When mice chew through the insulation that protects a house’s wires, an electrician can repair the wires. People with multiple sclerosis, whose immune systems malfunction and attack the insulation of their own neural wires, don’t have that option. Helping them could be a very big deal in MS care.
Swiss drug giant Roche, tapping into an unorthodox business model created by a San Francisco venture group, wants to find treatments to help. Roche and Versant Ventures have created the oddly named Inception 5—we’ll explain the name later—to house a promising new way to look for multiple sclerosis drugs, a high-throughput screen developed at the University of California, San Francisco.
Roche will contribute its vast libraries of compounds to test in the UCSF assay, and a seasoned team of drug discovery scientists in the employ of Versant’s Inception group will also try to design new compounds.
Repairing the neural insulation is called remyelination. Myelin is the substance that makes up the sheaths, and it’s also what the immune system mistakes for a pathogen. The attack leaves holes in the myelin, and like a house with faulty wiring, the patient’s nervous system starts to short-circuit, leading to a wide and unpredictable range of neurological symptoms.
While drug makers have produced improvements with drugs that tamp down the immune system’s attack, nothing is available to reverse the actual myelin damage. (Two monoclonal antibody therapies, one from Biogen Idec, Anti-LINGO-1, and another from Acorda Therapeutics, rHIgM22, are in the clinic.)
The UCSF assay, created by neurology professor Jonah Chan, is an innovative way to get at a thorny problem: It’s really hard to build tests that demonstrate remyelination. Neurons, the cells that need to be remyelinated, are finicky to grow in the lab. Also a problem: oligodendrocytes, the cells that produce myelin, don’t wrap their myelin around the axons of neurons in an easily measurable way. (Axons are the branching arms of neurons that transmit electrical signals.)
There are other reasons, too, but Chan created a work-around: Build tiny silica cones that encourage oligodendrocytes to wrap their myelin cleanly. In other words, he built axons from pure glass. And when those silica cones (which Chan calls “micropillars”) are lined up in a testing plate, their cone shape allows measurement of the myelin thickness as it wraps around. Imagine reading the myelin as if it were the rings in the cross-section of a tree.
“Jonah’s done a great job,” said Jay Tung, chief research officer of the Myelin Repair Foundation in Saratoga, CA, which has worked with Chan in the past. “We are ecstatic about pharma, academics, startups, anyone moving the field forward. This is exactly what we want to see.”
“My view is that the missing link for finding candidate therapies for myelin repair has been the lack of a platform for efficient high-throughput screening of agents,” said Timothy Coetzee, chief research officer at the National Multiple Sclerosis Society in New York. The nonprofit funded much of Chan’s work that went into the micropillars. “The complexities of co-culture systems just don’t lend themselves to HTS. Jonah’s technology fills that critical gap.”
With the screening platform, researchers can test how thousands of drugs spur oligodendrocytes to produce myelin. That’s exactly what Inception 5 plans to do.
The group is part of a Versant initiative to keep its own drug-discovery team in-house at a company called Inception Sciences, led by a group of scientists who, at the Merck-Frosst labs in Montreal, had a string of successes including the painkiller rofecoxib (Vioxx)—later withdrawn from the market for safety concerns—and the asthma drug montekulast (Singulair). One of those scientists, Peppi Prasit, and Versant teamed up to create Amira Pharmaceuticals, which they sold in 2011 for $475 million.
Prasit and Versant managing director Brad Bolzon (right) immediately pivoted to launch Inception Sciences, which describes itself as a “small-molecule pharmaceutical incubator.” It is wholly owned by Versant and has two labs, one in San Diego, another in Vancouver. A third is about to open as well.
Instead of turning Inception Sciences into a sprawling biopharma, Versant uses a few million dollars at a time to fund Inception spin-offs that it partners with outside drug companies. (Hence the Inception 5 name; there are four other spinoffs, with more soon to be announced, according to Bolzon.) With Inception 5, Roche is paying for the research and has the option to buy the company outright once the Inception team files an IND, which is industry shorthand for asking the Food and Drug Administration permission to test a drug in humans.
Chan told Xconomy his work had drawn a lot of industry interest, but meeting the Inception scientists at their San Diego facility last year “hooked him.” Two people in particular, the medicinal chemist Brian Stearns and the biologist Daniel Lorrain, were “very impressive,” said Chan. “They’re so focused on developing products and new drugs. It made perfect sense.”
Chan also liked the idea of a third party like Inception between his work and Roche, which previously had asked him directly to screen their compounds in his lab. “That wasn’t appealing,” he said. “I didn’t want to be a service provider for companies.”
Instead, Chan and his students can get back to basic research and leave the screening work to others. “I’m just a lab rat,” he said. “It’s up to the drug hunters to take the next steps.”
Chan and his fellow UCSF neurology professor Ari Green, also an MD who treats multiple sclerosis patients, are among Inception 5’s founders and have an undisclosed equity stake. (Versant is the main owner, and Inception’s employees also take equity in each spinout.)
Even as the micropillar screen goes over to Inception 5, Green is overseeing a 50-person trial at UCSF with a drug he and Chan found with the screen. Like much of the work surrounding myelin repair, Green is taking a creative tack to measure the drug’s effect. The trial measures the speed at which light shone in a patient’s eye is converted into a signal in the brain. Myelin damage to the optic nerve slows that conversion. Patients whose speed improves during the trial might be experiencing myelin repair.
Data could be ready by the end of the year, but the trial isn’t meant to get a new drug on the market. They’re testing an off-patent, over-the-counter antihistamine, and its drowsy effect on patients rule out its potential as an MS drug. “Fatigue is the number-one issue for MS patients,” said Green. “But if this trial goes well, we’ll pursue funding for a large scale clinical trial, because even if it doesn’t lead to development of a therapeutic, it’ll help advance the field.”
It’s a field full of unknowns. As promising as Chan’s micropillars are, they’re synthetic. They only approximate how myelin would wrap around real axons, and they lack the complicating factor of inflammation in the micro-environment. Tung of the MRF says his group has an “intense focus” to move toward a high-throughput screen without using a synthetic material. Inception 5 will work on next-generation assays, too, says Green.
If Roche pulls the trigger and buys Inception 5, it will take the micropillar screen with it, which doesn’t sit well with Tim Coetzee of the NMSS. “If this platform technology got walled off from rest of the world, I’d be worried,” said Coetzee. “This is about MS, but we’re also starting to see defects in myelin in Alzheimer’s, ALS, and other diseases. It’s not as profound right now as MS, but there are other places this technology could have relevance.”
Source: Xconomy © 2007-2014, Xconomy, Inc (23/06/14)
Two teams of researchers report success in stimulating the repair of nerve-insulating myelin in mouse models of MS. Myelin is a major target of immune attacks in MS, and although these are early results and further work is needed, these findings show some promise for strategies to repair damage and restore function for people with multiple sclerosis.
Background: In MS, myelin, the material that surrounds and protects nerve fibers, is damaged in the brain and spinal cord, and so are the cells that make myelin, called oligodendrocytes. Though the replacement cells that could repair myelin, called oligodendrocyte precursor cells (OPCs), exist in the brain, in MS they cannot adequately repair the damaged myelin.
Stem Cell Study: Lu Chen, PhD, Thomas Lane, PhD (University of California, Irvine) and colleagues report that administering neural precursor cells (nerve stem cells) to mice with MS-like disease reduced inflammation, decreased myelin damage, and increased myelin repair. (Stem Cell Reports, published May 15, 2014)
The team injected the stem cells into the spinal cord of mice with an MS-like disease induced by a virus. Although the stem cells were rejected by the body, and were not detectable within eight days after transplant, they were effective nevertheless in reducing the disease. Improvements in motor abilities of the treated mice were still apparent after six months.
