Hope for the future of MS stem cell research

“Bone Marrow Stem Cells Show Exciting Potential For Multiple Sclerosis Treatment” is the title of the article published on May 6th on the Medical News Today website (see link to the right under “Links”).

The article mentions that a groundbreaking trial, which aimed at testing bone marrow stem cell therapy with a small group of people with MS, shows how it has possible benefits for the treatment of MS. The purpose of the trial was to discover what kind of effects, be it good or bad, bone marrow stem cells has on MS patients, and their disability. In several experimental studies done previously, this stem cell therapy has been shown to have beneficial effects in disease models of MS.

(…)

“Research into the underlying mechanisms is ongoing and vital, in order to build on these results. We believe that stem cells mobilised from the marrow to the blood are responsible, and that they help improve disease in several ways, including neuroprotection and immune modulation.”

The next day (May 7th 2010) an article mentions that guidelines regarding stem cells and MS have been made.

Researchers have agreed that stem cells are likely to have a significant role to play in the treatment of MS, but also warn that expectations should be realistic. Professor Gianvito Martino said: “At this stage it is unreasonable to claim that stem cells are a magic cure for MS. It is, however, likely that they will one day play an important role in treating the condition.”

Which is why the booklet with guidelines was created and I think it is a great source of information regarding stem cells and how it works for MS in particular ; ). It is a public information booklet created in partnership by MS Societies from the UK, USA, Italy, France and Australia and the MSIF summarises the guidelines for people affected by MS: “Stem Cell Therapies in MS”.

I think this is a great research is a great step forward : o )

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PML (Tysabri) update – May/17/2010!!!!

From the NationalMSSociety.org website (news updated today – May 17th 2010)

As of May 6th 2010, information released by Biogen Idec reports a total of 49 confirmed cases of PML (progressive multifocal leukoencephalopathy) among people on Tysabri® (natalizumab) since July 2006, when it became available for prescription.

The risk of developing PML stays the same, that is, it increases with the number of Tysabri infusions received. However, the clinical benefits of Tysabri still continue to outweigh the potential risks.

As of the end of March 2010, 67,700 people worldwide have used Tysabri since it was marketed. Although the absolute risk for PML in patients treated with Tysabri cannot be precisely determined, the U.S. FDA and the sponsor have released data suggesting that the risk increases with increasing time on therapy, starting out lower than the one-in-one thousand level that was estimated at the time of Tysabri’s re-approval in 2006, and rising after two years of infusions to about one in one thousand. (….) There is insufficient information to determine the risk of PML in those who have been on therapy for three years or more.

The following paragraphs below are directly quoted from the website mentioned above as I thought they are easy to understand and rather important and wouldn’t want to leave something out by mistake.

Signs of PML: Typical symptoms associated with PML progress quickly over days to weeks, and can include:
• personality or behavioral changes
• changes in thinking, memory, and orientation leading to confusion
• onset of seizures, clumsiness or progressive weakness on one side of the body
• disturbances of vision

If individuals taking Tysabri experience new, unusual symptoms, they should contact their prescribing physician immediately. Physicians who need guidelines on the protocol to follow when they have a patient on Tysabri who experiences unusual symptoms should contact Biogen Idec.

Additional Details: According to the company, as of May 6, 2010 there have been 49 confirmed cases of PML, occurring in both men and women who had been given infusions of Tysabri every four weeks for a duration ranging from one year to three and a half years, with an average of two years.

• 27 of the cases occurred in Europe, 19 in the United States, and 3 in the rest of the world.

• Approximately one-fourth of those who have developed PML have died.

• The degree of disability in the survivors is a wide spectrum: at the milder end, some have recovered enough to return to work, and at the other extreme, some are confined to bed, requiring extensive assistance with activities of daily living, and others were in between this range.

• Based on these cases, the sponsor stressed that, contrary to prior information, the presence of gadolinium-enhancing lesions on MRI does not exclude the possibility of PML. Likewise, the absence of JC virus DNA in the spinal fluid does not exclude PML.

• There has been no characteristic among those who have developed PML that would give substantial clues to who might be more likely to develop it, except that half of the cases had prior histories of having been on immunosuppresive therapies, such as mitoxantrone, and less commonly, azathioprine and methotrexate.

• Right now there is no test that can predict who is more likely at risk for developing PML while using Tysabri; in a large company-sponsored study, testing of blood cells, plasma, serum and urine for the causative JC virus in people before and after 48 weeks of Tysabri therapy (Rudick et al, ECTRIMS 2009) did not show any differences in the presence of the virus in those fluids. The results of these studies, performed at the U.S. National Instituties of Health, differ somewhat from an earlier study (N. Engl. J. Med. 361:1067, 2009) suggesting higher virus levels after treatment.

