2009: Year of Research Breakthroughs in Multiple Sclerosis

2009 was an amazing year for research into the cause of and treatment for multiple sclerosis.

In January, researchers from Northwestern University’s Feinberg School of Medicine announced that the neurological dysfunction of early-stage multiple sclerosis patients appeared to be reversed by transplanting the patient’s own immune stem cells into their bodies and resetting their immune systems.

“This is the first time we have turned the tide on this disease,” said principal investigator Richard Burt, MD, chief of immunotherapy for autoimmune diseases at the Feinberg School. The clinical trial was performed at Northwestern Memorial Hospital. The patients in the small trial continued to improve for up to 24 months after the stem cell transplant and then stabilized. Improvements were seen in the areas which were affected by MS, including walking, ataxia, limb strength, vision, and incontinence.

The encouraging news is that patients’ own stem cells were used, eliminating ethical concerns about the use of embryonic stem cells in medical research.

The patient group was made up of 12 women and 11 men on the early stages of relapsing-remitting MS. After three years, 17 patients improved by at least one point on the standard disability scale. None of the patients scores were lower. More trials are now underway to confirm these findings. Researchers also caution that in order for this procedure to work, it must be done before permanent nerve-cell damage has taken place.

In June, two studies published in the journal Nature Genetics report identifying new genes and gene regions that contribute to making people susceptible to developing MS.

In August, Canadian researchers announced that mice with an disease akin to MS experienced recovery when administered “GIFT15″ - a compound formed by fusing two immune proteins. Findings by Jacques Galipeau, MD (McGill University, Montreal) were reported in Nature Medicine (August 2009).

In addition, an international team reversed MS in mice by administering lisinopril, a drug commonly used to lower blood pressure. A drug used to treat diabetes (metformin) also improved MS-like disease in mice in a study by researchers from Medical University of South Carolina and Mayo Clinic.

A study released in October challenged what we know about multiple sclerosis. Researchers at the Buffalo Neuroimaging Analysis Center at the University of Buffalo are looking into the possibility that MS results from narrowing of the primary veins outside the skull — chronic cerebrospinal venous insufficiency. In CCSVI, narrowing of the veins restricts the flow of blood from the brain, causing degeneration of neurons.

CCSVI was discovered by Paolo Zamboni, M.D., from Italy’s University of Ferrara. Results of a preliminary study of 16 patients with relapsing/remitting MS and eight healthy controls showed that all the MS patients, but none of the controls, had chronic insufficient blood flow out of the brain. Studies are ongoing. Previous theories about the cause of MS point to a genetic pre-disposition, environmental causes, or an abnormal response of the body’s immune system.

If the CTEVD study does, in fact, point to CCSVI as a cause of MS, it would be possible to identify people at risk of developing MS before symptoms are obvious and permanent damage has begun.

“If we can prove our hypothesis, that cerebrospinal venous insufficiency is the underlying cause of MS,” said Robert Zivadinov, M.D., Ph.D., UB associate professor of neurology, director of the Buffalo Neuroimaging Analysis Center (BNAC) and principal investigator on the study, “it is going to change the face of how we understand MS.” (quote from MedicalNews.net, emphasis mine)

Isolating the cause of MS is the first step toward more effective treatments and, eventually, a cure for this debilitating condition. The good news is that research is ongoing on multiple fronts and the last decade has seen major progress in treatment of relapsing/remitting MS, as well as treatment of symptoms.

2009 was quite a year — promising research on several fronts offer people with MS cause for great hope. Finding the cause means better treatments… and possibly the long-sought cure. 2010 is beginning on a positive note.