Discovery could help boost protection for MS patients

Researchers have discovered a natural mechanism in the body which could help prevent nerve damage for people with multiple sclerosis (MS).

In research spanning over decade, a team of from the University of Edinburgh discovered a molecular target which they believe can protect nerves from damage in MS.

The discovery, which has been hailed a ‘holy grail’, also points towards a common diabetes drug enhancing the new-found natural protection and potentially preventing the progression of disability in MS.

In MS, nerves become damaged when the protective coating that surrounds them – myelin – becomes damaged. This makes nerves less energy efficient and vulnerable to further damage, which causes disability over time.

Now, the team from the University of Edinburgh have discovered a natural mechanism in the body which tackles this issue. The mechanism, labelled ARMD (axonal response of mitochondria to demyelination), isn’t enough to stop myelin from being damaged by itself, but could be enhanced using the common diabetes drug pioglitazone.

Dr Don Mahad, lead author and senior clinical lecturer at the University of Edinburgh, said: “Disability in MS is caused by a loss of nerve fibres following damage to the myelin that protects them. Although our understanding of MS has vastly improved over the last two decades, new therapies still do not protect nerve fibres. Such protection is the Holy Grail in MS treatment – not only for the relapsing form of MS, which has various options available, but for progressive forms too, where treatment continues to lag behind.

“Our discovery shows that nerves respond to myelin damage by increasing the movement of mitochondria (the cell powerhouse, which produces energy) to the area of damage – a response we’re calling ‘ARMD’. Remarkably, we were able to enhance ARMD and protect these vulnerable nerves using the readily available diabetes drug pioglitazone. This is an incredibly important discovery – one we believe could finally bridge the gap in MS treatment.”

Current treatments for MS only address the damage that is caused by the immune system and this discovery could potentially address the need to protect nerves from further damage. 

Another discovery last year found that a diabetes drug was able to return cells to a more youthful state and encourage the regrowth of myelin. The study looked at the drug metformin and found it could reverse changes that happen to cells responsible for making myelin as they age, and restore their regenerative capacity. 

MS Society assistant director of research, Dr Emma Gray, said: “This represents another important stride towards our goal of stopping MS – and we believe that MS treatment could in the near future look completely different. People with MS will be prescribed a combination of therapies that work on every aspect of the condition: stopping immune attacks and relapses, protecting nerves from damage, and regenerating lost myelin. It will mean no-one needs to worry about their MS getting worse.

“Currently, there are no effective neuroprotective therapies available for MS, but Dr Mahad’s research demonstrates we are getting closer – and finding treatments for everyone with MS is now a very real prospect.”