans are approximately twice as likely as the general population to be diagnosed with the disease.

Risk Factors:

Age; Typically striking people between the ages of 40 and 70.

Gender; Men are at slightly higher risk of developing ALS

Ethnicity; Caucasians and non-Hispanics are at highest risk

Military veterans; Twice as likely when compared to the general population to develop ALS

Genetics; Approximately 5-10 percent of cases are inherited by one parent carrying the genetic mutation

How can stem cell therapy improve the symptoms of ALS?

A cure for ALS is not available at this time, and the disease typically leads to death within 3–5 years after diagnosis, primarily due to respiratory failure.

Stem cell therapy is a promising approach for the treatment of neurodegenerative disorders such as ALS. Mesenchymal stem cells (MSCs) specifically, seem to be the most suitable type of stem cells due to their demonstrated beneficial effects in many different experimental models, their easy access, and the lack of ethical issues associated with other types of stem cells.

The beneficial effects of mesenchymal stem cells are due to multiple factors. The beneficial effects are due in part to the paracrine effect that results in the release of different growth factors, cytokines, free nucleic acids, lipids and extracellular vesicles. These secreted biomolecules promote tissue repair, modulate the immune system, have an anti-inflammatory effect and provide antiapoptotic activities.1

Human umbilical cord mesenchymal stem cells (hUC-MSCs) can promote the release of acetylcholine, promote neurogenesis and synaptic formation and can reduce oxidative stress and cell death. Research is showing hUC-MSCs to be a better alternative to allogeneic stem cells because of their hypo-immunogenicity, superior tropism, high differentiation potential and paracrine activity.2,3

Evidence suggests HUC-MSCs can differentiate into a variety of neuro-regulatory molecules and can elevate several factors including brain-derived neurotrophic factor (BDNF), glial cell-derived neurotrophic factor (GDNF), insulin-like growth factor 1 (IGF-1), Glucagon-like pepetide-1 (GLP-1), and vascular endothelial growth factor (VEGF).4

Neural stem cells transplanted at sites of nerve injury are thought to promote functional recovery by producing trophic factors that induce survival and regeneration of host neurons. Intravenously administered mesenchymal stem cells are also capable of crossing the blood-brain barrier and effectively migrating to regions of neural injury, without inducing tumor growth or an immune response.4

What are scientists researching?

According ClinicalTrials.gov (https://clinicaltrials.gov) on August 22, 2019, there are 9 trials evaluating the safety and efficacy of cell based therapy for the treatment of Amyotrophic Lateral Sclerosis.

What is the recommended treatment protocol for ALS at the Stem Cells Transplant Institute?

The Stem Cells Transplant Institute recommends the use of hUC-MSCs for the treatment of ALS.

For optimal results, we recommend Aggressive Platinum Therapy (APT).  APT is a 4-day treatment plan.

Each day you will receive the following:

  1. Each day the patient receives 120 million mesenchymal stem cells (MSC) cultured and expanded from human umbilical cord tissue for a 4-day total of 500 to 480 million MSCs.
  2. Antioxidant therapy with vitamin C and glutathione
  3. Ozone therapy
  4. Platelet-rich plasma therapy (PRP)

Some studies have found autologous MSCs from patients diagnosed with ALS have reduced properties when compared to MSCs taken from healthy donors. Stem cells from patients with ALS showed reduced expression of several trophic factors and a reduced migration capacity.5-7

NIH trial NCT02881476 showed the intrathecal injection of allogeneic Wharton’s jelly-derived MSCs in ALS patients to be safe.8

What are the advantages of human umbilical cord mesenchymal stem cells?

