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A brief history of nearly everything…about tackling progressive MS

Sir Geoffrey Owen, former editor of the Financial Times, was part of a family living with MS at a time when no effective treatments were available. Since then, great strides have been made in MS research.

Sir Geoffrey has been interviewing top MS scientists to find out where things stand today. In this blog, he tells us about the history of research into progressive MS.

Professor Robin Franklin, a leading MS scientist, has compared MS research to a house fire. To tackle a fire, first you need the fire brigade to put out the flames, then you bring in builders to restore the house to its pristine condition.

In MS, first you need to prevent immune attacks – which current treatments can do very effectively. But to stop progression you also need to repair the myelin damage – which is where many researchers are now focussing their efforts.

Putting out the fire

Multiple sclerosis was first identified in the 1800s, but for many years there was little understanding of what caused it or how to treat it. It wasn’t until the 1980s that the first drug to effectively treat relapsing MS became available.

Since then, over 12 treatments for relapsing MS have been developed, but there are still no treatments that can stop progression.

Building the foundations

One of the first major contributions to knowledge about myelin repair was made by Professor William Blakemore from Cambridge University. He discovered how myelin repair could happen naturally in the brain and spinal cord, and suggested that nerve damage in MS could be caused by a problem with that natural myelin repair process.

Another pioneer, Professor Martin Raff at University College London, discovered that the cells that produce new myelin, called oligodendrocytes, are produced by a special type of stem cell.

Since these discoveries, other scientists have been working to better understand what cells and processes are involved in myelin repair.

Putting up the walls

Building on these advances, scientists have looked for ways of promoting myelin repair. This research has recently reached early stage clinical trials.

In the UK, scientists used samples from the MS Society Tissue Bank to identify a molecule that has an important role in promoting myelin repair. The next step was to find a drug that would stimulate this molecule. The drug selected was a cancer drug called Bexarotene which is now in a phase 2 clinical trial, with results expected this year.

In the US, early trials of an anti-histamine drug called clemastine showed promising results and a larger trial is now being planned.

Unanswered questions

MS researchers are now trying to solve the final pieces of the myelin repair puzzle. We don’t know for sure whether myelin repair will completely prevent nerve damage or whether we also need other treatments that work directly on the nerves themselves.

It is also hard to tell when myelin repair has been successful. We need really sensitive tools to make sure we can see the positive effects of potential myelin repair drugs.

Optimism

The current state of MS research is better than it ever has been. We know more about the condition and the prospects for further breakthroughs are more promising than in many other neurodegenerative diseases.

Treatments for MS progression are within reach. The challenge now is to speed up scientific progress and bring new medicines into the clinic.

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Read Sir Geoffrey’s full paper