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Introduction
Mesenchymal stem cells (MSCs) as multipotent stem cells can be derived from various sources including bone marrow, amniotic fluid, dental caries, adipose tissue, umbilical cord, synovial membranes, and peripheral blood (Dargahi et al. 2017). Adipose mesenchymal stem cells or adipose-derived stem cells (ADSCs) are a type of MSCs that are an appropriate candidate for cell therapy in some disorders such as Multiple sclerosis (MS) (Kimiskidis and Fassas 2013; Constantin et al. 2009). ADSCs can migrate to the inflammatory site across the blood–brain barrier (BBB) to release anti-inflammatory cytokines that are involved in remyelination. They also stimulate the proliferation and survival of nerve cells (Ghasemi 2015). One of the limitations of stem cells transplantation is graft-versus-host disease (GVHD) via stimulation of immune cells but ADSCs express a relatively low level of MHC-I and MHC-II and they don’t express co-stimulatory molecules such as CD40, CD40L, CD80, and CD86 and induce anergy in T lymphocytes (Winkelmann et al. 2014; Machado et al. 2013). As mentioned the advantages of ADSCs make them an appropriate candidate for the treatment of various diseases such as autoimmune disease (Maria et al. 2017). Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system. Activation of T lymphocyte against auto-antigens such as myelin sheath antigens leads to malignant neuronal damage and myelin deficiency. Also, the infiltration of lymphocytes and macrophages, as well as the death of oligodendrocytes are the main causes of myelin destruction in MS (McLaughlin and Wucherpfennig 2008; Patel and Balabanov 2012). Common therapies for MS such as interferon beta, glutylamer acetate, fingolimod, triplonomide, dimethyl fumarate, mitoxantrone, and natalizumab usually act as anti-inflammatory and immunosuppressive drugs and do not promote remyelination. Thus, these drugs are not capable of ameliorating the neuronal damages in MS patients (Tavazzi et al. 2014). Besides, a long period of administration and complications during the treatment are some of the problems in the application of these drugs.
Current therapy for MS often targets inflammation and cannot directly stop the degeneration of nerve tissue. So using stem cells with the ability of regulation neural immunity and neuroprotection can be a promising treatment for MS (Regmi et al. 2019). Including stem cells with these properties are ADSCs that can be genetically engineered to enhance their anti-inflammatory...