Q: My brother is suffering from motor neurone disease (MND). Kindly advise if stem cell therapy is useful for this?

A:Motor neurone disease (MND) is a group of progressive neurological disorders that destroy motor neurones, the cells that control voluntary muscle activity including breathing, speaking, walking, swallowing and general body movement. About 90% of cases of MND are sporadic, meaning that the patient has no family history of this or similar disease in the family, approximately 10% of cases are familial MND, defined either by a family history of MND or by testing positive for a known genetic mutation associated with the disease. Currently there is no cure for MND. The only drug that affects the course of the disease is riluzole. The drug functions by blocking the effects of the neurotransmitter glutamate, and is thought to extend the lifespan of an MND patient by only a few months. Treatment of patients with MND focuses on the relief of symptoms associated with the disease and thus, is mainly supportive in nature. This involves a variety of health professionals including neurologists, speech-language pathologists, physical therapists, occupational therapists, dieticians, respiratory therapists, social workers, palliative care specialists, specialist nurses and psychologists. While bone marrow transplantation is an approved indication for stem cell therapy, all the others including its use in MND, are still in an experimental mode. Their use in Parkinson’s disease, heart disease, endocrine disorders, etc. has been reported by various centres in the world but this is still not being done routinely or being offered as a therapeutic modality. On research basis, cellular and molecular studies, some of which involve stem cells, seek to understand the mechanisms that trigger selective motor neurons to degenerate. This work includes studies in animals to identify the means by which mutations lead to the destruction of neurons. Therapeutic use of stem cells in MND is purely incidental as of now and the claims of cure with this therapy are disputed. There is currently no specific therapeutic protocol for stem cell therapy in MND. However, on research basis many places including Prof. C Shaw, Kings College Hospital, London and some others in Japan, China, etc. are conducting trials. Hope this is helpful.