• When PML was suspected, Tysabri infusions were halted. There is no specific therapy to treat PML, but the best hope is to reconstitute a person’s immune responses. In most of the cases, once PML was confirmed, Tysabri was removed from their systems with the blood-cleansing treatments of either plasma exchange or immunoadsorption.

• During the aftermath of PML, as the immune system begins to recover, a condition called IRIS (immune reconstitution inflammatory syndrome) usually occurs about 4 weeks after the removal of Tysabri from the system. The sponsors suggested that some of the treating physicians found that prompt use of intravenous steroids to treat this brain inflammation led to improvement.

“Important control mechanism behind autoimmune diseases discovered”

I am sorry but I have been busy and thus late in my updates. Nevertheless I aim at posting everything I’ve read that I deemed relevant and interesting. The following is from an article (dated 05 May 2010 – Medical News Today).

Swedish researchers have discovered a new control mechanism in our immune system. This discovery might have be of great significance for the treatment of serious diseases such as MS, rheumatoid arthritis, and SLE (Systemic lupus erythematosus).

Mikael Karlsson, associate professor at the Department of Medicine at Karolinska Institutet in Solna states: “now that we’ve started to understand the regulatory mechanisms involved in these autoimmune diseases, we are hopeful that new treatments can be found“.

An important component of our immune defense is a type of cell called a B cell. Normally, the job of these cells is to produce antibodies, which in turn bind to and neutralise invasive microorganisms, such as bacteria and viruses. In people with an autoimmune disease, explains Dr Karlsson, these B cells actually have an injurious effect and instead of serving the body, are activated against its own tissues, which they start to break down.

What this research has demonstrated is that NKT cells can regulate how B cells become activated against healthy tissue, and also that a lack of NKT cells results in greater misguided B cell activation… Thus researchers claim they can now actually mechanically link the NKT cell defect in patients to the disease.

The study also shows that the NKT cells directly impede faulty B cell activation, and that they do so early in the misdirected process. The team managed to inhibit the activity of pathogenic B cells by adding NKT cells – a result that may one day lead to new types of treatment.

This simply opens the opportunity for the development of new treatments for MS (and the other diseases mentioned above) specifically targeted at the protective NKT cells.

Detecting MS in the blood… leading to a cure..!?!?!

I haven’t have the time to update the blog recently..sorry for that but I will make sure to update all things I’ve so far read and found relevant. Here is one of them. I’ll bring up the main things stated in the article (for more info check the link to the right)

(From Medical News Today – article dated 03 May 2010)

A breakthrough finding from a Tel Aviv University scientist and physician promises to lead to earlier diagnosis, more effective intervention, and perhaps even a cure MS!

This finding might provide clues for early intervention. If doctors can predict the onset of MS early enough, intervention therapies using immunomodulatory drugs such as Copaxone or beta-interferon drugs that stave off MS symptoms, might be used.

….

These early genetic markers may now be used to test for multiple sclerosis up to nine years before healthy young adults start developing symptoms. And because MS is thought to have a genetic component and a tendency to be found in siblings, Prof. Achiron says the biomarkers can be used as a tool for brothers and sisters of patients.

When Prof. Achiron was aksed why test in advance of a cure he replied: “the idea is that we’ll know more about the genetics of MS through this new discovery, with the hope that early intervention therapies may be more effective, and help advance medicine toward a cure” .

This new insight into who will develop MS in the future is a first on the path of finding a cure to the disease.

Link between MS brain atrophy, cognitive function & low vitamin D levels

It has long been known that lower-than-normal vitamin D levels were associated with a greater risk of developing MS…but little is known about its relationship to cognitive impairment. The study mentioned on May 3rd 2010, in Medical News Today, links low vitamin D levels to not only a more advanced physical disability but also cognitive impairment in people with MS.

In sum, the results of the study showed, among other things…:

  • Clinical evaluation and magnetic resonance imaging (MRI) images show low blood levels of total vitamin D and certain active vitamin D byproducts are associated with increased disability, brain atrophy and brain lesion load in MS patients.
  • A potential association exists between cognitive impairment in MS patients and low vitamin D levels.

… And also that only 7% of people with secondary progressive MS showed sufficient vitamin D (compared to 18.3% of patients with the less severe relapsing-remitting type).

“Results showed that MS patients who were impaired on tests of executive function — critical reasoning and abstract thinking — and the ability to plan and organize, were more likely to be deficient in vitamin D”… “This relationship held true when controlling for the season during which vitamin D was measured, as well as depression, which is known to be associated with lower vitamin D levels.” Morrow noted there also was a suggestion that verbal fluency (word generation) and visual-spatial memory (learning and memory of shapes and figures) is more likely to be affected when vitamin D levels are not sufficient.

(see under “links” to the right for more details on the study)