MS Repair: Rapidly moving out of the lab and into people

When I was in the lab, my research focused largely on using mouse models of MS to test concepts that couldn’t be explored in people yet. Studies presented at this week’s AAN meeting are making it clear how far research has advanced since that time. Case in point: I never would have thought just a few years ago that I would be writing about myelin repair in people, not mice.

So it was pretty exciting to see a presentation Wednesday evening showing the first results of a clinical trial of the myelin repair strategy called anti-LINGO, which is being developed by Biogen. This study involved giving this IV infusion or a placebo every 4 weeks for 20 weeks to 82 people who had experienced their first episode of optic neuritis. Optic neuritis involves inflammation of the nerve that connects to the eye, and it’s often one of the first signs of MS.

The study measured the speed at which electrical signals traveled along the optic nerve before and after 24 weeks of treatment. The investigators found that those who had been given Anti-LINGO therapy had faster nerve signals after treatment, compared to those who were given the placebo. This speeding up of signals is thought to be a consequence of myelin repair. They didn’t find differences between the groups in terms of vision, and the therapy seemed to be well tolerated except for some infusion reactions. (Abstract S56.008)

This is exciting stuff! But it is still early. Benefits will need to be demonstrated in larger and longer clinical trials before the FDA will consider this treatment for approval.

I’m now really looking forward to seeing the results from a parallel study of anti-LINGO in people with relapsing MS. This study will add important new information on the potential of anti-LINGO for restoring myelin and function for people with MS.

We’ve talked before about the potential of various kinds of stem cells to stop disease activity and possibly repair myelin. There have been a few updates at AAN about trials of adult mesenchymal stem cells, which are present in many tissues of the body. These trials isolate a person’s own mesenchymal cells from the bone marrow or blood stream, which are then multiplied in the lab, and then re-introduced in greater numbers into the body.

Previously, a small phase I clinical trial at Cleveland Clinic tested the ability of mesenchymal stem cells to both inhibit immune mechanisms and to augment intrinsic tissue repair processes in people with relapsing forms of MS. This study was led by Dr. Jeffrey A. Cohen and supported by the Congressionally Directed Medical Research Programs. This trial was designed to evaluate safety and not designed to determine benefits, and preliminary results were presented last year suggesting that this approach was safe.

The team has done some further probing to try to get at the question of whether these cells stimulated myelin repair and protected nerve fibers. We think degenerating nerve fibers are driving disability progression, so if this works, it could potentially slow down or stop progression. They looked at specific brain lesions before and after the infusions of stem cells using advance imaging called DTI. They reported that compared to before treatment, measures of axon loss stabilized, hinting that the cells may have stimulated repair and/or protected nerve tissue. A follow up clinical trial, which is now in planning stages, should shed more light on potential benefits of this exciting approach. (Abstract P1.152)

Researchers from the Tisch MS Research Center of New York presented some early findings from their trial of mesenchymal stem cells. These investigators are purifying and expanding neural progenitor cells from the bone marrow and then injecting them into the spinal fluid. In an interim update from this ongoing study, they reported no safety issues after treating 7 participants with one dose and 2 participants with three doses. (Abstract P7.200)

I’m proud that the National MS Society made strategic investments to encourage research in the area of nervous system repair and protection, and it’s really gratifying to see promising early results with potential implications for people with MS. We’ll be keeping a close eye on these and other studies that are the translation of many long years of basic lab work.  

Anyone can get a preview of the summaries, or abstracts, of presentations to be given at the Academy’s Annual Meeting at this link. Registration is necessary, but is free.

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Bruce Bebo, PhD

Bruce Bebo, PhD, is Executive Vice President, Research at the National MS Society, and was previously a research immunologist focusing on the influence of sex hormones on MS. He is a driven and passionate Society volunteer, successful fundraiser and advocate, fueled in part by the fact that his mother had MS.

