Professor Jeremy Chataway, from University College London, tells us about the work he’s doing to protect nerve cells from damage in MS
To stop MS, we need to protect nerves
When we talk about ‘neuroprotection’, we're talking about ways of protecting the brain from damage, by keeping nerve cells happy and healthy.
We used to think that nerve cells were only injured in MS when their protective myelin coating was attacked by the immune system. But we now know that nerve damage still happens even when the immune attacks have stopped.
We already have treatments that target the immune system in MS, and we're trying to ﬁnd treatments to repair myelin. But to really stop MS, we also need to protect nerves from damage.
Neuroprotective treatments have the potential to help everyone with MS. But they'll probably beneﬁt people with progressive MS the most, because neuroprotection is most important when the immune system isn’t the main problem.
Tackling energy, debris and transport
To protect nerves and keep them alive, we need to understand more about what makes them vulnerable to damage in the ﬁrst place.
One way is to make sure that nerve cells can generate the energy they need to work properly. If nerves don’t have enough energy they die. In MS, the energy system in cells doesn’t work properly, so we need to work out what goes wrong and how to ﬁx it.
The environment around nerves is important too. When myelin is damaged, debris can build up and cause inﬂammation. We need to clear up this debris so nerves have a safe environment and enough space for myelin repair.
In MS, the system that nerves use to transport important molecules to where they’re needed can go wrong. Finding out how to stop these trafﬁc jams could also restore some function
Neuroprotection trials are underway
There are many different aspects of neuroprotection to work on, but we’re already having success in clinical trials.
The MS-STAT1 trial tested whether simvastatin, commonly used to lower cholesterol, could reduce the loss of nerve cells. We found that simvastatin was able to reduce brain shrinkage. This suggests it can protect nerves and has the potential to slow or stop disability progression.
We’re excited to now be running the deﬁnitive trial to conﬁrm these encouraging results. The MS-STAT2 trial started recruiting last year and we're looking for over 1000 people with secondary progressive MS to take part. Over 600 people are already taking part - but we need more! Please visit the STAT2 website to find out more.
We won’t have the results for a few years, but if it’s successful, simvastatin could become the ﬁrst neuroprotective treatment for MS.