The team noted that improvements went along with an increase in a type of immune cell called “regulatory T cells,” or “Tregs.” To test whether the Tregs contributed to the improvements, they blocked Tregs activity, which reduced the stem cells treatments’ impact.
The team speculates that the stem cells may be stimulating the immune environment in a way that activates mouse OPCs, even though the stem cells themselves do not turn into myelin-making OPCs. They are now investigating this idea further to discover the factors released by the stem cells. Ultimately, this information could contribute to the development of stem cell therapies and even cell-free therapies that stimulate recovery in people with MS.
Stimulating Resident Cells: Jessica Williams, PhD, Robyn S. Klein, MD, PhD, and colleagues (Washington University School of Medicine) report that targeting a signaling receptor (docking site) called “CXCR7” on immature oligodendrocytes in mice enhances myelin repair (Journal of Experimental Medicine, published April 14, 2014).
Dr. Klein’s team focused on a messenger protein (chemokine) that interacts with the immature OPCs. They studied mice that were given a toxin called cuprizone, which mimics myelin damage that occurs in the brain during MS. Once cuprizone is withdrawn, myelin repair occurs. The team found that CXCR7 activity increased during myelin damage, and then reduced with myelin repair. When the team administered an experimental compound that inhibits CXCR7, the numbers of OPCs, as well as mature oligodendrocytes, increased within myelin-damaged areas. Myelin repair was enhanced.
These data suggest that CXCR7 might serve as an important therapeutic target to promote myelin repair. Since these studies were conducted in mice, further research is necessary to ultimately determine whether this approach might be an effective approach for stimulating myelin repair in people with MS.
Conclusion: Achieving success in the Society’s priority area of nervous system repair would provide life-changing advances for people with MS. Read more about this research strategy.
Source: US National MS Society (17/06/14)
Bionure Inc. has announced its drug candidate, BN201, was shown to promote myelination — the cellular process of repairing the protective sheath surrounding nerves that is damaged in people with multiple sclerosis (MS). The pre-clinical study was conducted in a novel cell-culture assay developed by the Myelin Repair Foundation (MRF) and assessed at the Foundation’s Translational Medicine Center under a previously announced collaborative agreement.
Bionure and the Myelin Repair Foundation are working together to evaluate BN201 as a potential myelin repair candidate for treating acute optic neuritis and the severe MS relapses that occur in some patients. Acute optic neuritis is a severe inflammation of the optic nerve that may lead to blindness in people with MS. Using the Foundation’s co-culture assay, the collaboration’s scientists were able to show BN201 promotes myelination in animal cells.
“We are working closely with scientists at the Myelin Repair Foundation’s Translational Medicine Center to advance the commercialization of BN201,” said Albert G. Zamora, CEO at Bionure, Inc. “The MRF’s myelin repair assay provided the confidence and independent validation to help us propel BN201 into clinical trials to determine its efficacy in humans. As a result, Bionure will now expand upon the intellectual property that we have for this compound.”
“We are delighted to collaborate with Bionure to advance a potential myelin repair therapeutic for MS and optic neuritis towards commercialization,” said Jay Tung, Ph.D., chief research officer at the Myelin Repair Foundation. “Our collaboration with Bionure exemplifies the value that our Translational Medicine Center brings to industry partners. Our goal is to leverage our non-profit status to partner with industry and accelerate the drug development of potential MS therapeutics that promote myelin repair.”
Source: MarketWatch Copyright © 2014 MarketWatch, Inc (27/05/14)
Real hope for modifying the disease course of multiple sclerosis (MS) may come from strategies to remyelinate damaged neurons and brain cells, says Catherine Lubetzki, MD, of the Pierre and Marie Curie University and Pitie-Salpetriere Hospital in Paris, France. Speaking on April 30, 2014, at the American Academy of Neurology’s 2014 annual conference in Philadelphia, PA, Lubetzki mapped out the pathway her lab is building from basic science to drug development for new MS agents.
She told the audience that treatments effectively targeting the inflammatory component of MS are still lacking. Pilot and phase 2 studies are underway with agents aimed at reducing inflammation, enhancing neuroprotection, and encouraging remyelination; however, the remyelination pathway in particular has not been well understood. Currently, the SPRINT-MS study for ibudilast in relapsing-remitting and primary progressive MS is underway with 250 patients planned to enroll. The phase 2 MS-SMART study of secondary progressive MS will enroll 440 patients in one of four treatment arms to receive riluzole, amiloride, ibudilast, or placebo.
Even given the current and emergent treatment landscape, remyelination, when it does occur, is insufficient to overcome chronic axonal damage and resultant disease progression. To understand why remyelination fails, the processes involved in oligodendrocyte precursor cell (OPC) activity must be made clear. These cells, which migrate to areas of plaque, mature, and eventually wrap around axons to remyelinate, do so through a four-step process. First, the cells are activated; then, they are recruited to migrate. Next, they achieve maturation before finally completing their wrap and myelination of the axon.
Lubetzki’s lab has used a mouse model to examine the transition from quiescent to activated OPCs, and to achieve a better understanding of the transcription profile of mature OPCs. Her group’s work shows that demyelination-induced activation of adult OPCs makes the cells revert to a less mature gene cell, providing cues to promote OPC motility, necessary for activation and recruitment of these cells to the demyelinated areas with plaque burden.
OPCs must then receive guidance for targeted migration to demyelinated areas. Two genes have been identified which seem to have opposing effects on OPC recruitment and remyelination rates. Overexpression of the Sema 3F gene has been associated with increased OPC recruitment and with increased remyelination rates, while overexpression of netrin has the opposite effect, decreasing OPC recruitment and reducing the rate of remyelination. Thus, a primary focus is to target Sema 3F at the lesion site, increasing the rate of remyelination by increased (and targeted) OPC recruitment. Critically, this must be accomplished early in the disease process, when axonal damage may still be reversible.
Lingo-1 has also been identified as a down-regulator of OPC activation and recruitment; researchers are also attempting to achieve early remyelination through use of an anti Lingo-1 monoclonal antibody. Two trials are currently underway examining this drug. The SYNERGY trial plans to follow 400 patients with relapsing-remitting MS over 18 months, while the RENEW trial for sufferers of optic neuritis (another inflammatory demyelinating disorder) will examine the drug’s effects on 80 patients over six months.
Fielding questions from the overflow crowd following the presentation, Lubetzski discussed the outcome measures under consideration to measure efficacy of these drugs in humans. In addition to using magnetic resonance imaging to show remyelination and to follow brain atrophy, positron emission tomography using a myelin ligand may become clinically useful. However, she also emphasized the primacy of maintaining a patient-centered focus, and the critical importance of paying attention to improvement in clinical endpoints.
Source: HCP Live Copyright HCPLive 2006-2014 (02/05/14)
Targeting CXCR7/ACKR3 as a therapeutic strategy to promote remyelination in the adult central nervous system
Current treatment modalities for the neurodegenerative disease multiple sclerosis (MS) use disease-modifying immunosuppressive compounds but do not promote repair. Although several potential targets that may induce myelin production have been identified, there has yet to be an approved therapy that promotes remyelination in the damaged central nervous system (CNS).
