MS who are taking a disease-modifying therapy.
This research could show
whether a well-tolerated
antioxidant can slow or prevent
the destruction of nerve cells.
Under study in the lab
Even more novel strategies are
under study in the laboratory,
where safety and effectiveness
must be determined before
human trials can proceed. Dr.
Kenneth Shindler, is studying
how mice with EAE respond to
resveratrol, a naturally occurring
antioxidant found in grapes
and other foods. Dr. Shindler’s
team has found that resveratrol
prevents nerve cell damage in
EAE. The compound did not
affect inflammation, so the
authors suggest that further
studies might test whether
combining resveratrol with
anti-inflammatory medications
used in MS would be beneficial
(Frontiers in Neurology,
2012;3:84).
Dr. Rhonda Voskuhl
(University of California, Los
Angeles) has shown that the sex
hormone estrogen may prevent
nerve damage in MS models
in the lab (PNAS, 2007;
104:14813). This is exciting
because Dr. Voskuhl—a
leader in research on gender
differences in MS—is already
conducting a clinical trial to
see whether estriol (an estrogen
hormone produced during late
pregnancy) can reduce disease
activity in women with MS.
The trial is funded in part by
the Society, NIH and other
generous donors.
Dr. Voskuhl is exploring
the neuroprotective role of
sex hormones in men with
MS as well. In 2008, she
administered testosterone to
10 men with MS, and found
that participants experienced
reductions in brain tissue loss,
and increases in proteins that
protect nerve cells (Journal
of Neuroinflammation,
2008;5: 32). In a more recent
study, Dr. Voskuhl showed
that testosterone, whether
administered before or after
disease induction, restored
proper nerve impulse
transmission in mice with EAE
(The Journal of Neuroscience
2012;32:12312).
Understanding how gender
hormones may confer protection
against nerve damage will help
lay the groundwork for their use
as a neuroprotective treatment
in people with MS.
Measuring success
How do we know if
neuroprotective treatments
are working—without having
to wait, possibly for years,
to see a difference in disease
course? Clinical trials of these
strategies are relatively new,
so measuring success is still
a work in progress. Gavin
Giovannoni, PhD (Barts
and The London School of
Medicine and Dentistry), is
investigating one possible
assessment tool: levels of a
protein called “neurofilament,”
found in the fluid that bathes
the brain and spinal cord
(cerebrospinal fluid, or CSF).
Neurofilament is released into
the CSF in conditions that
cause nerve damage, such as
MS. Dr. Giovannoni, who was
team leader in the Society’s
Nervous System Repair and
Protection Initiative, funded by
the Promise: 2010 campaign,
is studying whether the level
of neurofilament is a good
indicator of nerve protection.
