Now
system in other diseases also
worked in MS, it could mean
a speedier road to approval
from the Food and Drug
Administration (FDA). Dr. Raju
Kapoor (National Hospital,
London) is testing whether the
epilepsy drug phenytoin can
reduce or prevent nerve fiber
injury in 90 people with optic
neuritis, an eye disorder that’s
often the first sign of MS.
Optic neuritis involves
inflammation of the optic nerve,
causing a loss of vision that is
usually temporary. Since damage
is limited to one nerve, and can
be measured relatively easily
using an eye scan known as
optical coherence tomography
(OCT), this is an ideal group in
which to test whether nerves are
being protected.
Beyond OCT, Dr. Kapoor’s
team is also assessing the extent
to which phenytoin improves
recovery of visual function.
Dr. Kapoor’s team is working
within a newly formed clinical
trials network in the United
Kingdom that was created
specifically to speed the
development of neuroprotective
strategies for MS. The trial,
co-funded by the Society and
the MS Society in the UK, is
proceeding on schedule, and
results are expected in 2014.
Dr. Emmanuelle Waubant
(University of California, San
Francisco) and her colleagues are
testing whether an oral therapy,
called riluzole, which has been
approved to treat amyotrophic
lateral sclerosis (ALS, also known
as Lou Gehrig’s disease), can also
protect nerve fibers from damage
in MS. The team is conducting a
small trial in 40 people recently
diagnosed with MS. Participants
are taking the approved immune-modulating therapy Avonex plus
riluzole, or Avonex plus inactive
placebo, for two years. Besides
looking at safety, the team also
is using MRI scanning to track
disease activity and progression
in the brain. Results are expected
this year.
Dr. Vijayshree Yadav
(Oregon Health & Science
University) and her colleagues
found that one antioxidant in
particular—lipoic acid—reduced
inflammation and prevented
nerve fiber loss in mice with
optic neuritis (Journal of
Neuroimmunology, 2002;
131:104–14). Now they are
conducting a clinical trial
sponsored by the Society of oral
lipoic acid involving 54 people
who have optic neuritis to see
whether this dietary supplement
MS researchers are exploring the
uses of therapies approved for
other diseases.
A successful result from
both of these trials would
likely lead to larger scale, more
definitive trials.
Assessing antioxidants
Other researchers are
looking at novel strategies
for neuroprotection, such as
the use of antioxidants. “Free
radicals” are normal byproducts
of bodily processes that may
cause tissue injury and even
turn on immune attacks in
MS. In particular, damage to
nerve cells in MS is thought
to be due to free radicals
affecting mitochondria, the
energy factories of nerve cells.
Antioxidants are compounds
that block or sweep up free
radicals.
can protect the optic nerve. They
are using tests of vision and
direct measurements of the loss
of nerve fibers in the back of the
eye (retina) to look for benefits.
Dr. Jesus Lovera (Louisiana
State University, New Orleans)
is investigating polyphenon E,
an antioxidant isolated from
green tea. Previous work
(Journal of Immunology
2004;173:5794) indicates that
a component of polyphenon E
reduces the loss of nerve cells in
mice with EAE (experimental
autoimmune encephalomyelitis),
a disease similar to MS. Now,
Dr. Lovera and his colleagues
are conducting a small clinical
trial ( 48 people) to see whether
oral polyphenon E alters the rate
of nerve damage in people with