Remyelination of damaged axons requires the generation of new oligodendrocytes from oligodendrocyte progenitor cells (OPCs). Although OPCs are detected in MS lesions, repair of myelin is limited, contributing to progressive clinical deterioration.
In the CNS, the chemokine CXCL12 promotes remyelination via CXCR4 activation on OPCs, resulting in their differentiation into myelinating oligodendrocytes. Although the CXCL12 scavenging receptor CXCR7/ACKR3 (CXCR7) is also expressed by OPCs, its role in myelin repair in the adult CNS is unknown. We show that during cuprizone-induced demyelination, in vivo CXCR7 antagonism augmented OPC proliferation, leading to increased numbers of mature oligodendrocytes within demyelinated lesions.
CXCR7-mediated effects on remyelination required CXCR4 activation, as assessed via both phospho-S339-CXCR4-specific antibodies and administration of CXCR4 antagonists.
These findings identify a role for CXCR7 in OPC maturation during remyelination and are the first to use a small molecule to therapeutically enhance myelin repair in the demyelinated adult CNS.
Williams JL, Patel JR, Daniels BP, Klein RS.
Sources: J Exp Med. 2014 Apr 14 & Pubmed PMID: 24733828 (29/04/13)
Harvard neuroscientists have made a discovery that turns 160 years of neuroanatomy on its head.
Myelin, the electrical insulating material long known to be essential for the fast transmission of impulses along the axons of nerve cells, is not as ubiquitous as thought, according to a new work lead by Professor Paola Arlotta of the Harvard Stem Cell Institute (HSCI) and the University's Department of Stem Cell and Regenerative Biology, in collaboration with Professor Jeff Lichtman, of Harvard's Department of Molecular and Cellular Biology.
"Myelin is a relatively recent invention during evolution," says Arlotta. "It's thought that myelin allowed the brain to communicate really fast to the far reaches of the body, and that it has endowed the brain with the capacity to compute higher level functions." In fact, loss of myelin is a feature of a number of devastating diseases, including multiple sclerosis and schizophrenia.
But the new research shows that despite myelin essential roles in the brain, "some of the most evolved, most complex neurons of the nervous system have less myelin than older, more ancestral ones" Arlotta, co-director of the HSCI neuroscience program, says.
What this means, Arlotta says, is that the higher in the cerebral cortex one looks - the closer to the top of the brain, which is its most evolved region - the less myelin one finds. Not only that, but "neurons in this part of the brain display a brand new way of positioning myelin along their axons that has not been previously seen. They have 'intermittent myelin' with long axon tracts that lack myelin interspersed among myelin-rich segments.
Arlotta continues: "contrary to the common assumptions that neurons use a universal profile of myelin distribution on their axons, the work indicate that different neurons choose to myelinate their axons differently. In classic neurobiology textbooks myelin is represented on axons as a sequence of myelinated segments separated by very short nodes that lack myelin. This distribution of myelin was tacitly assumed to be always the same, on every neuron, from the beginning to the end of the axon. This new work finds this not to be the case."
The results of the research by Arlotta and post doctoral fellow Giulio Srubek Tomassy, the first author on the report, are published in the latest edition of Science, the journal of the American Association for the Advancement of Science.
The paper is accompanied by a "Perspective" by R. Douglas Fields, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, at the National Institutes of Health, who says that Arlotta and Tomassy's findings raise important questions about the purpose of myelin, "are likely to spark new concepts about how information is transmitted and integrated in the brain."
Arlotta and Tomassy collaborated closely on the new work with postdoctoral fellow Daniel Berger of the Lichtman group, which generated one of the two massive electron microscopy data bases that made the work possible.
"The fact that it is the most evolved neurons, the ones that have expanded dramatically in humans, suggests that what we're seeing might be the "future". As neuronal diversity increases and the brain needs to process more and more complex information, neurons change the way they use myelin to "achieve" more", says Arlotta.
It is possible, said Tomassy, that these profiles of myelination "may be giving neurons an opportunity to branch out and 'talk' to neighboring neurons". For example, because axons cannot make synaptic contacts when they are myelinated, a possibility is that these long myelin gaps may be needed to increase neuronal communication and synchronize responses across different neurons. Perhaps, he and Arlotta postulate, the intermittent myelin is intended to fine-tune the electrical impulses traveling along the axons, in order to allow the emergence of highly complex neuronal behaviors.
Source: News-Medical.Net (22/04/14)
For a healthy nervous system, axons—the long projections of our nerve cells that run throughout our bodies—must be properly insulated.
Much like conventional power cords need electrical insulators around the conducting wires for efficient and effective transfer of current, axons rely on multiple bilayers of myelin to maintain a rapid and optimal transfer of impulses between, for instance, brain and organ, or spinal cord and muscle. These bilayers are composed of lipids (fat molecules), protein, and water.
“Basically, myelin is this multiple stacking of lipid bilayers,” says Dong-Woog Lee, a researcher in the chemical engineering department at the University of California, Santa Barbara. “They need to be compact, and with very little water between the bilayers.”
Lee and colleagues found that even the slightest change in the composition of these myelin bilayers affect their ability to insulate axons. Their findings could offer insights into demyelinating diseases, such as multiple sclerosis.
Stick Like Glue
To observe and measure the characteristics and differences between healthy and diseased myelin bilayers, they studied the ability of these layers to adhere to each other.
The researchers used a highly sensitive instrument, called the surface forces apparatus, that can measure interactions between membranes. The deposited a lipid bilayer on a mica substrate on each of the two opposing surfaces of the apparatus.
Then they immersed the setup in a buffer solution containing myelin basic protein (MBP), a biomolecule commonly found in myelin that gives them adhesive properties and plays a role in maintaining the optimal structure of the myelin sheath.
They brought the two bilayers close together, allowing them to stick to each other, and then pulled them apart, measuring the strength of the adhesion brought about by the MBP “glue” between the bilayers, and also the MBP’s adsorption—the ability of the MBP molecules to stick to the bilayers’ surfaces.
They performed this experiment with both healthy myelin and with “disease-like” myelin bilayers.
“A lipid bilayer simulating a normal or healthy myelin membrane adsorbs this protein much better than a lipid bilayer simulating a multiple sclerosis-type of myelin membrane,” says UC Santa Barbara researcher Kai Kristiansen, “meaning that the protein attaches more strongly to the lipid bilayer and can make two apposing lipid bilayers adhere more firmly to each other and at a smaller distance—which is highly desirable for a well functioning myelin around a neuron.”
Swelling and Multiple Sclerosis
One common characteristic of diseased myelin is swelling, due to various causes such as the autoimmune responses associated with multiple sclerosis and its variants, or in cases of infection or exposure to certain chemicals. Genetics also play a role in the health of myelin.
“When the disease progresses, people can see that they swell and eventually vesiculate, creating scars,” says Lee, who is lead author of the study published in the Proceedings of the National Academy of the Sciences.
The MBP layer between the lipid bilayers also swells with water that seeps in between the double lipid layers. Instead of being a compact, molecule-thick film, the MBP layer becomes more gel-like.
“And since there’s more water between the bilayers, their insulation property decreases,” says Lee. From there, impulses slow down along the axon, or dissipate before they reach their destinations, causing paralysis and loss of function.
Disease–related changes in the lipid domain structures’ size and distribution also causes irregular adsorption of MBP onto the lipid bilayers and weakens their adhesion properties. This in turn also leads to lower nerve insulation.