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  • Joey   Apr 24, 2015 1:19 PM
    Will this work for Primary Progressive MS too? So far I have not read anything for PPMS. I currently can walk but like a drunk and use a walker if i go out to eat. Don't drive any more cus of the MS and gave my car to my grandson but really miss my independence. I am sure many do also!
  • Olympia Hadjimichael   Apr 24, 2015 2:02 PM
    You are providing a great service for people living with MS and for their families. We are all anxious to hear about research results and search for a ray of hope. Almost all new medications are developed for the relapsing-remitting type and the newly diagnosed. Research that may benefit the rest of those living with MS is presented in conferences and it is not easily available. Thank you.
  • joey   Apr 24, 2015 2:08 PM
    Forgot to leave my email address for an answer! It's the MS I tell ya! ha ha ha
  • Scott richter   Apr 24, 2015 2:14 PM
    Why did The national multiple sclerosis society decide to NOT help fund Dr. Sadiq's research?
  • Damaris Vazquez   Apr 24, 2015 3:31 PM
    Good news
  • Kelly   Apr 24, 2015 4:31 PM
    This is wonderful news about the research!! I have been living with MS shortly after I turned 25 and am now 49. I have missed so much of my live because now I have to live with my parents. I am a single mom and my daughter is grown and married. Cant be alone which I would love to be able to do. I would love to be in a Trial. You can get in touch with me at 304-546-3746 or the email I provided. KEEP ON RESEARCHING FOR A CURE!! Thank YOU!!!
  • Joan fuller   Apr 24, 2015 5:05 PM
    Thanks for your post. This really IS exciting news for all of us who are so hopeful that we Can defeat MS or at least stop it in it' s tracks.
  • paula   Apr 24, 2015 5:56 PM
    If all of these new treatments are available, like myelin sheath repair and/or stem cell research, why do we still have to suffer
  • paula   Apr 24, 2015 5:57 PM
    If all of these new treatments are available, like myelin sheath repair and/or stem cell research, why do we still have to suffer
  • Avatar
    IraS  Apr 25, 2015 4:44 PM
    A trial I hope I can get into..
  • Marie   Apr 26, 2015 6:59 AM
    I hope that this becomes a therapy available to everyone with MS in the near future!!
  • davepris  Apr 26, 2015 7:45 AM
    Thank you all for your effort and hard work. I don't know how long I can endure and hope there where be cure real soon.
  • Paula Collins   Apr 26, 2015 7:44 PM
    I was diagnosed with relapsing remitting MS in 1996. I believe that I have progressed into secondary progressive. I am very interested in your study. I think that these treatments should be available to all people with MS. I was also reading about stem cell research however my doctor will not be able to start it until four years from now.I am hoping to be in the study for Milan repair. how wonderful it would be to get some of the losses from Ms back. I am still able to walk however only for about 45 minutes and then I can no longer walk. I hope that you contact me. thank you for your research on this terrible disease
  • Eva Marsh   Apr 27, 2015 12:31 PM
    So glad you are catching up to me and Dr Mary Bunge!! I found her work in 1967 when I was diagnosed and told I would never recover, and didn't have long. Saw electron microscope slide that proved myelin repairs WITH MOVEMENT!! I am now 70 recovered from all symptoms, and fully mobile. NO DRUGS! NO MONEY! I just kept moving - body heals itself when we let it. Eva Marsh
  • Eva Marsh   Apr 27, 2015 12:50 PM
    Dear Bruce
    You should read Mary Bunge et al (1961) Ultrastructural Study of Remyelination in an Experimental Lesion in Adult Cat Spinal Cord. Journal of Biophysics, Biochemistry and Cytology, Volume 10, pages 67-94, 1961. I worked in Veterinary College and knew that adult cats and humans are same biological class, and recovered from all symptoms since diagnosis in 1967 - WITH MOVEMENT!
  • shorty5   May 1, 2015 7:20 PM
    Yet more examples of drugs and treatments that are being, or have been, evaluated for RRMS but PPMS has been excluded from the trials so the drug companies can wait a few years then trial them for progressive forms of the disease and claim a 'new application' and so extend their patents. Disgusting!

    Our system for drug evaluation badly needs reassessment and reform. The system originated because of a need to protect people from snake oil salesmen but has been debased into a system for protecting vested monetary interests at the expense of the people it should be protecting.

    I have PPMS and have been involved in a phase 3 trial of Fingolimod for the last 3 years. As you know it was approved for other types of MS in about 2008 but, as PPMS had been kept out of the previous trials, not for Primary Progressive. This has of course only removed 10% of the ‘market’ (read people who need it) and has allowed Novartis to wait a few years then run these trials and then claim a ‘new application’ and so extend their patent by about 8 years allowing them to continue to charge $3000 for 28 day’s supply.

    This highlights 2 issues. Firstly the drug has been shown to slow the progression of the disease. There would not be a phase 3 trial at all if no effect had been observed. In PPMS the average progression from diagnosis to death is about 17 years and there are no other treatments for the progression of this disease so with holding this drug from this group for 8 years is a significant sentence for these people and a serious abuse of human rights.

    Secondly the use/abuse of the system to extend the life of their patent and so allow the company to sell the drug to 90% of their market for 8 years and then start the clock again on the patent for 100% of the market at a price that is determined by how much can be screwed out of government subsidies (they couldn’t sell it for this amount otherwise) is a serious rort and amounts to fraudulently obtaining tax payers money.

    This is technically not criminal because it is not illegal but it is certainly not ethical or morally justifiable. It has denied access to this drug for the people (yes PEOPLE, patients are people) who could have benefitted from this drug for 8 years, during which time many have suffered terribly, and all in the name of company profits and, possibly, jobs for people conducting the new round of unnecessary trials. This corruption, and it definitely is corruption, is the main reason why reform of the system is so badly needed
  • Melissa   May 11, 2015 8:06 AM
    The last paragraph should be rewritten. The National MS Society will not fund Dr.Sadiq. I only now donate to him rather than the Society. When Sadiq has the cure, the Society will feel like idiots for not sponsoring him.
  • SARA McCLOSKEY   Jul 27, 2015 1:31 PM
    I am a 60yr old women DX in 2010 after contacting MRSA in 2008 after a kidney tumor removal. It seeded up my blood stream and landed c-3 to c-5