Warum 20 Million vs 40 Millionen Stammzellen können beide leistungsstark sein – und wenn jede bei ALS Sinn macht
Einführung
When a person or a family faces a diagnosis such as ALS (Amyotrophe Lateralsklerose), one of the first questions they ask is:
“What can be done to slow this down?”
Over the last two decades, mesenchymale Stammzellen (MSCs) have emerged as one of the most promising biological tools to modulieren Entzündungen, protect neurons, and slow degeneration.
One of the most common questions patients ask is:
“Is 40 million stem cells better than 20 Million? Is twice the dose twice as effective?”
The answer is surprisingly nuanced — and understanding it can save patients both money and false expectations.
What are mesenchymal stem cells (MSCs)?
Mesenchymal stem cells are special repair cells that live mainly in:
- Knochenmark
- Fettgewebe
- Bindegewebe
They have four remarkable abilities:
- They calm inflammation
- They protect neurons
- They release growth and healing signals
- They regulate the immune system
They do not replace neurons — instead, Sie change the biological environment in which neurons live.
This is extremely important in ALS, because ALS is not just neuron death — it is a disease of:
- chronische Entzündung
- immune mis-regulation
- toxic microenvironment
- oxidativer Stress
- blood-brain barrier dysfunction
MSCs target all of these.
How many MSCs are normally in your blood?
In a healthy adult:
- There are thousands to tens of thousands of MSCs in the entire bloodstream at any moment
- In many people, there are almost none
These cells live mostly in tissues — not in blood.
So biologically speaking:
The natural concentration of MSCs in the blood is extremely low.
What happens when we inject 20–40 million MSCs?
When MSCs are given intravenously, we create a temporary flood of healing cells.
| Normal level | 1,000 – 50,000 MSCs |
|---|---|
| Therapeutic infusion | 20,000,000 – 40,000,000 MSCs |
This means:
- 20 million = thousands to tens of thousands times more
- 40 million = even higher
But here is the key truth:
Biology does not respond linearly.
More does not always mean proportionally better.
The Plateau Effect — Why More Cells Do Not Equal More Healing
In der Medizin, this is called a dose-response curve.
Let us visualize it:
Biological
Effect
|
100| _________
90| _/
80| _/
70| _/
60| _/
50| _/
40| _/
30| _/
20|_/
+-----------------------------
5 10 20 40 80
MSC Dose (Millions)
This curve shows something critical:
- Aus 5 → 10 million = huge jump in effect
- Aus 10 → 20 million = big jump
- Aus 20 → 40 million = smaller jump
- Aus 40 → 80 million = tiny jump
This is called the therapeutic plateau.
Once you pass a certain threshold, the body’s biological systems are already fully activated.
What MSCs actually do in ALS
MSCs do not “fix” neurons — they protect the ones that remain.
They do this by:
- Reducing toxic inflammation around motor neurons
- Suppressing autoimmune attack
- Increasing blood supply and oxygenation
- Releasing neurotrophic factors (BDNF, NGF, VEGF)
- Stabilizing the blood-brain barrier
- Protecting mitochondria inside neurons
Once these systems are turned on, doubling the cell dose does not double the effect.
So what is the real difference between 20M and 40M?
Clinically and biologically:
| Dose | What it does |
|---|---|
| 20 Million | Reaches the therapeutic threshold for immune modulation, Neuroprotektion, and inflammation control |
| 40 Million | Extends and strengthens the same effects, giving more durability and more coverage |
In simple terms:
20 million turns the system ON
40 million keeps it ON longer and stronger
Warum 20 million is often ideal in early or slow ALS
In early-stage or slow-progressing ALS:
- Neurons are still present
- Inflammation is moderate
- Immune dysregulation is not extreme
Also 20 million MSCs:
- already create a massive biological shift
- already activate all healing pathways
- already slow the disease environment
Using 40 million here gives only modest extra benefit for much higher cost.
This is why many experienced clinicians prefer:
20 million for early or slow disease
It is efficient, powerful, and cost-effective.
Warum 40 million makes sense in late or aggressive ALS
In advanced or fast-progressing ALS:
- Inflammation is severe
- Immune activation is high
- Neurons are under heavy stress
- Tissue damage is widespread
Hier, the system is harder to control.
Also 40 million MSCs:
- create a larger biological buffer
- provide longer-lasting immunomodulation
- deliver more neuroprotective signals
This is not because 20 million “doesn’t work” — it’s because the battlefield is bigger.
Think of it like fire suppression
If a small fire starts in a room:
- One fire extinguisher is enough
If a large fire is burning:
- You need many more
The mechanism is the same — only the scale changes.
Safety and compatibility
Because these are autologous MSCs (from the patient):
- No rejection
- No immune attack
- No genetic mismatch
- No tumor risk when properly prepared
This allows higher doses to be used safely when needed.
Abschluss
20 million MSCs:
- Already exceed natural levels by thousands of times
- Already activate all key healing pathways
- Already provide most of the biological benefit
40 million MSCs:
- Extend and strengthen the same mechanisms
- Are most useful in aggressive, advanced disease
This is not about “more is better” — it is about using the right biological dose for the right stage of disease.
That is what truly personalized regenerative medicine means.