The next step, according to Jacob Israelachvili, professor of chemical engineering and of materials, is to develop a user-friendly bench-top instrument that could be used in hospitals and clinics to visualize the membranes of certain cells, both healthy and pathological, whose domain structure can be an indicator of the progression of a disease.
“We are currently planning a collaboration with a local hospital to provide us with such membranes, for example, from leukemic blood cells, that we would tag with a suitable fluorescent dye to enable this imaging,” he says.
Source: Futurity © 2014 Futurity (06/03/14)
Multiple Sclerosis is an autoimmune disease that affects the brain and spinal cord, destroying tissue and cells along the way. Previous research and practices have found that therapies can help with relapses of MS, but cannot help repair the tissue and cells that have been affected.
After MS has affected the body and caused cell damage, the brain produces new cells to repair the old ones. However, a majority of cases has shown that there are unknown factors that hinder the cells from completely repairing, thus creating a permanent loss. The brain inflammation caused by MS leads to the destruction of myelin, which is the fatty insulation for the axon nerve fibers in the brain, thus destroying brain cells. A molecule known as Endothelin-1 (ET-1) is known to inhibit the repair of the myelin.
Yesterday, Gallo and his team of researchers reported their findings in Neuron and cited the effectiveness of a certain protein that could help fully repair previously damaged cells. This protein, known as "ET-R antagonist PD142,893" can be used therapeutically to promote remyelination and effectively block ET-1 from inhibiting cell repair.
"We demonstrate that ET-1 drastically reduces the rate of remyelination," Gallo said. "ET-1 is potentially a therapeutic target to promote lesion repair in deymyelinated tissue. It could play a crucial role in preventing normal myelination in MS and in other demyelinating diseases," Gallo said.
Source: Science World Report (10/02/14)
Some 2.5 million people around the world have multiple sclerosis (MS), a potentially debilitating disease in which the body's immune system destroys the protective sheath (myelin) that covers nerves.
This damage interferes with the communication between the brain, spinal cord and other parts of the body, causing symptoms that can range from a mild weakness to an inability to walk or speak clearly. There is no cure for MS, but there are some preliminary data showing that Vitamin D, retinoic acid or Vitamin A, may help alleviate these symptoms.
To determine if Vitamin A could help, the Conrad N. Hilton Foundation recently awarded the Los Angeles Biomedical Research Institute (LA BioMed) a $900,000 grant to study the role of serum Vitamin A in halting – or at least slowing – disease progression in people with Relapsing-Remitting MS. About 80% of MS patients have Relapsing-Remitting MS, in which new symptoms flare up and then go into remission.
"This grant will jump start this area of research in the United States," said Bijal Mehta, MD, MPH, the lead researcher for the LA BioMed study into Vitamin A. "This will be the first large-scale study of whether higher levels of Vitamin A in the bloodstream may lead to improved outcomes for people who have Relapsing-Remitting MS. If the study finds MS patients with higher levels of Vitamin A have reduced progression of the disease, we could then examine using Vitamin A as an additional treatment."
LA BioMed researchers plan to recruit 100 volunteers with Relapsing-Remitting MS to measure the Vitamin A levels in their blood. The researchers also will study Vitamin A's role in promoting repair to the myelin sheaths, which cover the nerves, a process known as remyelination. The research will examine Vitamin A's effectiveness in correlation with two commonly used MS medications: interferon-beta (Avonex, Rebif and Betaseron) or glatimer acetate (Copaxone).
Source: Phys Org © Phys.org™ 2003-2014 (07/01/14)
Study finds clues to understanding MS(02/01/14)
Scientists at the Sanford-Burnham Medical Research Institute have found a possible explanation for the loss of nerve function caused by multiple sclerosis and similar neurodegenerative diseases. The research provides a new approach to finding potential therapies.
A protein called contactin-1 is required to wrap nerves with myelin, a protective sheathing that enables proper function, the scientists found. When myelin is worn away, as in multiple sclerosis, nerves in the brain and spinal cord become damaged and don’t properly transmit sensory and motor signals.
Multiple sclerosis is considered an autoimmune disease, in which the body’s own immune system attacks the nerves for some unknown cause.
Contactin-1 acts like a messenger coordinating a construction crew. It directs myelin formation around axons, the long strands that carry impulses down nerve cells, said Barbara Ranscht, who led the research. Without the protein, myelin-producing cells called oligodendrocytes don’t do their jobs.
The study was published in the Proceedings of the National Academy of Sciences. Ranscht was senior author; Gülsen Çolakoglu was first author.
Working in mice, the researchers found the protein was produced in both the oligodendrocytes and the axons during myelination.
The researchers also inactivated the gene for making contactin-1 in mice. The offspring died shortly after birth, displaying a greatly reduced production of myelin. Moreover, what myelin was produced wasn’t functional, because it wasn’t attached to the axons, Ranscht said.
Myelin formation takes many steps that must be performed in harmony, Ranscht said.
“First of all, the axons need to be there, then the oligodendrocytes come to the axons. They proliferate, they make more cells, then the cells align nicely along the axons, then they get signals from the axons to make the myelin,” she said. “The axons get signals from the oligodendrocytes to be myelinated. It’s a constant cross-talk between the two different cells. What we show in the paper is that contactin is absolutely necessary for this cross-talk.”
Although the study was performed in animals, there’s evidence of the protein’s role in people. A 2011 paper in PNAS found that contactin-1 is involved in development of precursor cells to the myelin-forming oligodendrocytes. Moreover, a 2009 study also in PNAS found that a related molecule called contactin-2 is targeted in an autoimmune response in multiple sclerosis patients.
The study is impressive, said P. Hemachandra Reddy, a neuroscientist at Oregon Science & Health University who published his own research on multiple sclerosis Dec. 26. Reddy and colleagues found that an antioxidant called MitoQ reverses symptoms in mice with an MS-like demyelinating disease.
“This is a very well-executed study,” Reddy said. “I am excited to see this paper.”
The paper described the function of contactin-1 in the optic nerve, providing an explanation for why multiple sclerosis patients may experience blurred vision, Reddy said.
“We did not look at the contactin protein levels in our study; we are going to look at it now, because it makes a lot of sense,” he said. “Maybe MitoQ is enhancing contactin levels.”
Ranscht emphasized that the Sanford-Burnham study represented basic research, and years of further work would be needed before any potential drug could be found. But on the positive side, the research provides a clear guide about what to look for, namely a drug that restores contactin functioning.
“This is something that is a top priority on our research list. ... Is this really the molecule that might help to restore myelin in a demyelinating disease?” Ranscht said. “It’s exciting, because we have a candidate now to look for. That’s where we are. We don’t have a cure.”
Source: U-T San Diego © 1995-2014 The San Diego Union-Tribune (02/01/14)
Multiple sclerosis is a debilitating condition that involves the degeneration of myelin—the fatty tissue that insulates nerve fibers and helps them to conduct impulses. This process, called demyelination, can lead to deficits in sensation, movement and thought processes, depending on exactly which nerve fibers are affected. Replacing lost myelin is a promising approach for treating multiple sclerosis and related diseases, but the mechanisms underlying demyelination and remyelination remain poorly understood.
In research that opens up an encouraging avenue for the development of new treatments, Naoyuki Taniguchi and colleagues from the RIKEN–Max Planck Joint Research Center for Systems Chemical Biology have shown that remyelination is inhibited by sugar molecules called branched O-mannosyl glycans.
