October 22, 2021
Advances were reported from many different avenues of research, driving progress along Pathways to Cures that will stop MS, restore function, and end MS by prevention. Below are a few highlights from the many important presentations, with links to their abstracts. Studies presented at scientific meetings are generally considered preliminary until they are published in peer-reviewed journals.STOPPING MSMany presenters shared results demonstrating continued benefits of available therapies, and longer-term safety data showing that early and ongoing treatment with a disease-modifying therapy has long-term benefits for controlling disease activity, delaying buildup of disabilities, and protecting quality of life. Several studies also reported on efforts to determine how to predict an individual’s disease course and progression to guide better treatment decisions. Other studies reported on potential benefits of experimental therapies including “BTK inhibitors” (such as fenebrutinib, evobrutinib, tolebrutinib), which are in late-stage clinical trials in both progressive and relapsing MS. BTK inhibitors are thought to both reduce the activation of immune B cells that play a role in MS, and inhibit immune cells in the brain called microglia, which have been linked to MS progression.“Progressive MS has moved to center stage,” noted Professor Alan Thompson, who gave the ECTRIMS Lecture as the recipient of the 2021 MSIF Charcot Award. Understanding what drives chronic inflammation and nerve degeneration, and how aging plays a role, are key to stopping progression. Many presentations focused on the cause of tissue damage that might be targeted by new therapies in the not too distant future. Microglia: For example, the brain’s internal immune cells, called microglia, are the subject of intense investigation. These cells conduct important functions, including clearing away myelin debris to make way for myelin repair. But they can also go rogue and contribute to “smoldering” inflammation and nerve degeneration.
- Dr. Dori Schafer (University of Massachusetts Medical School, Worcester) described how an immune mediator called complement can team up with microglia to snip nerve connections (synapses) and interrupt brain circuitry in MS. The team is are now working to understand the sources of complement molecules and determine how they regulate synapse loss and inflammatory activity in MS. (Abstract 110) This study adds to recently published data on the role of complement in MS.
- Dr. Anthony Chomyk (Cleveland Clinic) presented results showing that microglia, which are present on the borders of slowly expanding MS lesions, show different patterns of gene activation depending on which area of the brain the lesions are in. Identifying gene alterations in microglia from different brain areas could help to provide new targets for MS therapeutics. (Abstract 175)
Stem cells for nerve protection: Dr. Jeffrey Cohen (Cleveland Clinic) presented first results from a phase 2 open label clinical trial that tested a stem cell therapy (NurOwn®, Brainstorm Cell Therapeutics) on 18 people with primary progressive or secondary progressive MS. The cells were derived from individuals’ own bone marrow (mesenchymal) stem cells, which were treated in the laboratory to encourage them to secrete neuroprotective factors. The participants then received three separate cell treatments by injection into the spinal canal every two months. The treatment appeared to be safe (which was the primary purpose of the study), and there also appeared to be some improvements in cognition, vision, mobility, and other functions by comparing participants with those involved in other studies. A grant from the Society’s commercial investment program-Fast Forward provided funding to measure the levels of anti-inflammatory and neuroprotective substances in the spinal fluid as a potential way to quickly detect the biological activity of the treatment in future clinical trials. Biomarkers in spinal fluid suggested nerve protection and reduced inflammation. The company is determining next steps for developing this experimental approach for treating progressive MS. (Abstract 114) CLICK to Continue reading about
THEN Click to Subscribe for MS News, information and educational events
|
