Among the numerous human ailments for which effective treatments are lacking, few are as devastating as progressive neurodegenerative disorders. The hallmark of these disorders is the insidious erosion of cognition and the loss of independence due to the deterioration of thinking, remembering, and reasoning faculties. The extreme personality alterations that these disorders inflict on individuals add a heavy emotional burden on family members. The severe psychological strain of caregiving for these family members is due, in large part, to the inability of modern medicine to alleviate the relentless erosion of cognition. There is an intense and urgent demand for novel therapeutics that go beyond simply alleviating symptoms. This need has intensified the focus of the clinical community on the restorative potential of regenerative medicine and the promise of repair that various stem cell therapies can provide. Among these therapies, UC-MSCs hold potential for the repair of the distorted and damaged neural circuitry affected by Alzheimer’s disease and bring hope to the millions of people suffering from this disease.
Cellular Mechanisms
Pathological understanding of Alzheimer’s disease is incomplete without an understanding of the myriads of microscopic changes that occur in the brain. The most well-known and studied of the numerous changes that are involved in cognitive impairment of Alzheimer’s disease are the neurofibrillary tangles and the plaques of amyloid-β. The aggregation of hyperphosphorylated tau protein within a neuron leads to the tangling of the protein and the collapse of the neuron’s transport system. The tangles of tau protein, along with plaques of amyloid-β that accumulate in the synapse and cause toxic disruption of intercellular communication, lead to extensive and rapid degeneration of the brain. These abnormal protein aggregates also lead to a pathological immune response, which novel UC-MSCs stem cell interventions aim to target. Microglia become abnormally activated. Instead of being able to clear debris, they begin to release inflammatory cytokines. This leads to a chronic state of neuroinflammation that will worsen the initial inflammation and create further damage to the tissues. This will further create a complicated cycle of damage. Stopping this cycle and damage in Alzheimer’s disease will be the primary focus of any stem cell therapy utilizing UC-MSCs.
Conventional Treatments
The current treatment protocols focus on pharmacologic means. The most common treatment approach is to prescribe cholinesterase inhibitors which increase the level of a presynaptic neurotransmitter that is involved in the encoding of memory. Another common prescription is a medication that controls glutamate to lessen the excessive excitability of the neurons. While these drugs may provide a temporary improvement of cognitive function, they are truly inadequate. The effects of these drugs are temporary and typically last a few months to a few years. Most importantly, these drugs do not and cannot reverse the damage of Alzheimer’s disease. They provide a temporary chemical balance and do not remove the protein plaques, nor do they regenerate the neurons. In addition, patients have adverse side effects and these include severe nausea, intermittent dizziness, insomnia, and severe fluctuations in heart rate. These limitations of the drugs indicate a true need for stem cell therapies that include UC-MSCs that will modify and alter the progression of the disease instead of only providing a temporary improvement.
The Justification for Different Therapies
The philosophy of regenerative medicine is completely different from conventional therapies. The implementation of a stem cell approach in this instance will provide direct repair of damaged tissues in the central nervous system associated with Alzheimer’s disease. UC-MSCs have a unique and excellent biological basis for neuromodulation and repair. Unlike conventional pharmacological therapies, these cells will migrate to the region of damaged and inflamed tissues. When the UC-MSCs reach the damaged tissue of the brain, they will produce and secrete neurotrophic factors. Brain-derived neurotrophic factor and similar molecules preserve existing neurons and foster the generation of new synapses. Further, this type of stem cell, specifically UC-MSCs, has significant immunomodulatory effects. They reduce the effects of hyperactive microglia and promote an anti-inflammatory environment. This promotes the clearing of amyloid-β plaques. Further, these cells even have the potential to differentiate into neuron-like cells to fill the gaps of dead tissue. By addressing multiple pathways of Alzheimer’s disease simultaneously, these therapies provide greater latitude of defense beyond that which traditional medications have offered.
Figure 1: comparative of conventional and regenerative medicine in Alzheimer’s disease treatment
Future Trends in Thailand
Regenerative medicine is developing quickly across Southeast Asia, and Thailand has become the leading country for new medical procedures. The need for solutions to dementia and other associated disorders like Alzheimer’s disease have been increased by Thailand’s quickly aging population. As a result, greater investments are being made in new medical technologies by local health services. Thailand has some of the best hospitals in the world. Their laboratories have some of the latest technology available. Their legal framework plays a role by allowing new clinical trials to be done safely with UC-MSCs. There are many collaborations between local researchers and international biotech firms which are focused on the same goal. Their medical tourism is a good infrastructure for attracting patients who need new therapies that are not available in their home countries. Their new complex stem cell therapies are the best in the world, and Thailand is positioned to be the best in treating neurological disorders for the next ten years.