Taniguchi and his colleagues genetically engineered a strain of mice carrying mutations in the gene encoding an enzyme called N-acetylglucosaminyltransferase-IX (GnT-IX), which catalyzes the branching of O-mannosyl glycan sugars on proteins in the brain. Using these mice, the researchers found that GnT-IX acts on a specific brain protein called receptor protein tyrosine phosphatase ? (RPTP?), which has previously been shown to play a critical role in demyelination.
Next, the research team fed normal and mutant mice a diet containing the neurotoxin cuprizone, which normally induces demyelination. Over the course of eight weeks, the normal mice were found to have experienced gradual demyelination of the corpus callosum—a major tract of white matter connecting the two hemispheres of the brain. By contrast, although myelin in the corpus callosum had degraded by four weeks in the mutants, myelination had markedly increased by the eight-week mark, suggesting that the defect in the GnT-IX gene enhanced remyelination.
Further experiments revealed that cuprizone treatment can activate non-neuronal cells called astrocytes into a disease state, which leads them to express RPTP? containing branched O-mannosyl glycans. In wild-type mice, activated astrocytes express these branched O-mannosyl glycan molecules, which inhibit remyelination. In mice with a defective GnT-IX gene, however, astrocytes are rarely activated, and the absence of the branched O-mannosyl glycans allows the differentiation of myelin cells and the remyelination of nerve fibers in the corpus callosum.
"We would like to unveil the molecular mechanism by which branched O-mannosyl glycan activates astrocytes," says Taniguchi. "Understanding the underlying mechanism is important for developing a drug to treat multiple sclerosis."
The team next plans to screen for a GnT-IX inhibitor that attenuates astrocyte activation. "The difficult thing is that the drug has to pass through the blood–brain barrier, so collaboration with clinicians will be important," Taniguchi notes.
Primary Source: Kanekiyo, K., et al. Loss of branched O-mannosyl glycans in astrocytes accelerates remyelination, The Journal of Neuroscience 33, 10037–10047 (2013). dx.doi.org/10.1523/JNEUROSCI.3137-12.2013
Source: MedicalXpress © Medical Xpress 2011-2013 (04/10/13)
Scientists from ENDECE Neural presented preclinical data today showing that the company’s lead compound, NDC-1308, addresses one of the root causes of multiple sclerosis (MS) by significantly inducing remyelination in nerves that have been damaged by MS. In an oral presentation at the 29th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Copenhagen, Denmark, the ENDECE Neural researchers also reported a dramatic upregulation of genes in signaling pathways involved in myelin sheath production.
NDC-1308 works by inducing differentiation of oligodendrocyte progenitor cells (OPCs) into mature oligodendrocytes, cells that synthesize and maintain the myelin sheath that covers nerves in the brain and spinal cord, the researchers noted. By contrast, the female hormones estradiol and estriol do not exert that effect.
“Repair of the myelin sheath, called remyelination, has long been an elusive goal in the treatment of multiple sclerosis,” explained Steven Nye, Ph.D., Vice President of Discovery at ENDECE Neural. “The synthesis of NDC-1308, an estradiol analog, was inspired by observations that pregnant women typically do not experience the symptoms of MS during the third trimester. In our experiments, NDC-1308 induces remyelination in animal models of demyelination, compared to estradiol and estriol which appear to be neuroprotective but do not induce OPC differentiation.”
In his presentation, Dr. Nye described how he and his colleagues synthesized more than 40 proprietary estradiol analogs in which the core structure of estradiol had been modified, and assessed how subsets of those modifications changed the hormone’s biological activity. The researchers identified NDC-1308 as the most potent of several proprietary analogs having the ability to directly induce differentiation of OPCs into mature oligodendrocytes. NDC-1308 derives its novel biological activity from the addition of a specific alkoxyalklyl moiety to the C-6 position on the estradiol B-ring.
Dr. Nye reported the following findings:
- A 20% increase in remyelination (compared to vehicle control) of hippocampal regions of the brain (P<0.01) was associated with a 2-week course of NDC-1308 (50 mg/Kg once daily) in a mouse model of demyelination, in which the neurotoxicant cuprizone was used to remove the myelin sheath from the axons (nerve fibers) of mice.
- NDC-1308 caused a dramatic upregulation of key genes (5- to 75-fold) in signaling pathways involved in OPC differentiation and myelin sheath production.
- NDC-1308 significantly induced OPCs to differentiate into mature oligodendrocytes (P<0.05).
- NDC-1308 (3 μM/day for 4 days) enhanced remyelination in demyelinated rat brain slices visualized by staining for myelin basic protein, which was consistent with the mouse cuprizone data.
Prophylactic administration of NDC-1308 (10 mg/kg/day for 10 days) delayed the onset of MS symptoms and reduced the severity of MS in a mouse model of experimental allergic encephalitis (EAE) induced by myelin oligodendrocyte glycoprotein (MOG), suggesting that the compound may play a dual remyelination/anti-inflammatory role in treating MS. “Despite its structural similarity to estradiol and estriol, NDC-1308 differs from those two female hormones by virtue of its potent induction of remyelination, as demonstrated in animal models of MS,” commented James G. Yarger, Ph.D., chief executive officer and co-founder of ENDECE Neural. “Unlike estradiol and estriol, NDC-1308 induces OPC differentiation and maturation of oligodendrocytes. We envision administration of NDC-1308 either alone or in combination with current therapeutics that target the immune response and/or inflammation associated with MS. NDC-1308 may thus fill an unmet medical need for a remyelinating therapy in MS, one that may help improve the lives of patients living with this devastating neurological disease.”
NDC-1308 is a novel chemical entity designed to address one of the root causes of MS, and is being developed for potential use either alone or in combination with other MS therapeutics that slow the progression of the disease. By controlling key genes in pathways leading to myelin synthesis, NDC-1308 appears to induce restoration of the lost myelin sheath that is believed to cause the devastating symptoms of MS. NDC-1308 is a small molecule that readily crosses the blood-brain barrier, allowing it to reach the tissues in the brain and spinal cord where promoting myelin production is needed. ENDECE Neural discovered NDC-1308, and owns the intellectual property surrounding the compound.
Source: Rock Hill Herald Online © Rock Hill Herald Online (04/10/13)
A groundbreaking study in multiple sclerosis focusing on “remyelination in the brain” has been initiated by Omar Khan, M.D., professor and chair of neurology at the Wayne State University School of Medicine.
“This is a novel approach in the treatment of multiple sclerosis, which is characterized by diffuse demyelination and axonal loss in the central nervous system,” said Dr. Khan, who also serves as director of the Multiple Sclerosis Center and director of the Sastry Foundation Advanced Imaging Laboratory. “In this study, we are targeting remyelination in the central nervous system.”
Dr. Khan noted that there are 10 United States Food and Drug Administration-approved treatments for multiple sclerosis, none with any well-characterized reparative or remyelinating potential. Those treatments primarily focus on altering the behavior of the immune system and target inflammation.
However, this new approach targets remyelination in the central nervous system using a humanized monoclonal antibody that binds to the semaphorin 4D, a member of the semaphorin family of proteins and an important mediator of axonal growth cone guidance. Semaphorin-induced signaling also has been shown to induce growth cone collapse of neurons and apoptosis of neural precursors, and to induce process extension collapse and apoptosis of oligodendrocytes. Semaphorins consist of a family of soluble and membrane-bound proteins that were originally defined as axonal-guidance factors. These proteins play important roles in establishing precise connections between neurons and their appropriate targets.
“Therefore, it is a plausible target with the realistic goal of achieving remyelination,” Dr. Khan said. “This is a paradigm shift and the start of the next generation of therapies to treat multiple sclerosis that will change its focus to repair rather than inflammation.”
