Trials lead to first-ever success in the repair of nerve coating in humans,
fueling hope for sufferers of the disease.
Words By Jerry Silvester
A clinical study funded by the MS Society has proven that damage caused by the disease to myelin, which is the coating of nerves can, in fact, be repaired.
The drug bexarotene, which was initially developed to treat cancer, has demonstrated that remyelination is possible in humans. This is an arguably monumental revelation that, until now, had been thought not possible. The trial involved visual tests and MRI scans, which both exhibited significant verification that Bexarotene could successfully repair myelin. At the MSvirtual2020 conference where the evidence was presented, Professor Alisdair Coles revealed that findings on brain scans showed a substantially improved speed of the signals sent from the retina to the visual cortex, something which he states is only possible through the process of remyelination.
While the drug has been ruled out as a current treatment option due to severe side effects such as high levels of fats in the blood, which critically increases the risk of strokes and heart attack, the discovery is thought to have had a seismic impact on the understanding of myelin and its potential to repair.
Conventional treatments currently available to manage multiple sclerosis vary depending on the severity of the disease and the patient’s tolerance of the side effects of such treatments. All available treatments are currently prophylactic, seeking to prevent further lesions on the brain or spinal cord but are, as of yet, unable to facilitate the repair of any damage currently existing. Most commonly diagnosed between the ages 20-50, multiple sclerosis is an immune and neurodegenerative disease of the human central nervous system, usually affecting young adults. The fatty myelin coating that protects nerve fibres is attacked within the central nervous system by MS, causing many symptoms including visual disturbances and dizziness. There are currently over 130,000 people living with multiple sclerosis in the UK.
Although bexarotene has now been officially ruled out as a safe or viable option for treatment, there are currently ongoing studies looking at the performance of another drug that is commonly prescribed to diabetes patients. The stringent study is certainly controversial to some as it involves drug trials on animals, a contentious discourse amongst many. The drug Metformin has so far shown progressively promising results in a study of myelin repair in rats, and will soon be tested on 50 human participants who have relapsing-remitting MS, the most common form of the disease.
Metformin appeared to return cells to a more ‘youthful state’ thus encouraging the regrowth of myelin in the rats. Speaking to the MS society about this development, Professor Robin Franklin said, “Metformin is one of the most exciting developments in myelin repair we have ever seen. Our findings last year shed light on why cells lose their ability to regenerate myelin, and how this process might be reversed. We’re very proud to have done this work and thrilled to see our discovery taken forward so quickly”.
The prodigious developments in the research of treatments for MS, and the increasingly
frequent dissemination of such information, is welcomed wholeheartedly by those whose lives the advancements could impact the most. Amy Thompson, founder of leading charity for young people with MS, ‘MS Together’, said, “This breakthrough is incredibly positive for me and my community. The significant progress in the treatment of MS really does give us all hope for the future. These new advancements have also meant that more people are now talking about MS, which has been important in raising awareness and understanding of the illness”.