April 20, 2015

expert reaction to study reporting on two new drugs to treat multiple sclerosis in mice

A paper published in the journal Nature has described the use of two drugs in mouse models of multiple sclerosis, reporting the ability of the drugs to repair specific parts of damaged nerve cells and to reduce disease severity.

Prof. Daniel Altmann, Professor of Immunology, Imperial College London, said:

“Multiple sclerosis is an autoimmune disease in which immune attack against proteins of the myelin sheath around nerves leads to progressive disability, especially once disease reaches a progressive phase – here there is generally irreversible damage to the nerves themselves. There has been tremendous progress in recent years in development, clinical trials and licensing of new drugs that aim to block the immune attack and thus ameliorate progress of disease. The problem that has been much harder to crack is what to do about the fact that this still leaves patients with irreversible disability through the damage to the myelin sheaths in the central nervous system that has been sustained. There has been consideration of approaches such as myelin repair by stem cell therapy, but application of these approaches still looks a little way off.

“This study by Tesar and colleagues offers the highly attractive possibility of retargeting existing, safe, drugs for the purpose of promoting therapeutic remyelination. They screened a library of 727 existing drugs for ability to promote myelination in tissue culture models and homed in on two that seem especially promising. One had been developed for use as an anti-fungal agent, the other a steroid skin cream.

“The data appear to suggest that the drugs can to some extent limit disability in experimental models of MS, though there is clearly much more to be optimised in this area, not least as the models tried thus far do not really look at effects on chronic demyelination. However, particularly for patients with progressive MS, where it can be difficult to know how to impact the ongoing deterioration, these approaches offer the great advantage that these are tried, tested and safe drugs passed for use in humans.

“Some caution is clearly warranted, however, when one considers the long haul from benefits in tissue culture models of myelination to a complex and diverse human disease such as MS.”

‘Drug-based modulations of endogenous stem cells promotes functions remyelination in vivo’ by Najm et al. published in Nature on Monday 20th April. 

Declared interests

Prof. Daniel Altmann: No conflicts to declare.