Researchers in London and Cardiff have developed a new test to detect how people are responding to the MS treatment alemtuzumab (Lemtrada).
The test uses antibodies which are molecules made by the immune system to fight invaders. Antibodies can also be used as drug treatments - alemtuzumab is an antibody drug for relapsing MS that targets and kills certain immune system cells. Most people need to take alemtuzmab in two courses a year apart. But some people need to take it more often, and for a small number of people the drug unfortunately doesn’t work.
Anti-drug antibodies and alemtuzumab
Sometimes antibodies are also made in response to drug treatments. These are known as anti-drug antibodies. They can stick to the drug and make it less effective.
The team wanted to see if anti-drug antibodies could explain why some people don’t respond to alemtuzumab. So they developed a new method to measure levels of anti-alemtuzumab antibodies and tested it in blood samples from 32 people who were taking the drug.
GloBody: Shedding light on MS treatments
The new technology, known as GloBody™ uses a molecule from a glowing deep sea shrimp called luciferase. The team engineered part of the alemtuzumab drug to link it to luciferase. This means light is produced when anti-drug antibodies are present.
The researchers showed that levels of anti-alemtuzumab antibodies could indicate people who are not responding to the treatment and for whom having another dose was unlikely to work.
The right treatment at the right time
The results could be used to improve the safety of MS treatments as people who are not likely to respond could quickly switch to another, potentially more effective, treatment rather than having another dose of alemtuzumab.
“This test shows that the vast majority of people are likely to respond to their treatment, but it helps create a safety net to spot those that may not.” - study co-author Dr David Baker from Queen Mary University London (QMUL).
We know early treatment with a disease modifying therapy can slow the accumulation of disability and reduce relapses. So finding the best treatment as quickly as possible is really important for people with MS.
Potential for COVID-19 antibody test
In this study the team only looked at the technology in alemtuzumb treatment for MS. But the technology could be adapted for antibody drugs used for other conditions. The team say the test could also be used to detect COVID-19 antibodies.
Study lead author Dr Angray Kang from QMUL said: “Some antibody tests will only give you a ‘yes’ or ‘no’ answer, however GloBody™ technology could tell you how much antibody is present and if the antibodies can block re-infection. This will be needed when assessing the effectiveness of a vaccine.
“Within a few days, we have already been able to produce sufficient amounts of the COVID-19 GloBody™ reagent to potentially test 1.6 million people for COVID-19. That’s enough to test all of the NHS staff in the UK. And if the virus mutates, a new test could be made just as quickly.”
The test would first need to be validated as an accurate test before being used widely. This process has started within Barts Health NHS Trust and QMUL.
Promising technology for people with MS
Our Director of Research Dr Susan Kohlhaas said, “The new technology could help detect people who aren’t responding to alemtuzumab so they can be switched to another treatment.
"We know early treatment can slow the build-up of irreversible damage and reduce the number of relapses people experience, so this could be really valuable for people with MS. We still need more research to test the new technology and to understand why certain MS treatments don’t work for some people.”
New data from the MS Register is allowing researchers to understand the impact of the coronavirus pandemic on people with MS. Sign up to our free webinar on Thursday 18 June to find out more.