The brain can largely be divided into gray and white areas. Neurons are located in the gray area, and the white parts are where neurons send their axons – similar to electrical cables carrying messages – to communicate with other neurons and bring messages from the brain to muscles. The white parts of the brain are white because a cell type called oligodendrocytes makes a cholesterol-rich membrane called myelin that coats the axons.
The myelin’s function is to insulate the axons, similar to the plastic sheath coating electrical cables. In addition, the myelin speeds communication along axons and makes that communication more reliable. In patients with MS, their immune system attacks the myelin sheathing. The subsequent degradation leads to the messages from the brain to other parts of the body leaking and derailing from their intended target.
Restoring the myelin sheathing is the goal of Dr. Khan’s new study.
The Wayne State University Multiple Sclerosis Center, in collaboration with Vaccinex, a privately-held biotechnology company headquartered in Rochester, N. Y., initiated this early stage dose-defining study.
“If successful, this will lead to large scale studies with this molecule targeting remyelination in the brain as a primary focus, detected by advanced imaging techniques such as magnetization transfer ratio,” Dr. Khan said. “The real challenge will be to reverse or reduce conduction blocks in the demyelinated nerve that may translate into neurologic improvement. If we could achieve that with this approach, it opens the door for hundreds of thousands of multiple sclerosis patients for whom no therapy is currently effective. This may also provide a unique opportunity in combining therapies with different mechanistic approaches.”
WSU is home to the only MS center in Michigan and among the 10 sites in the world undertaking this translational initiative. The center is among the top five MS centers in the U. S., with more than 4,000 patients. The center is involved in cutting-edge immunologic, genetic, MR imaging and therapeutic studies.
Dr. Khan said only three molecules in the world, including this monoclonal antibody, are being investigated in patients with multiple sclerosis that focus on remyelination. “It is humbling to lead such a unique groundbreaking effort and that Wayne State University is one of the few centers in the world that are participating in this next true generation translational research,” he said. “The patients are observed over night at Harper University Hospital, which has been a great partner in facilitating this research endeavor.”
Multiple sclerosis affects more than 500,000 people (or one in 600) in the U.S. and more than 2 million worldwide. After trauma, it is the most common cause of disability in young adults. While there is no cure, several treatments are approved for the relapsing form of multiple sclerosis that reduces the frequency of flare-ups and slows disease progression.
This study was funded by Vaccinex.
Source: Newswise ©2013 Newswise, Inc (19/09/13)
University of Chicago researchers awarded NIH grant to develop novel multiple sclerosis treatment(18/09/13)
Researchers from the University of Chicago have been awarded a five-year, $1.5 million grant from the National Institutes of Health (NIH) to develop stimulated dendritic cell-derived exosomes that show remarkable promise as a treatment for multiple sclerosis and other neurological diseases involving loss of myelin, the insulation around nerve fibers.
Exosomes produced in the blood appear to play a causal role in the protective effects of regular exercise and learning, collectively known as "environmental enrichment," on the brain. These exosomes contain specific microRNAs that promote myelination of aging brain as well as brain damaged by multiple sclerosis modeled in animal brain tissues.
Based on this discovery, the Kraig lab is currently exploring the possibility of using cultured dendritic cells to recreate this effect. To do so will open new research opportunities for treatment of disorders that occur with a loss of myelin.
Led by Richard Kraig, MD, PhD, the William D. Mabie Professor in the Neurosciences in the department of Neurology at the University of Chicago, the research project is part of the Extracellular RNA Communication program, which aims to better understand extracellular RNA. This new initiative is supported by the NIH Common Fund, which funds high-impact, trans-NIH projects that have the potential to dramatically affect biomedical research over the next decade.
The Kraig project focuses on exosomes-small lipid vesicles that carry protein, RNA, and importantly, non-coding, extracellular microRNA, which are thought to enable cell-to-cell communication throughout the body.
Kraig and his team, which includes Aya Pusic and Kae Pusic, PhD, discovered that dendritic cells, professional antigen presenting cells of the immune system, can be stimulated by factors released during environmental enrichment to produce exosomes containing microRNAs that improve brain health.
When applied to cultured brain tissue or administered nasally to live animals, these dendritic cell-derived exosomes significantly increased baseline levels of myelin-the protective sheath around neurons, which is damaged in multiple sclerosis. Importantly, exosome administration also improved the recovery of demyelinated nerve cells, which serve as a model for multiple sclerosis.
"All evidence suggests these exosomes can be crafted into a novel therapy to treat multiple sclerosis," Kraig said. "The NIH Common Fund grant allows us to pursue the development of this promising discovery, while simultaneously characterizing its basic mechanisms."
Dendritic cell-derived exosomes have no known toxic effects, can cross the blood-brain barrier without use of an additional delivery vehicle and are scalable for mass production through laboratory-cultured dendritic cells. These traits make them an extremely promising treatment for multiple sclerosis and many other neurodegenerative diseases that involve loss of myelination, such as traumatic brain injury. They may also be useful in slowing the degradation that occurs with normal aging.
The Kraig lab will investigate the underlying biological mechanisms and functions of the extracellular microRNAs contained in stimulated dendritic cell-derived exosomes. In addition, the team will study a promising link between these exosomes, reduced oxidative stress and increased antioxidant levels seen in treated brains, effects they hope also will lead to potential therapeutics for neurological diseases.
"We believe that we have identified a naturally occurring mechanism by which increased exercise and learning improves brain health through myelination," said Kraig. "Importantly, we have also discovered a way to mimic this nutritive effect through the use of cultured dendritic cell-derived exosomes containing specific microRNAs."
Source: News-Medical.Net (18/09/13)
Scientists from ENDECE Neural presented pre-clinical data this week showing that the company's lead compound, NDC-1308, can address one of the root causes of multiple sclerosis (MS) by inducing remyelination (restoration of the lost myelin sheath in nerves that have been damaged by MS). The results, which were presented at the CNS Diseases World Summit 2013 in Boston, suggest that NDC-1308 can induce remyelination in an animal model of demyelination, in which the neurotoxicant cuprizone was used to remove the myelin sheath from the axons (nerve fibers) of mice.
According to the researchers, NDC-1308 induces differentiation of oligodendrocyte progenitor cells (OPCs) into mature oligodendrocytes (cells that synthesize and maintain the myelin sheath that covers nerves in the brain and spinal cord).
"For decades, researchers have been seeking ways to induce remyelination in diseases such as MS that are characterized by demyelination," noted James G. Yarger, Ph.D., chief executive officer and co-founder of ENDECE Neural. "Observations that pregnant women typically do not experience the symptoms of MS during the third trimester have led researchers to investigate various forms of synthetic estrogen for the treatment of MS. Our research shows that the estradiol analog NDC-1308 can induce remyelination in demyelinated axons in a cuprizone animal model of demyelination."
In their poster presentation, Dr. Yarger and colleagues described how they synthesized more than 40 proprietary estradiol analogs in which the core structure of estradiol had been modified, and assessed how those modifications changed the hormone's biological activity. NDC-1308 was identified as the most potent of several proprietary analogs having the ability to directly induce differentiation of OPCs into mature oligodendrocytes. By contrast, the female hormones estradiol and estriol do not exhibit that activity. The investigators reported the following findings:
-- In a cuprizone mouse model of demyelination, a 2-week course of NDC-1308 (50 mg/Kg once daily) was associated with a 20% increase in remyelination of hippocampal regions of the brain (P<0.01) in proof-of-concept studies.
