MS treatment a step closer after drug shown to repair nerve coating

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According to the National Multiple Sclerosis Society, nearly one million people in the United States are living with MS. This is more than twice their original estimate from a previous study [1].

Currently, there are some treatments that can help speed up the recovery process after an MS attack, modify the course of the disease, and manage symptoms. Unfortunately, there is no cure [2].

Recent research may provide some hope for people suffering from the debilitating disease. Doctors think they may be closer than ever before to an MS treatment, after discovering a drug that repairs the coatings around nerves that have been damaged by MS.

What is Multiple Sclerosis?

Multiple sclerosis (MS) is a disease that affects your central nervous system. When someone has the disease, their immune system attacks the protective sheath that covers nerve fibers, called the myelin. This causes communication problems between your brain and the rest of your body.

As MS progresses, it can cause permanent damage to the nerves. This can cause numbness or weakness in one or more limbs, electric-shock sensations in the neck, and tremors or an unsteady gait. In more severe cases, individuals with MS may lose their ability to walk.

People with MS may also experience full or partial loss of vision, difficulty speaking, dizziness, tingling or pain in certain parts of the body, and problems with sexual, bowel, or bladder problems.

Most people with MS will experience periods of new symptoms (relapses), followed by periods of remission. These times of remission can last months or even years. At least fifty percent of those who have remission periods eventually develop a steady progression of symptoms. This usually takes place within ten to twenty years after the disease starts.

Doctors still don’t know why MS develops in some people. They do believe, however, that it is likely a combination of genetic and environmental factors [2].

Getting Closer to an MS Treatment

Recently, in a clinical trial for the cancer drug bexarotene, researchers showed that it repaired the myelin destroyed by MS. Doctors will not be able to use bexarotene itself as a treatment because it’s side-effects are too serious, but this trial proved that “remyelination” is possible.

Professor Alasdair Coles led the research team at the University of Cambridge. He is disappointed that they will not be able to use bexarotene, but is hopeful that another drug or drug combination will have the same effect.

The researchers assessed bexarotene in a phase 2a trial. They monitored patients with relapsing MS, using brain scans to observe any changes to their damaged neurons. The drug did repair the damaged myelin, however it also produced some serious side effects.

These side effects included thyroid disease and raised fat levels in the blood. For this reason, bexarotene will not go to phase three trials.

“It’s disappointing that this is not the drug we’ll use, but it’s exciting that repair is achievable and it gives us great hope for another trial we hope to start this year,” said Coles [3].

Hopeful for Future Trials

Armed with the knowledge that it is possible to stimulate the nervous system to resheath damaged neurons, scientists are very hopeful about another trial they will be conducting later this year.

This new trial will be a continuation of work that professor Robin Franklin at the Welcome-MRC Cambridge Stem Cell Institute did last year. His research proved that when you combine the diabetes drug metformin with an antihistamine called clemastine, you can drive remyelination in animals.

Franklin’s research showed that metformin could rejuvenate stem cells in the central nervous system. The cells can then go on to become myelin-producing cells called oligodendrocytes. He has not yet tried to reproduce his results in humans.

“It’s always a leap in the dark when you go from lab experiments to humans, but the data is as strong and as compelling as it is ever likely to get,” Franklin said. “I am very optimistic that this is going to work.” [4]. 

The researchers hope that the combination of metformin and clemastine will, at the very least, slow down the progression of MS. They believe that there is a chance it could even prevent further damage to neurons.

Doctor Emma Gray at the MS Society said that finding treatments to stop the progression of MS is their top priority. To do this, they need to protect nerves from damage, and repair what was lost.

“This new research is a major milestone in our plan to stop MS and we’re incredibly excited about the potential it’s shown for future studies.” [3]

Read: Meet the Women Who Tackled Her MS with Food and Lifestyle Choices

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