New Ways to Treat Multiple Sclerosis
By THOMAS GRYTA and JON KAMP
Multiple sclerosis seems to damage the central nervous system at a pace faster than the body's own repair mechanism can keep up. In an attempt to find new approaches to treat the disease, scientists are exploring techniques to give the repair process a boost.
An important area of research focuses on ways to help the body regenerate a fatty substance called myelin, which is damaged by attacks brought on by MS patients' own immune system. Myelin protects nerve fibers, or axons, much like insulation on electrical wire. Currently, the principal treatment for MS is with medications that aim to slow the disease's progression, but don't help repair the damage.
Multiple sclerosis is a chronic, inflammatory condition that can be disabling in advanced stages. The disease affects an estimated 400,000 people in the U.S. While typically not fatal, it can cause an array of debilitating symptoms, including fatigue, vision problems and even paralysis.
Scientists are tantalized by signs the body can create new myelin. Bruce Trapp, head of the neurosciences department at the Cleveland Clinic's Lerner Research Institute, has studied myelin for decades by dissecting brains of deceased MS patients. "We know the MS brain can repair its lesions," or areas of damage, says Dr. Trapp, who founded a small start-up company Renovo Neural Inc., that is trying to grow and activate cells that create myelin.
Myelin-rebuilding research is in the early stages and there is a long road ahead to prove it could work safely in people?it hasn't progressed beyond rodents. Researchers believe it will be important to replace myelin soon after it's damaged, and before harm to nerve fibers has advanced too far.
Research on other MS treatment strategies could yield results first. MS often requires lifelong treatment, and MS drugs brought in more than $8.7 billion in 2009 revenue worldwide, according to Bernstein Research.
Biogen Idec Inc., a Cambridge, Mass., biotechnology company has a big business in MS drugs and is now targeting myelin repair. Biogen biologist Sha Mi discovered a molecule dubbed "Lingo-1" that Biogen believes stops myelin production in adults after axons are well covered. After years of work Biogen researchers found an antibody in 2007 that they believe can safely turn off Lingo-1, and allow myelin regeneration. Biogen plans to launch its first study on humans soon.
Some researchers, though, are wary of any steps that shut off potentially important processes. Likewise, artificially boosting myelin production could trigger unexpected side effects.
While people with MS produce new myelin, the rebuilding effort often doesn't keep pace with the damage, and the efficiency of that process decreases with age even in healthy adults.
In patients with the disease, debris created when myelin falls off can bog down the system, and in the progressive-disease stage many patients enter into a feedback loop of chronic inflammation.
Peter Calabresi, director of the Johns Hopkins Multiple Sclerosis Center in Baltimore, is screening already approved medicines, as well as unsuccessful drugs shelved by developers, to see if they can help the cells that grow myelin?oligodendrocyte progenitor cells?develop more efficiently. Finding that an already approved drug, such as an antidepressant, works would be helpful because the side effects are already understood.
Anna Williams, a neurologist at the University of Edinburgh Multiple Sclerosis Centre in Scotland, has focused on trying to direct oligodendrocytes to damaged areas. She and other researchers are also working to trigger those cells to make myelin, which is another important step.
Another approach to fighting MS in the research stage: stem cells transplant. Steven Goldman, head of the cell and gene therapy division at the University of Rochester Medical Center, used this technique to successfully remyelinate the entire nervous system of mice born with no myelin. Such mice usually live four or five months, but some of the mice he treated recovered all neurological function and achieved normal life expectancy.
While promising, this approach presents limitations for MS patients who would likely need repeated transplants. The treatment makes more sense initially for children born without myelin due to a rare genetic disorder, Dr. Goldman says.
"Stem-cell transplant in MS has been historically attractive, but has been overtaken by our understanding of how remyelination works and the potential of the brain's own stem cells," says Robin Franklin, who heads a neural stem cell program at the University of Cambridge in England.
According to Howard Weiner, who directs the Partners Multiple Sclerosis Center at Boston's Brigham and Women's Hospital, there are more leads right now aimed at shutting down the early part of the disease than on repairing damage.
"My own personal view is that I think we're better attacking the pathologic processes that are causing it as opposed to rebuilding after it's happened," Dr. Weiner says.
Write to Thomas Gryta at thomas.gryta@dowjones.com and Jon Kamp at jon.kamp@dowjones.com
http://online.wsj.com/article/SB10001424052748704363504575003442473185972.html?mod=WSJ_hpp_MIDDLENexttoWhatsNewsThird#articleTabs=article
I found this comment at the bottom of a Wall Street Journal article that may help folks with MS. I posted one of the comments here and the link to several more comments made by people with MS.
SAMMY JO WILKINSON commented:
This article misses a huge new treatment garnering much attention in the MS community - CCSVI, or Chronic Cerebrospinal Venous Insufficiency. MS may have a cause, which is immediately treatable. I just completed a stent procedure at Stanford Medical Center with Dr. Dake, this is to correct the jugular stenosis that was causing blood reflux to my brain. The National MS Society is offering to fund research on CCSVI in MS. Stanford and other universities around the world are reading their grant applications. I have detailed my case with MRI venography images at http://healingpowernow.com
http://online.wsj.com/article/SB10001424052748704363504575003442473185972.html?mod=WSJ_hpp_MIDDLENexttoWhatsNewsThird#articleTabs=comments
By THOMAS GRYTA and JON KAMP
Multiple sclerosis seems to damage the central nervous system at a pace faster than the body's own repair mechanism can keep up. In an attempt to find new approaches to treat the disease, scientists are exploring techniques to give the repair process a boost.