-- Consistent with the mouse cuprizone data, NDC-1308 enhanced remyelination in demyelinated rat brain slices in culture visualized by staining for myelin basic protein.
-- NDC-1308 induced isolated OPCs to differentiate into mature oligodendrocytes in culture, whereas estriol and estradiol did not (P<0.01).
-- NDC-1308 caused a dramatic upregulation of genes (5- to 75-fold) in signaling pathways involved in OPC differentiation and myelin sheath production.
"While NDC-1308 is structurally similar to estradiol and estriol, it differs from those two female hormones in that it potently promotes remyelination by inducing OPC differentiation and maturation of oligodendrocytes at the sites of demyelination," explained co-investigator Bruce D. Trapp, Ph.D., who is chair of the Department of Neurosciences at the Lerner Research Institute at the Cleveland Clinic. "NDC-1308 induces significant remyelination of axons in the demyelination model in mice."
"There is a large market opportunity for NDC-1308, as no commercially available drug is capable of directly restoring the lost myelin sheath on damaged axons in patients with MS," added Dr. Yarger. "Dependent on the outcome of clinical studies, we envision NDC-1308 being administered either alone or in combination with current therapeutics that target the immune response and/or inflammation associated with MS. By inducing remyelination, it may be possible to restore muscle control, mobility, and cognition in patients with MS. Therefore, a drug that induces remyelination, such as NDC-1308, could potentially double the size of the current market for MS therapeutics."
NDC-1308 is a novel chemical entity designed to address one of the root causes of MS, and is being developed for potential use either alone or in combination with other MS therapeutics that slow the progression of the disease. By controlling key genes in pathways leading to myelin synthesis, NDC-1308 appears to induce restoration of the lost myelin sheath that is believed to cause the devastating symptoms of MS. NDC-1308 is a small molecule that readily crosses the blood-brain barrier, allowing it to reach the tissues in the brain and spinal cord where promoting myelin production is needed. ENDECE Neural discovered NDC-1308 in-house, and owns the intellectual property surrounding the compound.
Source: Market Watch Copyright © 2013 MarketWatch, Inc (10/09/13)
Sleep may play a key role in the production and repair of myelin, the protective covering of nerve cells that is attacked and damaged in people with multiple sclerosis, according to early research in mice carried out at the University of Wisconsin.
The research found that the rate of production of a type of brain cell called oligodendrocyte precursor cells (OPCs) doubled in sleep relative to waking. OPCs are a type of cell that give rise to myelin in both healthy and injured adult brains.
“OPCs are among the few brain cells that in an adult brain keep proliferating and dividing and producing more cells,” said Dr. Chiara Cirelli, a professor in the department of psychiatry at the University of Wisconsin and senior author on the paper, which was published online Sept. 4 in The Journal of Neuroscience. “Most all neurons in the adult brain don’t do that—that’s why people are studying them now quite extensively.”
Cirelli began studying the functions of sleep about 15 years ago, by looking at all the genes that change in an animal’s brain during sleep versus waking. In a 2004 study in the journal Neuron, her research group found that up to five percent of genes expressed in the cortex or "gray matter" of the brain change solely due to whether an animal is asleep or awake.
In the current study, they looked specifically at OPCs, a type of glial cell. Glial cells are all the brain cells that are not neurons, and used to be thought of as simply the "glue" of the brain, whose only function was to support the neurons. Now, the glia, which have been discovered to help maintain the brain’s internal equilibrium and produce myelin (among other functions), are the subject of intense scientific focus.
In Cirelli’s current research, sleep triggered genes produced OPCs, while sleep deprivation led to a suppression of these genes and more activity in genes that have been implicated in cell death and stress responses.
The findings suggest that chronic sleep loss could aggravate symptoms of diseases like MS which involve damage to myelin, Cirelli said, but there is a lot more work to be done before any firm conclusions can be drawn in people.
“Disturbed sleep may aggravate perhaps the symptoms of the disease, in a vicious cycle,” she said. “It would be nice to try to block the vicious cycle and improve the quality of sleep in these patients.”
Multiple sclerosis, which affects 400,000 people in the United States and has no cure, is a disease in which the body’s own immune system attacks the myelin surrounding nerves and can cause numbness, paralysis and loss of vision.
In Cirelli’s study, the rate of OPC production was particularly high during rapid eye movement (REM) sleep, which the researchers determined using brain wave measurements in sleeping mice. REM sleep, which is when people typically dream, occurs at the tail end of a regular sleep cycle.
“What this means, we don’t know,” Cirelli said, “but there might be hormonal changes in non-REM versus REM sleep.”
For example, in older adults prolactin (a hormone which regulates the immune system and is involved in nursing) is released during REM sleep, and studies in pregnant women have shown that as prolactin increases, symptoms of MS decrease.
“This is just speculation, though,” Cirelli points out. She hopes that other researchers will take up the study of sleep and OPCs in MS.
“It would be nice if someone could follow up and just look to see if there is any indication if the symptoms of the disease are aggravated during periods of especially severe sleep deprivation,” she said.
Her research group plans to study the effect of sleep on gene activation in other glial cells, called astrocytes.
Source: cleveland.com © 2013 Northeast Ohio Media Group LLC (06/09/13)
New treatments that could help slow the progression of multiple sclerosis could be a step closer due to research by Edinburgh University.
In MS patients the protective layer around nerve cells in the brain, known as myelin, is broken down.
Scientists have discovered that immune cells, known as macrophages, help trigger the regeneration of myelin.
The researchers hope their work could eventually lead to the development of new drugs.
The sheath around nerves cells, made of myelin, is destroyed in MS, leaving the nerves struggling to pass on messages.
This leads to problems with mobility, balance and vision. There is no cure but current treatments concentrate on limiting the damage to myelin.
Now the team at Edinburgh University has found that the immune cells, known as macrophages, can release a compound called activin-A, which activates production of more myelin.
Dr Veronique Miron, from the Medical Research Council Centre for Regenerative Medicine at the university, said: "In multiple sclerosis patients, the protective layer surrounding nerve fibres is stripped away and the nerves are exposed and damaged.
"Approved therapies for multiple sclerosis work by reducing the initial myelin injury - they do not promote myelin regeneration.
"This study could help find new drug targets to enhance myelin regeneration and help to restore lost function in patients with multiple sclerosis."
The study, which looked at myelin regeneration in human tissue samples and in mice, was funded by the MS Society, the Wellcome Trust and the Multiple Sclerosis Society of Canada.
The findings are published in Nature Neuroscience.
Scientists now plan to start further research to look at how activin-A works and whether its effects can be enhanced.
Dr Susan Kohlhaas, head of biomedical research at the MS Society, said: "We urgently need therapies that can help slow the progression of MS and so we're delighted researchers have identified a new, potential way to repair damage to myelin.
"We look forward to seeing this research develop further."
Source: BBC News © British Broadcasting Corporation 2013 (22/07/13)
The Myelin Repair Foundation (MRF) today has granted a non-exclusive sublicense to Biogen Idec for the use of MRF's technologies to generate a novel mouse model for all demyelinating diseases, including multiple sclerosis (MS). Biogen Idec, an independent biotechnology company with a strong focus on multiple sclerosis therapies, will use the MRF technology in its in-house drug discovery programs. The Myelin Repair Foundation and Biogen Idec will collaborate to improve the licensed technologies to enhance discovery of myelin repair therapeutics and speed clinical development.
