Anna WilliamsScottish Senior Research Fellow and Honorary

Consultant Neurologist

MS and Update on research

Scottish Centre for Regenerative Medicine

Project Base - Edinburgh

No 9, BioincubatorMRC Scottish Centre for Regenerative Medicine230 Researchers

Queen’s Medical Research Institute650 ResearchersDrug Discovery Core

Clinical ResearchImaging Centre

Royal Infirmary870 bedsMedical School

250 ResearchersAnne Rowling Regenerative Neurology Clinic – 1700 MS patients. 1/500 in Scotland

Clinical Research FacilityMHRA Accredited Phase 1 Unit

MRC hub for Stem cell niche - £5.6 million

3

What causes MS?Young 1 in 500 in Scotland2F:1M

Genetics Family - 5%, Twin studies – 30% MZMac/McGenes – HLA DR2, IL7R,IL2R+

Immune/autoimmune – HLA DR2, periventricular plaques

Latitude Guernsey 87/105 populationOrkney287/105 populationVitamin D

Post-infective EBV, chlamydia, coxsackie, canine distemper virus, HHV6

Radon/ organophosphates/ whiplash/mercury fillings etc

Oligodendrocyte precursor cells to remyelinateNeural protection

Immune attackWhat is MS?

There is an unmet need in MS therapy

Anti-inflammatory drugs Neuroprotective therapies

Inflammation neurodegeneration

RelapsesProgression

disa

bilit

y

time

βIFN, Fingolimod, Natalizumab

Teriflunomide, Fumarate, Alemtuzumab

7

Demyelination

Axondegeneration

Remyelination

(inefficient)

Neuroprotective strategies

Promote axon survival

as in MND, AD, stroke etc.

8

stem cell

stem cellSELF-RENEWAL(copying)

specialised celle.g. muscle cell, nerve cell

DIFFERENTIATION(specialising) grow

repair renew

A stem cell can self-renew or differentiate

Blastocyst

Inner cell mass

Throughout life Cell from the body

Genetically reprogrammed

Pluripotent cell

Add varying factors to

differentiate into any cell type

Embryonic stem cells

Tissue stem cells Embryonic stem cells Induced pluripotent stem cells

Add varying factors to

differentiate into any cell type

Liver stem cells make liver cells

Brain stem cells make brain cells

etc

Different types of stem cells

What is a stem cell?

Mesenchymal stem

cell

Pluripotent (embryonic) stem cell

Neural stem cell

Gut stem cell

Bone

Blood stem cell

Cardiac stem cell

Nerve Oligodendrocyte

Skin stem cell

Fat

Cartilage

?

Immunecell

Induced pluripotent stem cell

Skincell

Recruitment Maturation

Demyelination Remyelination

OPC(Tissue

stem cell)

What is required for remyelination?

Anti- Lingo 1 absRXRg~10 other targets in rodent

ChemorepellentSema3A and its

receptor neuropilin 1

Stem cell transplant problems

Multiple lesions

New lesions

Some lesions repair themselves

How do we get stem cells in?

Can they migrate?

Where do we get them from?

How will they know what connections to make?

Danger – operations, drugs, infection, tumours

How do we get stem cells in?

One lesion

No new lesions

Very little repair

Can they migrate?

Where do we get them from?

How will they know what connections to make?

Danger – operations, drugs, infection, tumours

Spinal cord injury – better bet

STEM CELLS FOR HOPE

Stem cell tourismPut ‘stem cell’ and ‘MS’ into Google – get almost 13 million hits

Researchers Highlight Warning Signs On Adult Stem Cell Treatments

Stem Cell Fraud: A 60 Minutes investigation

‘Stem cell tourism’ growing trendPanel decries overseas clinics that provide treatments devoid of scientific validity

Stem cell hype and the dangers of stem cell “tourism”

Stem cells in Texas: Cowboy culture

STEM CELL TOURISM: SEEKING TREATMENT ON THE INTERNET AND PAYING FOR IT WITH YOUR LIFE

Desperate patients warned to avoid stem cell tourism abroad over unproven 'miracle' claims

Counter culture