Happy New Year! For most of 2011 I have focused solely on my own journey to obtain Gilenya and continue using it. I threw away the needles and felt great about it. And what’s been going on in the meantime? Montel got CCSVI! A new stem cell trial without chemotherapy is almost underway! New medications (*ahem* BG-12) are winding their way through the pipeline! And also in that time, much has been discovered. Multiple Sclerosis Research has recently revealed more about the nature of the Multiple Sclerosis, a disease that needs ever more illumination.
These are the discoveries I find most exciting of all right now.
Fatty Acids And Relapses?
A link between diet and MS is nothing new. I think we’ve all heard about the Swank Diet (a great name, in my opinion – he even wrote a book). Once upon a time a doctor noticed that MS patients who never ate red meat or dairy or anything delicious had significantly less relapses than those of us who love cheese and filet mignon (both of which I had last night). He developed a diet that essentially involves no red meat for a year then very limited servings of it after that. Unfortunately, we have absolutely no scientific proof to back this diet up….
UC San Diego Skaggs School Of Pharmacy And Pharmaceutical Sciences (specifically, Marianne Manchester and Leah P. Shriver) have discovered something fascinating. By studying how our quasi-evil immune cells in the central nervous system oxidize fatty acids when they have no glucose for fuel in inflamed tissue (mouse tissue….) inhibiting a specific enzyme that aids immune cells in exploiting fatty acids caused the cells to starve and die.
In other words, no glucose + preventing immune cells that like to kill our brains from using fatty acid = preventing relapses.
Furthermore, a treatment involving only targeting an enzyme means that, if the model also works on humans, then there is very very little risk compared to the medications now available to us.
Another bonus: the enzyme-inhibitor used in this study is already used by humans with congestive heart failure. Even with its looming challenges, this seems incredibly promising.
Breaking Through The Blood-Brain Barrier
One challenge with virtually every MS treatment is, how do you safely and effectively deliver therapy through the blood-brain barrier? Cornell University has been working on this issue and have discovered that adenosine, which occurs naturally in the body, can control the passage of large molecules to the brain. They believe that an existing drug, Lexiscan, which is currently used in heart imaging, can trigger receptors and open the barrier for treatment delivery. Or at least that worked in mice. Here’s hoping it can work in us, too!
Remyelinating With Stem Cells
Paul Tesar of Case Western Reserve University School Of Medicine has actually found a way (in mice! again!) to myelinate cells rapidly using stem cells. They used pluripotent epiblast stem cells, which sound like they should be neon. Past attempts have failed, but this team used signaling proteins, growth factors, and thyroid hormone which caused restoral of normal myelin in only a few days!
Neurosteroid Rage! Or Not…
It seems like every day brings more hope, even for a realist / pessimist like me. The University Of Alberta Edmonton (it is notable that Alberta, Canada has the highest concentration of MS in the world) have made a discovery that adds yet another piece to the why-do-we-have-MS puzzle. Those of us with multiple sclerosis have remarkably less neruosteroids than everyone else.
So, apparently, there are things called neurosteroids and apparently these neurosteroids make brain cells work correctly. Our brain cells obviously do not, and neither did the brain cells of the mice used in the study. Researchers have discovered that people with MS have significantly lower levels of these brain chemicals, specifically allopregnanolone, that help build brain cells and maintain their function, connecting different areas of activity in the brain. Trials for it via pill form are already underway for other neurological diseases – it looks especially promising for MS.
Mice in this study were treated with allopregnanolone (normally derived from cholesterol and vitamin D) and the result was reduced inflammation, repaired nerve fibers, a 50% reduction of MS-like severity, and increased mobility in just 30 days.
Progressive Treatment For Progressive MS
Even if you don’t have primary-progressive MS, if you have MS you may develop secondary-progressive MS. This is an issue I am certainly concerned with as there is no serious treatment for progressive MS at this time. It is always good news when a possibility for treatment is found. It is VERY good news when one is this far along.
Masitinib, an oral drug hoped to treat primary-progressive MS and relapse-free secondary-progressive MS has entered trial phase three. Masitinib is a tyrosine Kinase inhibitor targeting mast cells and other kinases. This study will compare a 6 mg/kg daily dose against placebo in 450 individuals spread across 60 centers worldwide. Spearheaded by Professor Patrick Vermersch of CHRU Lille – Hospital Roger in Salengro, France. He explains the study:
Masitinib is a selective inhibitor of specific kinases that play a major role in the activation of mast cells, which are cells involved in the immune response, in the recruitment of lymphocytes to the brain, and also in inflammatory processes associated with multiple sclerosis and many of its resulting symptoms. Masitinib therefore represents an oral treatment different from those drugs already on the market for this indication, with a unique mechanism of action in blocking mast cells.
In 30% of mice treated over 18 months, Masitinib delayed symptoms of MS after 3 months of treatment.
Unlike Mitoxantrone (used currently in progressive MS), cardiac toxicity is not a risk related to Masitinib. Another benefit over other MS drugs are that it does not increase the risk of opportunistic infections.
I come from a family with a history of MS, but even those who don’t must find a great deal of hope in these discoveries for our future generations. Maybe one day I will feel better, walk better, and live with less fear than I do now. Thanks to all the researchers out there who are striving to find better treatments and possible cures for us!
What do you hope to learn from MS research? Have you ever participated in a clinical trial?