  • Abundant supply containing up to 10 times more stem cells than bone marrow or adipose derived stem cells
  • hUC-MSC have immunosuppressors and immunomodulatory properties that allow their use in any individual without rejection- Human Leukocyte Antigen (HLA) matching is not necessary
  • Greater proliferation ability than adult autologous stem cells
  • They regenerate at a very rapid rate
  • They are young and very adaptive
  • They have not been impacted by the aging process
  • They have not been affected by environmental toxins
  • Umbilical cord stem cells can be administered multiple times over the course of days
  • Eliminates the need to collect stem cells from the patient’s fat or hip bone reducing pain and recovery time

What are the challenges?

ALS is a group of neuromuscular diseases that destroys many different types of neurons in the brain and spine.

Successful treatment requires all the stem cells to travels to the brain and spine and differentiate into different types of neurons and other cells correctly.

At this time stem cell therapy does not stop the underlying cause of ALS and patients may need more than one treatment due to a declining effect over time.

Stem Cells Collected

How are the stem cells collected?

We use only umbilical cord stem cells that are derived exclusively from umbilical cord donations. 

The umbilical cord stem cells from are collected after informed consent has been given by the parent, or parents, and only after the delivery of the baby.

The collection follows strict ethical protocols ensuring the stem cells are from safe, reliable sources using a non-invasive, simple and painless procedure.

Once collected, the cord blood is then screened for disease.

How are the stem cells administered?

The stem cells are administered by intrathecal (spinal) injection, intramuscular and intravenous injection

About the Stem Cells Transplant Institute

Costa Rica has one of the best healthcare systems in world and is ranked among the highest for medical tourism.

Using the most advanced technologies, the team of experts at The Stem Cells Transplant Institute believe in the potential of stem cell therapy for the treatment of autoimmune diseases.

We are committed to providing personalized service and the highest quality of care to every patient.

References.

  1. Agnese Gugliandolo, Placido Bramanti, and Emanuela Mazzon, “Mesenchymal Stem Cells: A Potential Therapeutic Approach for Amyotrophic Lateral Sclerosis?” Stem Cells International, Vol. 2019, Article ID 3675627, 16 pages, https://doi.org/10.1155/2019/3675627
  2. Kim, J. Y., Jeon, H. B., Yang, Y. S., Oh, W. & Chang, J. W. Application of human umbilical cord blood-derived mesenchymal stem cells in disease models. World J Stem Cells2, 34–8 (2010).
  3. Jeong, S. Y. et al. Thrombospondin-2 secreted by human umbilical cord blood-derived mesenchymal stem cells promotes chondrogenic differentiation. Stem Cells31, 2136–48 (2013).
  4. Fang Y, Gao T, Zhang B, Pu J. Recent Advances: Decoding Alzheimer’s Disease With Stem Cells. Front Aging Neurosci. 2018;10:77. Published 2018 Mar 22. doi:10.3389/fnagi.2018.00077
  5. Boucherie, A.S. Caumont, J.M. Maloteaux and E. Hermans, “In vitro evidence for impaired neuroprotective capacities of adult mesenchymal stem cells derived from a rat model of familial amyotrophic lateral sclerosis (hSOD1 G93A),” Experimental Neurology, vol. 212, no. 2, pp.557-561, 2008.
  6. W. Cho, M.Y. Noh, H.Y. Kim, S.H. Koh, S. Kim and S.H. Kim, “Bone marrow-derived stromal cells from amyotrophic lateral sclerosis patients have diminished stem cell capacity,” Stem Cells and Development, vol. 19, no. 7, pp. 1035-1042., 2010.
  7. H. Koh, W. Baik, M.Y. Noh et al., “The functional deficiency of bone marrow mesenchymal stromal cells in ALS patients is proportional to disease progression rate,” Experimental Neurology, vol. 233, no. 1, pp.472-480, 2012.
  8. Barczewska, M. Grudniak, S. Maksymowicz et al., “Safety of intrathecal injection of Wharton’s jelly-derived mesenchymal stem cells in amyotrophic lateral sclerosis therapy,” Neural Regeneration Research, vol. 14, no.2, pp. 313-318, 2019.