Immunomodulatory Role of Mesenchymal Stem Cell Therapy in Multiple Sclerosis: A Systematic Review

The progressive immune-mediated disease known as multiple sclerosis (MS) is characterized by myelin degradation, inflammation, and neurodegeneration. Recent research has examined the potential of mesenchymal stem cell (MSC) therapy for treatment, focusing on its neuroprotective and immunomodulatory properties. This study looked at how MSC transplantation affects cerebrospinal fluid (CSF) biomarkers and the immune system, and checked whether they can indicate the safety and effectiveness of the treatment for MS. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this systematic review was conducted. The final selection comprised eight studies: two randomized controlled trials (RCTs), two non-randomized experimental studies, three systematic reviews with meta-analyses, and one narrative review. Following MSC therapy in MS patients, significant alterations in neuroprotective biomarker levels were found in the CSF, exhibiting positive results. Immunologically, MSC therapy facilitated the expansion of regulatory T cells (Tregs) and suppressed T helper type 17 (Th17) cell activity, restoring immune balance and diminishing neuroinflammation. Clinically, improvements in Expanded Disability Status Scale (EDSS) scores and MRI lesion burden were observed in a significant subset of patients. Across the included studies, MSC therapy was generally safe, with mild, self-limiting adverse effects. However, heterogeneity in MSC sources, administration routes, and outcome measures, along with small sample sizes, limited comparability. In conclusion, MSC-based therapies show promising potential as a personalized approach to MS management.