Multiple sclerosis is debilitating, incurable and treatment is often a long and complex experience. But there might be a glimmer of hope...
An experimental immune-system therapy appears safe for people with progressive forms of multiple sclerosis. And it may ease symptoms in some patients, a preliminary study suggests.
Immune-system therapy or immunotherapy is a relatively new medical approach that attempts to stimulate the patient's own immune system to successfully fight the disease they're suffering from.
No cure as yet
The current findings are based on just six patients, and the Australian researchers stressed that a lot of work still lies ahead.
But they were encouraged that this new approach to MS had no major side effects. In addition, three of the six patients showed symptom improvements, including reduced fatigue and better mobility.
There is as yet no cure for MS. A Health24 review indicates that many individuals living with MS do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks.
It's not clear, however, what to make of those improvements, said Bruce Bebo, executive vice president of research for the National Multiple Sclerosis Society.
The study was a "phase 1" trial, meaning it was designed only to test the therapy's safety.
"Based on this very preliminary study, the therapy appears safe," said Bebo, who was not involved in the research.
"But I'd be even more cautious in drawing any conclusions about the clinical improvements," he stressed.
Larger, rigorous clinical trials are needed to show whether the treatment truly works, Bebo said.
Different forms of MS
Multiple sclerosis is caused by a misguided immune system attack on the protective sheath around nerve fibres in the spine and brain. Depending on where the damage occurs, symptoms can include vision problems, muscle weakness, numbness and difficulty with balance and coordination.
Most people with MS are initially diagnosed with the "relapsing-remitting" form, which means that symptoms flare up for a time and then ease.
The new study involved patients with progressive MS, where the disease steadily worsens without periods of recovery.
Most had the "secondary" progressive form – which means they initially had relapsing-remitting MS, but it worsened. One patient had progressive MS from the start, which is known as "primary" progressive MS.
New treatment method
The patients agreed to try a treatment never studied in MS, said study co-author Rajiv Khanna, of the QIMR Berghofer Medical Research Institute in Brisbane, Australia.
The approach is known as "adoptive immunotherapy", where a patient's own immune system T-cells are genetically tweaked to fight an enemy – such as cancer cells.
Immunotherapy is a type of biological therapy which makes use of substances that stimulate or suppress the immune system in order to fight off many diseases by only targeting certain cells of the immune system.
Previous results with immunotherapy in the treatment of cancer indicated that 90% of the participants in the study – who had between two to five months to live – showed an improvement.
Khanna's team took samples of the MS patients' T cells, then altered the cells to boost their ability to recognise and attack the Epstein-Barr virus. Those T-cells were infused back into the patients' blood, at gradually escalating doses over six weeks.
Epstein-Barr is a common virus that infects most people at some point. But researchers suspect it plays a role in MS in some people.
According to Khanna, there is also evidence that MS progression correlates with Epstein-Barr "activation" in the body. The aim of the T-cell therapy is to "clear out" B-cells – another type of immune system cell – that are infected with Epstein-Barr.
Over six months, the researchers said, none of the patients suffered serious side effects from the treatment.
In addition, three showed symptom improvements within two to eight weeks of their first T-cell infusion.
The findings are scheduled for presentation at the annual meeting of the American Academy of Neurology, April 22-28, in Boston.
The biology behind the T-cell therapy is not fully clear, Bebo said. Although Epstein-Barr is suspected as one factor in driving the initial development of MS, even that is not established, he said.
On the other hand, there is evidence that B cells drive inflammation in MS, Bebo said.
It is not yet clear when it will be available – especially in South Africa – but at least hope is on the horizon and with the rate of improvement in science, it might be sooner than later.
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