New Multiple Sclerosis Treatment Promises Unique Benefit
It appears that a new multiple sclerosis treatment has a unique benefit not offered by other approved treatments for the disease. Results of a phase I trial suggest the novel therapy does not have a negative impact on a patient’s immune system, which is a problem with current treatments.
What does the new MS treatment do?
Multiple sclerosis is an autoimmune disease, which means the body’s immune system destroys healthy cells and tissues, which makes individuals highly vulnerable to infections and cancer. In the case of MS, the body attacks the substance called myelin that protects nerve cells.
Currently available treatments for MS suppress the immune system, which can be especially serious for MS patients given they are already in a compromised situation. In addition, some of the drugs also expose patients to other potentially serious and debilitating side effects, including but not limited to liver damage, neuropathy, seizures, birth defects (both men and women), diarrhea, hair loss, severe allergic reactions, and suicide attempts.
In the phase I trial, the new MS treatment did not appear to have a negative impact on the immune system and the ability of patients to fight off infection. In fact, the drug reduced the immune system’s reactivity to myelin by 50 to 75 percent.
The study’s co-senior author Stephen Miller, the Judy Guggenheim Research Professor of Microbiology-Immunology at Northwestern University Feinberg School of Medicine, stated that the new treatment “stops autoimmune responses that are already activated and prevents the activation of new autoimmune cells.”
The new treatment actually uses a patient’s own blood to make the drug. Here’s how the new treatment works.
Researchers first collect blood from patients and filter out the white blood cells. These cells are processed and mixed with myelin antigens, which are components of the myelin protein to which the immune system responds.
Patients than are injected with the newly processed white blood cells, which make their way to the spleen, the organ responsible for cleaning up old and dying blood cells. The immune system recognizes the myelin antigen as “friendly,” thus stopping the destruction process.
According to the researchers, the patients who were given the highest dose (up to 3 billion cells) of processed white blood cells responded best. Thus far, in the nine patients treated in this manner, no adverse effects were noted.
Here is another bonus from the trial: the treatment did not reactivate the patients’ disease, nor did it have a negative impact on the ability of the immune system to fight real pathogens. In other words, “Our approach leaves the function of the normal immune system intact,” noted Miller.
What about cost?
Since this treatment is not an off-the-shelf type of therapy (because it requires the use of each patient’s own white blood cells to make the treatment), it is both expensive and labor-intensive. Miller and his colleagues are working to determine whether the use of nanoparticles may provide a less costly and more effective way to deliver the myelin antigens.
For now, patients with multiple sclerosis are left to choose from among the available immune-suppressing drugs (e.g., dimethyl fumarate, fingolimod, glatiramer,interferon beta-1a and 1b, mitoxantrone, teriflunomide) and a variety of alternative options, such as nutritional supplements, dietary measures, and even marijuana. In the meantime, research into this new multiple sclerosis treatment continues.
Lutterotti A et al. Antigen-specific tolerance by autologous myelin peptide-coupled cells: a phase I trial in multiple sclerosis. Science Translational Medicine 2013 Jun 5; 5(188): 188ra75
National MS Society