Patient’s Own Stem Cells Treat Rare Neurological Disorder


Stiff-Person syndrome is a rare neurological disease that, for all intents and purposes, looks like an autoimmune disease. It is characterized by muscular rigidity that tends to come and go. This rigidity occurs in the muscles of the trunks and limbs. Patients with Stiff-Person syndrome also have an enhanced sensitivity to stimuli such as noise, touch, and emotional distress, and various stimuli may cause the patient to experience painful muscle spasms that cause abnormal postures and stiffening. Stiff-Person syndrome or SPS is more common in women than in men and SPS patients often suffer from other autoimmune conditions in addition to SPS (for example, pernicious anemia, diabetes, vitiligo, and thyroiditis). Unfortunately, the precise cause of SPS is not known, but again, it looks like an autoimmune condition.

A research team at Ottawa Hospital Research Institute has made a breakthrough in the successful treatment of SPS using bone marrow stem cell transplants. The medical director at the Ottawa Hospital Research Institute, Dr. Harold L. Atkins, who is also a physician in the Blood and Bone Marrow Transplant Program at The Ottawa Hospital and an associate professor at the University of Ottawa has used bone marrow transplants to two female SPS patients into remission.

SPS can leave patients bedridden and in severe pain, but thanks to Atkins and his team, the progression of the disease in these women has ceased, allowing both women to regain their previous function and leaving them well enough to return to work and normal everyday activities.

Adkins and his group published this case study in JAMA Neurology, which is produced by the Journal of the American Medical Association. This is the first documented report that taking stem cells from a person’s own body can produce long-lasting remission of stiff person syndrome.

“We approach these cases very carefully and are always aware that there have just been a few patients treated and followed for a short time,” says Dr. Atkins. Atkins and his extracted bone marrow stem cells from each woman, and then used chemotherapy to eliminate their immune systems. Once their immune system were reliably eliminated, both women had their own stem cells returned to their bodies in order to reconstitute their immune systems. This procedure essentially gives the immune system a “do-over.”.

“By changing the immune system, one hopes to put the stiff person syndrome into remission,” adds Dr. Atkins. “Seeing these two patients return to their normal lives is really every physicians dream.”

This very procedure, which is known as an “autologous stem cell transfer” or ASCT has been used to successfully treat people who suffer from autoimmune diseases such as multiple sclerosis, scleroderma, and systemic lupus erythematosis. Atkins and his team used high-doses of chemotherapy and antibodies that specifically bind lymphocytes to rid the women’s bodies of their rogue immune cells before their immune systems were regenerated using their own stem cells. Adkins an his colleagues viewed this as a viable treatment option based strategies that had been used to treat other autoimmune diseases.

Patient 1 was diagnosed with stiff person syndrome in 2005 at age 48 after experiencing leg stiffness and several falls. After her treatment, her symptoms disappeared and she was fully mobile again six months after receiving the stem cell transplant procedure in 2009.

Patient 2 was diagnosed with stiff person syndrome in 2008 at age 30. She had stopped working and driving, and had moved back in with her parents before her stem cell transplant in 2011. Also, she has been able to return to her work and previous activities, and has not had any stiff person syndrome symptoms in more than a year.

“The results achieved by Dr. Atkins and his team through this innovative treatment show how research at The Ottawa Hospital can lead to life-changing and, even life-saving care,” says Dr. Duncan Stewart, Chief Executive Officer and Scientific Director of the Ottawa Hospital Research Institute. “Translating research into better care for patients is what we’re all about at the research institute.”

Turning Muscle Stem Cells into Brown Fat


Michael Rudnicki’s laboratory at the Ottawa Hospital Research Institute has managed to convert stem cells from skeletal muscle into brown fat. Because brown fat burns calories, studies have shown that trimmer people tend to have more brown fat, Therefore, Rudnicki’s findings are being viewed as a potential treatment for obesity.

According to Rudnicki, “This discovery significantly advances our ability to harness this good fat in the battle against bad fat and all the associated health risks that come with being overweight and obese. Rudnicki is a senior scientist and director for the Regenerative Medicine Program and Sprott Center for Stem Cell Research at the Ottawa Hospital Research Institute.

Obesity is the fifth leading risk death, globally speaking, and an estimated 2.8 million people dying every year from the effects of being overweight or obese, according to the World Health Organization. The Public Health Agency of Canada estimates that 25% of Canadian adults are obese.

in 2007, Rudnicki and his research team demonstrated the existence of a stem cell population in skeletal muscle. In this new publication, Rudnicki and others show that these adult muscle stem cells not only have the ability to produce muscle fibers, but can also make brown fat.

An even more important aspect of this paper (Yin, et al., Cell Metabolism 17(2) 2013: 210), is that it shows how adult muscle stem cells become brown fat. The main switch is a regulatory molecule called microRNA-133 or miR-133. When miR-133 is present, the muscle stem cells produce muscle fibers, but when the intracellular concentration of miR-133 is reduced, the muscle stem cells form brown fat.

Graphic Abstract

Rudnicki’s research staff developed a molecule that could reduce the concentration of miR-133 in cells. This molecule an antisense oligonucleotide or ASO that is complementary to miR-133. When injected into mice, the ASO caused the mice to produce more brown fat and prevented obesity. Additionally, when injected into the hind leg muscle, the metabolism of the mouse increased, and this effect lasted for four months after the ASO injection.

Even though antisense oligonucleotides are being used in clinical trials, such trials with miR-133 ASOs are still years away.

Rudnicki noted that “we are very excited by this breakthrough.” He continued: “While we acknowledge that it’s a first step there are still many questions to be answered, such as: Will it help adults who are already obese to lose weight? How should it be administered? How long do the effects last? Are there any adverse effects we have not yet observed?”

Surely these questions will be addressed in good time, and Rudnicki’s lab is probably working on them as you read this entry.