An important area of research focuses on ways to help the body regenerate a fatty substance called myelin, which is damaged by attacks brought on by MS patients' own immune system. Myelin protects nerve fibers, or axons, much like insulation on electrical wire. Currently, the principal treatment for MS is with medications that aim to slow the disease's progression, but don't help repair the damage.
Multiple sclerosis is a chronic, inflammatory condition that can be disabling in advanced stages. The disease affects an estimated 400,000 people in the U.S. While typically not fatal, it can cause an array of debilitating symptoms, including fatigue, vision problems and even paralysis.
Scientists are tantalized by signs the body can create new myelin. Bruce Trapp, head of the neurosciences department at the Cleveland Clinic's Lerner Research Institute, has studied myelin for decades by dissecting brains of deceased MS patients. "We know the MS brain can repair its lesions," or areas of damage, says Dr. Trapp, who founded a small start-up company Renovo Neural Inc., that is trying to grow and activate cells that create myelin.
Myelin-rebuilding research is in the early stages and there is a long road ahead to prove it could work safely in people?it hasn't progressed beyond rodents. Researchers believe it will be important to replace myelin soon after it's damaged, and before harm to nerve fibers has advanced too far.
Research on other MS treatment strategies could yield results first. MS often requires lifelong treatment, and MS drugs brought in more than $8.7 billion in 2009 revenue worldwide, according to Bernstein Research.
Biogen Idec Inc., a Cambridge, Mass., biotechnology company has a big business in MS drugs and is now targeting myelin repair. Biogen biologist Sha Mi discovered a molecule dubbed "Lingo-1" that Biogen believes stops myelin production in adults after axons are well covered. After years of work Biogen researchers found an antibody in 2007 that they believe can safely turn off Lingo-1, and allow myelin regeneration. Biogen plans to launch its first study on humans soon.
Some researchers, though, are wary of any steps that shut off potentially important processes. Likewise, artificially boosting myelin production could trigger unexpected side effects.
While people with MS produce new myelin, the rebuilding effort often doesn't keep pace with the damage, and the efficiency of that process decreases with age even in healthy adults.
In patients with the disease, debris created when myelin falls off can bog down the system, and in the progressive-disease stage many patients enter into a feedback loop of chronic inflammation.
Peter Calabresi, director of the Johns Hopkins Multiple Sclerosis Center in Baltimore, is screening already approved medicines, as well as unsuccessful drugs shelved by developers, to see if they can help the cells that grow myelin?oligodendrocyte progenitor cells?develop more efficiently. Finding that an already approved drug, such as an antidepressant, works would be helpful because the side effects are already understood.
Anna Williams, a neurologist at the University of Edinburgh Multiple Sclerosis Centre in Scotland, has focused on trying to direct oligodendrocytes to damaged areas. She and other researchers are also working to trigger those cells to make myelin, which is another important step.
Another approach to fighting MS in the research stage: stem cells transplant. Steven Goldman, head of the cell and gene therapy division at the University of Rochester Medical Center, used this technique to successfully remyelinate the entire nervous system of mice born with no myelin. Such mice usually live four or five months, but some of the mice he treated recovered all neurological function and achieved normal life expectancy.
While promising, this approach presents limitations for MS patients who would likely need repeated transplants. The treatment makes more sense initially for children born without myelin due to a rare genetic disorder, Dr. Goldman says.
"Stem-cell transplant in MS has been historically attractive, but has been overtaken by our understanding of how remyelination works and the potential of the brain's own stem cells," says Robin Franklin, who heads a neural stem cell program at the University of Cambridge in England.
According to Howard Weiner, who directs the Partners Multiple Sclerosis Center at Boston's Brigham and Women's Hospital, there are more leads right now aimed at shutting down the early part of the disease than on repairing damage.
"My own personal view is that I think we're better attacking the pathologic processes that are causing it as opposed to rebuilding after it's happened," Dr. Weiner says.
Write to Thomas Gryta at thomas.gryta@dowjones.com and Jon Kamp at jon.kamp@dowjones.com
http://online.wsj.com/article/SB10001424052748704363504575003442473185972.html?mod=WSJ_hpp_MIDDLENexttoWhatsNewsThird#articleTabs=article
I found this comment at the bottom of a Wall Street Journal article that may help folks with MS. I posted one of the comments here and the link to several more comments made by people with MS.
SAMMY JO WILKINSON commented:
This article misses a huge new treatment garnering much attention in the MS community - CCSVI, or Chronic Cerebrospinal Venous Insufficiency. MS may have a cause, which is immediately treatable. I just completed a stent procedure at Stanford Medical Center with Dr. Dake, this is to correct the jugular stenosis that was causing blood reflux to my brain. The National MS Society is offering to fund research on CCSVI in MS. Stanford and other universities around the world are reading their grant applications. I have detailed my case with MRI venography images at http://healingpowernow.com
http://online.wsj.com/article/SB10001424052748704363504575003442473185972.html?mod=WSJ_hpp_MIDDLENexttoWhatsNewsThird#articleTabs=comments