Dec 2010
A small study in people with relapsing-remitting MS showed that applying a skin patch containing components of myelin, the material that surrounds nerve fibers and is the target of immune attacks in MS, succeeded in suppressing immune activity. Maciej Juryńczyk MD, Krzysztof Selmaj MD, PhD (University of Lodz, Poland) and colleagues report their findings in Annals of Neurology. (2010;68:593-601) Further studies will be needed to determine whether this approach is safe and effective for treating MS.
Background: Multiple sclerosis involves immune attacks launched against the brain and spinal cord. A main target of this attack is myelin, the substance that insulates nerve fibers and facilitates proper nerve impulse conduction. Researchers have long explored whether the immune system could be trained to ignore myelin by inducing “tolerance.” One approach is to inducing tolerance is to injecting people with MS with myelin peptides, that is, fragments of proteins found in myelin.
The results of such studies in MS have been mixed and have not yet shown this to be a safe and effective therapeutic strategy, although work in this area continues. For example, a previous large clinical trial of orally administered myelin protein altered some immune activity but was clinically ineffective, as was a more recent clinical trial of an injected myelin peptide in secondary-progressive MS.
The Study: In this placebo-controlled study, the team enrolled 30 people with relapsing-remitting MS (http://nationalmssociety.org/about-multiple-sclerosis/relapsing-ms/relapsing-remitting-ms-rrms/index.aspx). Treatments were administered via an adhesive patch placed on the right upper arm. Participants were randomly assigned to receive either an inactive placebo patch; a patch containing a mixture of 1 mg each of proteolipid protein (PLP), myelin oligodendrocyte protein (MOG), and myelin basic protein (MBP) peptides; or a mixture containing 10 mg each. The patches were changed once each week for four weeks, and then once each month for 11 months. Immune cell reactions were determined via skin biopsies and blood samples. The study was not designed to detect a clinical impact of the treatment, but rather to look for signs of altered immune responses.
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