Novel technologies such as this mouse model come as a direct result of MRF's Accelerated Research Collaboration™ (ARC™) model, which centers on a collaborative research approach that accounts for the entire continuum of therapeutics development, from early research through clinical trials. The DTA mouse model was pioneered by MRF Principal Investigator Dr. Brian Popko, Ph.D., and Dr. Maria Traka, Ph.D., both from the University of Chicago, in collaboration with MRF Principal Investigator Dr. Stephen Miller, Ph.D. and Dr. Joseph Podojil, Ph.D., both from Northwestern University. The most commonly used models for MS currently mimic the hyperactive inflammatory process in MS patients. The DTA model is unique because demyelination is the result of the specific loss of the principal target cells in multiple sclerosis, thus facilitating the identification of potential treatments that will restore myelin production by these target cells.
“Our collaboration with the Myelin Repair Foundation will incorporate their technology into our evaluation of novel approaches to stimulating myelin repair,”? said Ken Rhodes, Vice President of Neurology Research, Biogen Idec. “Our collaborative efforts with MRF scientists will evaluate drug candidates' effectiveness in reversing myelin damage and hopefully advance R&D efforts for a new generation of MS therapeutics.”?
“We are thrilled to collaborate with Biogen Idec as a demonstration of our commitment to patients,”? said Scott Johnson, CEO, founder and president of the Myelin Repair Foundation. “We feel it is unique that as a nonprofit research organization, we are licensing our technology to a pharmaceutical company to support drug discovery of MS therapeutics. The MRF's Accelerated Research Collaboration model is designed to translate academic research discoveries to the industry setting. With Biogen Idec by our side, our goal is to utilize improved technology to advance MRF programs for myelin repair therapies into the clinic, to ultimately impact patients with MS.”?
The DTA model displays characteristics reminiscent of the progressive form of MS, not yet available in any other mouse model. The DTA mouse model is designed to facilitate the discovery of drugs for MS and other demyelinating diseases. Currently, there are no treatments on the market to repair myelin damage from MS. This chronic disease is typically due to active degeneration of the myelin sheath surrounding the nerves and inadequate repair of the damage.
Source: Myelin Repair Foundation (02/07/13)
A skin patch delivering peptides derived from the presumed autoimmune target in multiple sclerosis reduced relapse frequency and brain lesions in a pilot clinical trial, researchers said.
In 30 patients with relapsing-remitting MS enrolled in the 1-year, placebo-controlled trial, those receiving the myelin skin patches containing 1 mg of peptides had an annualized relapse rate of 0.43 versus 1.4 in patients treated with a placebo patch (P=0.007), according to Krzysztof Selmaj, MD, PhD, of the Medical University of Lodz in Poland, and colleagues.
The mean cumulative number of gadolinium-enhancing brain lesions per patient was lower with the 1 mg patch by 66.5% compared with controls (0.0085 versus 0.0255, P=0.02), they reported online in JAMA Neurology.
However, a 10-mg patch appeared to be substantially less effective than the lower-dose patch. Brain lesion counts and volumes in this group (which had only four patients) were similar to those in the placebo group, even as the mean annualized relapse rate was lower at 0.25 than in either of the other two treatment arms (P not reported).
Selmaj and colleagues speculated that the higher peptide dose in the 10-mg patch may have triggered increased pathological immune cell activity, potentially "inducing a number of specific T cells to differentiate into effector cells," they wrote.
No serious adverse events were reported. Patch-site reactions of "modest intensity" were seen in four of the 20 patients receiving the myelin patches. Other adverse effects occurred at similar rates in all three arms.
In an accompanying commentary, Lawrence Steinman, MD, of Stanford University, called the results "promising" and added that they were consistent with what many in the field have considered the Holy Grail in MS: the induction of immunological tolerance.
MS is widely believed to result from an autoimmune attack on myelin, the principal component of the sheathing that surrounds nerve fibers. When the myelin sheaths become sufficiently degraded, nerve function is impaired as well.
But, compared with the drug-development effort industry has expended toward agents that interfere with some aspect of immune function, comparatively little has focused on persuading the immune system to stop attacking myelin in the first place, Steinman indicated.
"It is clear that the pharmaceutical industry is taking the safer approach, the 'well-traveled road,' when they redirect drugs with a major impact on immune function, drugs often already approved for other diseases," he wrote, alluding to drugs such as anti-CD20 drugs including rituximab (Rituxan) and ocrelizumab and the anti-CD52 agent alemtuzumab (Lemtrada).
Hitting those targets "results in massive perturbation and deletion of major components of the immune system, an approach well worth taking in malignancy, but an approach that could prove problematic in the long run for chronic autoimmune diseases of the nervous system," Steinman wrote.
In the current study, Selmaj and colleagues selected three myelin-based peptides (without industry funding or participation) that could be delivered transdermally from patches placed on the upper arm. These peptides included epitopes that earlier studies had suggested were targeted for immune attack in MS patients.
The patches were formulated to deliver 1 or 10 mg of these peptides or saline -- 10 patients received the saline patches, 16 the 1-mg patch, and four the 10-mg patch. The patches were changed weekly during the first 4 weeks and then monthly for 11 months. Patients and clinical staff were blinded to treatment assignments; the patches were visually identical.
Reflecting the clinical MS population, most patients were women. The mean age was about 37, with duration of MS symptoms averaging about 8 years and baseline EDSS disability scores averaging 2.6. Mean annualized relapse rate prior to enrollment was 1.1.
After one year in the study, the number of relapse-free patients and the number showing disability progression in each treatment group were as follows:
Placebo: relapse free, 1/10; progressive disability, 7/10
1 mg myelin: relapse free, 10/16; progressive disability, 3/16
10 mg myelin: relapse free, 3/4; progressive disability, 1/4
Mean EDSS scores increased by 0.75 in the placebo group versus 0.08 and 0.00 in the 1- and 10-mg patch groups, respectively.
MRI results showed a more mixed picture, especially with respect to the 10-mg group. The mean cumulative number of gadolinium-enhancing lesions with 10 mg was actually higher than in the placebo group (0.0341 versus 0.0255), and the volume of those lesions was nearly doubled with the 10-mg patch versus placebo.
But the mean cumulative number of new T2 lesions was lower with both the 1- and 10-mg patches (0.75 and 1.25, respectively) than in the placebo group (2.4).
Mean T1 lesion volume decreased in both of the myelin patch arms whereas it increased with placebo, yet mean T2 lesion volume decreased only with the 1-mg patch.
Overall, Selmaj and colleagues concluded that "the efficacy and safety profiles that have emerged from this study make the transdermal application of a mixture of three myelin peptides, an attractive and promising therapeutic approach in patients with relapsing-remitting MS."
And, in line with Steinman's cautions about untoward immune effects of other treatment strategies, Selmaj and colleagues suggested that myelin peptide delivery would "spar[e] other mechanisms critical for immune protection."
Steinman suggested that the same approach could also yield good results in other neuroimmunological diseases thought to have single-antigen autoimmune targets -- specifically, neuromyelitis optica and myasthenia gravis. The self-antigen damaged in the former is aquaporin 4, while in the latter it's the acetylcholine receptor molecule
The study had no external funding.
Selmaj and colleagues reported relationships with Novartis, Biogen Idec, ONO Pharma, Genzyme, Roche, Synthon, Teva, and Merck Serono.
Steinman reported serving as founder of a company, Tolerion, aimed at developing antigen-specific tolerance therapies.
Source: Medpage Today © 2013 MedPage Today, LLC (02/07/13)