06.06.2013 - An international research team has found a way to calm the autoimmune reaction that leads to myelin destruction in Multiple Sclerosis patients.
A phase 1 clinical trial for the first treatment to reset the immune system of multiple sclerosis (MS) patients showed the therapy was safe and reduced patients' immune system reactivity to myelin by 50 to 75 percent. In 9 patients, the researchers from Hamburg, Vienna, Zürich, and Chicago succeeded to reduce the autoimme reaction against myelin, which surrounds neurons like an insulator. They did so by coupling 7 myelin antigens thought to induce MS to the patients’ white blood cells ex vivo, which induced immune tolerance after reinjection in their bloodstream. Most of the patients who received high doses of the antigen-coupled blood cells did not show any new brain lesions or symptomatic relapses up to the end of the study’s six month follow-up period (Science Translat. Medicine, 5 May, 2013).
"The therapy stops autoimmune responses that are already activated and prevents the activation of new autoimmune cells," said co-author Stephen Miller from Northwestern University Feinberg School of Medicine. "Our approach leaves the function of the normal immune system intact. That's the holy grail." According to lead author Andreas Lutterotti from Innsbruck Medical University/Medical Center Hamburg-Eppendorf, the dead lymphocytes carrying the myelin antigens are filtered out of the blood in the spleen. During this process, immune cells start to recognise the myelin antigens as harmless and immune tolerance quickly develops. They confirmed this in patients by immune assays.
Although the patient numbers are small in this first-in-human study, the safety, feasibility, and early results suggest that this approach may provide a promising avenue for future trials. Unlike current immunosuppressive drugs for MS, the new approach does not compromise the immune system’s infection-fighting abilities. The process mimics a natural process by which millions of red and white blood cells, which normally die each day, are cleared from the bloodstream without alerting the immune system.
The human safety study sets the stage for a phase 2 trial to see if the new treatment can prevent the progression of MS in humans. Scientists are currently trying to raise $1.5 million to launch the trial, which has already been approved in Switzerland. The new approach may be useful for treating not only MS but also a host of other autoimmune and allergic diseases simply by switching the antigens attached to the cells.
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