Article: Hopes Raised for Effectiveness of Multiple Sclerosis Drug

http://www.emaxhealth.com/39/5267.html


Hopes Raised for Effectiveness of Multiple Sclerosis Drug
Posted by:
University of Cincinnati
on 03-31-2006.

"A national research team report new insights into how anti-rejection
drug helps Multiple Sclerosis patients."



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Multiple Sclerosis Drug
Discovery of the mechanism of a drug being tested for the treatment of
multiple sclerosis (MS) has revealed that it's not only more effective
than first thought, but might also help in the management of other
autoimmune diseases, organ transplant rejection and even cancer.

A research team led by the University of Cincinnati's Bibiana
Bielekova, MD, report new insights into the role of the multiple
sclerosis drug daclizumab (Zenapax) in the March 27 online version of
the Proceedings of the National Academy of Sciences. The article will
appear in print April 11.

The exact cause of multiple sclerosis is unknown, but one theory is
that it may it be triggered by exposure to a viral infection or
environmental influences. The disease takes different courses in
different people and can go into remission for many years, recurring
occasionally or progressing quickly into degeneration of all motor
functions that control muscles, strength, vision and balance. The very
progressive form of the disease can end in death.

Scientists have long thought that in MS the specific white cells
(T-cells) that fight off infection actually turn on the body they are
supposed to protect, attacking the myelin sheath that protects the
nerves.

"Without the insulating cover, the nerve axons short-circuit, much like
a damaged electric cord might," says Dr. Bielekova, director of UC's
Waddell Center for Multiple Sclerosis. "Also, many nerve cells
(neurons) do not survive without myelin sheath."

It was also believed that since activated T-cells need a growth factor
called interleukin 2 for their function, drugs that can block the
interaction of interleukin-2 and T-cells could be used to control
multiple sclerosis.

Daclizumab is being tested against MS because it has already proved
useful in preventing rejection of transplanted organs, "and we thought
it works by inhibiting T-cell activation," Bielekova says.

Earlier research by Dr. Bielekova and her group showed that daclizumab
benefits MS patients, especially those who have highly inflammatory MS.
This latest study, sponsored by the National Institutes of Health
(NIH), involved 22 MS patients.

"We monitored T-cell function in patients who were injected with the
drug, expecting to see that the drug inhibited T-cell function," says
Dr. Bielekova.

"We didn't see that at all. To our surprise the T-cells were
functioning normally."

But something unexpected was happening-the numbers of T-cells
circulating in the blood of patients taking daclizumab were declining
by about 10 percent. Simultaneously, the number of immune cells known
as "regulatory natural killer cells," which are very rare in normal
human blood, increased.

Regulatory natural killer cells are known to proliferate in special
conditions, such as pregnancy or bone marrow transplantation.

"Not only did the number of regulatory natural killer cells increase in
patients treated with daclizumab," says Dr. Bielekova, "but that
expansion correlated with the treatment outcome--the more these cells
expanded, the better the MS patients did during the trial. And the
longer the patients were on the therapy, the more regulatory natural
killer cells they had and the better they responded to treatment."

"The best news is that natural killer cells are actually very efficient
immune cells that fight viruses or cancers," says Dr. Bielekova, "so it
appears that daclizumab doesn't damage the immune system. It only
shifts the emphasis of the immune reaction from T-cells to natural
killer cells. However, larger studies need to be performed to evaluate
the safety of long-term daclizumab therapy."

The current results, however, suggest that daclizumab might also help
in the management of autoimmune diseases, organ transplant rejection
and perhaps even cancer, she says.

Having found one drug pathway that appears to be important for the
treatment of MS, Dr. Bielekova says, "The hope is that we can learn how
to enhance this pathway by drugs that can be taken orally, rather than
injected." As a result of these findings by Dr. Bielekova's research
team, daclizumab is now being tested as a possible MS treatment in a
phase-2 trial across the United States, including UC, and Europe.

Dr. Bielekova is a member of the Neuroscience Institute, a
collaborative of nine academic departments at UC College of Medicine,
University Hospital and independent physician practice groups. The
institute is dedicated to patient care, research, education and the
development of new medical technologies.


Has anyone heard about this before??
Cyd

.

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