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Medicine

MS Treatment a Step Closer After Drug Shown To Repair Nerve Coating (theguardian.com) 20

An anonymous reader quotes a report from The Guardian: Doctors believe they are closer to a treatment for multiple sclerosis after discovering a drug that repairs the coatings around nerves that are damaged by the disease. A clinical trial of the cancer drug bexarotene showed that it repaired the protective myelin sheaths that MS destroys. The loss of myelin causes a range of neurological problems including balance, vision and muscle disorders, and ultimately, disability.

While bexarotene cannot be used as a treatment, because the side-effects are too serious, doctors behind the trial said the results showed "remyelination" was possible in humans, suggesting other drugs or drug combinations will halt MS. "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 Prof Alasdair Coles, who led the research at the University of Cambridge. The drug had some serious side-effects, from thyroid disease to raised levels of fats in the blood, which can lead to dangerous inflammation of the pancreas. But brain scans revealed that neurons had regrown their myelin sheaths, a finding confirmed by tests that showed signals sent from the retina to the visual cortex at the back of the brain had quickened. "That can only be achieved through remyelination," said Coles.

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MS Treatment a Step Closer After Drug Shown To Repair Nerve Coating

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  • by rossdee ( 243626 ) on Friday September 25, 2020 @10:56PM (#60544800)

    is long overdue

  • by NoNonAlphaCharsHere ( 2201864 ) on Friday September 25, 2020 @11:42PM (#60544854)
    And MS hardly *EVER* gets on my nerves any more.
  • For people with other courses of the disease where they'd have to be on it continuously, those side effects would be horrible, but IIRC, most MS patients have the relapsing-remitting variety, which only periodically flares up. If you could deliver something like this quickly at the start of each flare-up to stop the damage in its tracks, even with the risk, it might still be better than the progressive neurological degradation that would otherwise occur.

    Just a thought.

    • That would depend on relative effectiveness though. They wouldn't rule it out so completely if it were possible to shut down an exacerbation with significant risk. Suggests to me either the risk is extreme, or that short term treatments wouldn't significantly affect the disease. Probably both - something like you need to be on huge doses for three months to get any appreciable benefit, and the side effects put your life at risk starting on day 1. The current medication are already in "Stab yourself dail
      • by dgatwood ( 11270 )

        But the principal adverse effect was hypothyroidism, which is treatable with regular injections of synthetic thyroid hormone, and the other effect mentioned (high blood sugar) is probably caused by the hypothyroidism. So basically, they're saying that because this drug could require someone to have to take thyroid hormone, it's better for them to slowly decay physically and mentally. I'm really scratching my head trying to understand that logic — perfect is the enemy of the good and all.

        Even if the

  • Ibogaine/GDNF (Score:5, Informative)

    by bill_mcgonigle ( 4333 ) * on Saturday September 26, 2020 @08:05AM (#60545412) Homepage Journal

    If you know somebody with MS or Parkinsons, look into ibogaine's GDNF-mediated remyelination pathways. No chance of a patent or large FDA clinical trial, so the studies are small. Still, if it were me I'd give it a try - there's still not enough known about the physiology to even create an ideal trial yet. Genotypes vs. inflammation vs. epigenetic regulation, etc. Some populations will respond better than others.

  • Not just MS ... (Score:4, Interesting)

    by thomst ( 1640045 ) on Saturday September 26, 2020 @08:27AM (#60545454) Homepage

    De-myelinization is a feature of many neuropathic disease processes, not just MS. This clue - and it's just that, since the drug in question has such toxic side effects - might eventually lead to the discovery of a pathway to re-myelinize damaged nerves. Or, y'know, not.

    The thing is, according to the National Institutes of Health, as of 2016, approximately 10% of the U.S. population currently has Type II diabetes [nih.gov], and, of that number, approximately 28% have diabetically-mediated neuropathy. [nih.gov]

    With the current population of the USA at 328 million or so, that means over 9 million Americans currently have diagnosed diabetic neuropathy (the symptoms of which can range from mild tingling in the toes and fingertips - because the longer the nerve path, the more perceptible the damage - to severe mobility impairment and a greatly increased risk of developing gangrene from wounds on the feet and ankles that the patient fails even to notice, because the nerve pathways are so badly compromised). That's almost exactly 10X as many diabetics with neuropathy as there are MS sufferers in total.

    Then there are all the other autoimmune-mediated disease processes that cause peripheral neuropathy [mayoclinic.org], among them Guillaine-Barre, ALS, motor neurone disease, and lupus, any one or all of which could be positively impacted by a working re-myelinization therapy.

    Now comes the hard part: figuring out the mechanism by which bexarotene (which is quite toxic [nih.gov]) achieves re-myelinization of the affected nerves' insulation, and determining whether there's a way to replicate the effect without so poisoning the patient that the treatment is, quite literally, worse than the disease ...

    • You've hit on exactly why I'm looking at this closely. Mast cell disease ultimately leading to CRPS - a horrible pain nerve feedback loop that does this kind of damage. I'd be helped by something like this.

      They may have ended this study because others like the linked Metformin/Clemastine are showing greater promise. I'm curious about how that one is going. It looks 'safe-ish' to try considering the well understood drugs involved.
      • by thomst ( 1640045 )

        Spamalope confided:

        You've hit on exactly why I'm looking at this closely. Mast cell disease ultimately leading to CRPS - a horrible pain nerve feedback loop that does this kind of damage. I'd be helped by something like this.

        Sorry to hear about your underlying disorder, which seems to be all kinds of awful. (And given that one of the most-orten-fatal of CoVID-19's array of life-threatening symptoms is massive cytokine storms leading to potentially-lethal anaphylactic shock, it sounds as though your condition puts you at particularly-high risk of a fatal outcome, which makes it double-plus ungood, in that regard. I'm going to assume that's not news to you, though.) The prospect of developing CPRS on top of cyt

  • by twocows ( 1216842 ) on Saturday September 26, 2020 @08:34AM (#60545472)
    My mom suffered greatly from relapsing-remitting MS (as opposed to progressive, the relatively much worse kind) before she passed a few years ago from unrelated issues. MS is nasty; your body's immune system attacks your nerve cells, which is both excruciatingly painful and, over time, debilitating. If you've ever experienced raw nerve pain (e.g. from like a dental procedure where you weren't numb enough), there's a lot of that. I remember as a young kid frequently waking up to my mom crying and screaming in agony at night. That's not something that anyone should have to suffer through or watch a loved one suffer through.

    The damage it's doing to your brain is also largely random. You can end with any number of downstream disabilities as a result of brain/nerve damage from MS. Mom said that vision and speech problems were pretty common in her support group, but she never experienced them herself; instead, she had the pleasure of dealing with reduced hand-eye coordination, tremors in her dominant hand, and incontinence. Not being able to effectively use your hands is very limiting in a lot of the stuff you're able to do in day-to-day life.

    It's not exactly a common disease thankfully, but it does affect a good number of people around the world and it's suspected to have some kind of genetic component too, so it often runs in extended families (Mom had an uncle who also had MS). Any research toward reversing its effects is of extreme value to those unfortunate enough to suffer from it and I hope something big comes out of this.
  • These patients face walking disability. Their imbalance function of brains is the reason for having difficulty in walking. They can use lightweight wheelchair [aids4mobility.co.uk] for moving one place to another without any injury. There are no bad feelings for using it. Many people are leading their life using it. You can also modify it by your choice of action.

"The whole problem with the world is that fools and fanatics are always so certain of themselves, but wiser people so full of doubts." -- Bertrand Russell

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