Neuroprotection

Image credit: Eric Kalkman, University of Glasgow

If we can find drugs that can protect nerves from damage then we have the potential to stop MS getting worse, and even reverse disability for some people.

Excitingly, neuroprotective therapies could be useful for all types of MS, which is not the case for disease modifying treatments (DMTs) we have right now.

Nerve damage in MS

Our brains are remarkable, but delicate. And the same is true of the billions of individual cells that make it up.

Nerve cell death is a natural part of ageing for everyone. But for people with MS, this happens at a faster rate, because more cells are being lost. You can see this on MRI scans, with our brains shrinking over time.

We used to think that MS only injured nerve cells by damaging myelin. But we now know that nerve damage can happen in areas of the brain or spinal cord where myelin is still intact.

It’s vital we find treatments that can protect nerves from damage.

How can we protect nerves?

The aim of neuroprotection is simple – to keep nerve cells happy, healthy and alive.

Researchers have identified a number of different targets to help us protect nerves. These include helping to control nerve cell signalling, and regulating the way that nerve cells use energy.

Clinical trial progress

We’ve not got any neuroprotective treatments available yet, but we’re getting closer. Researchers are testing the benefits of a number of neuroprotective treatments in clinical trials for progressive MS:

Nerve cell signalling

Nerve cells communicate with each other using a variety of chemicals. These chemicals are vital to help nerves work well, but we know that too much chemical signalling can be fatal.

Researchers are testing whether reducing these chemical signals, using a drug called riluzole, could help to protect nerves.

Keeping the power on

Nerve cells use a lot of energy. This is generated by tiny powerhouses spread throughout the cell called mitochondria. Scientists have found that mitochondria are damaged in MS, meaning nerves don’t get the energy they need, stop working properly and eventually die.

Our researchers are working hard to unravel the more of the mysteries of mitochondria. Once we understand what goes wrong with mitochondria in progressive MS, we can start developing therapies to fix it.

As part of the International Progressive MS Alliance, Dr Don Mahad and his team have developed animal models to see how problems with mitochondria affect symptoms. So far they’ve shown that it can cause fatigue and changes to walking.

Creating a healthy environment

Healthy cells require healthy surroundings. We know that when myelin is damage, debris and toxins build up around the nerves, causing inflammation.

Researchers are looking at ways to encourage the brain to clear this debris, creating a healthy environment for nerves.

Nerve cell transport

Inside every nerve there is a network of super highways that allow important molecules to go where they are needed.

Research suggests that in MS this transport system goes wrong, with traffic jams stopping the nerve working properly.

Ion channels

Nerves have special gateways all over them to let chemicals like sodium in and out, which is vital for nerve cells to send messages.

Researchers think that a build-up of sodium can damage the cell. They’re testing if drugs that block sodium channels can reduce damage and slow progression in MS in clinical trials. This includes trials of amiloride for secondary progressive MS, and phenytoin for optic neuritis.

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Our neuroprotection research

We’re investing in some exciting research to help protect nerves in MS.

MS Society Tissue Bank

Our Tissue Bank supports scientists around the world who are working to understand nerve damage in MS. It enables researchers to investigate what actually happens in the human brain and spinal cord in MS, and to identify new treatment targets.

>> Find out more about the MS Society Tissue Bank

Clinical trials

In 2017 we announced we’re co-funding a phase 3 trial to test if simvastatin can slow progression in secondary progressive MS. Simvastatin is commonly used to treat high cholesterol, but research suggests that it reduce inflammation and could protect nerves from damage. 

As well as funding the trial, we’re supporting researchers to understand how simvastatin works in more detail. Our scientists will use MRI to visualise changes in the brain of spinal cord of people taking simvastatin.

>> Read more about this research

We’re also co-funding an innovative phase 2 trial that’s testing if three existing drugs can slow progression in secondary progressive MS, called MS-SMART. Results are expected in 2018.

Key molecules

Our researchers are working to understand nerve damage in more detail and identify targets for drug development.

Every discovery brings new opportunities for us to develop neuroprotective treatments – and these could be effective for everyone with MS.

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The next research breakthrough is within reach

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