January 2018 News – MS Remyelination Drugs, Genetic Markers To Predict Response to Copaxone and More

Remyelination Drugs & Supplements for MS- a Few Showing Potential (Animal Studies Only)

1.C-Phycocyanin (C-PC) from Spirulina platensis and Phycocyanobilin (PCB) were found to promote white matter regeneration in EAE (animal models of MS), helping promote remyelination. I expect to see soon studies in humans [1].

2.More Klotho To Boost Remyelination ?

Gene therapy targeting Klotho protein is now investigated for MS. Klotho protein promotes neuronal survival and remyelination, being mostly known for its neuroprotective, anti-aging effects [2]. We all have Klotho protein in the blood and central nervous system. This protein helps us live longer and correlates with IQ, thus be more intelligent. It also offers resistance to oxidative stress and inflammation [3]. The problem is that the levels of Klotho decrease as we age. Abnormal levels of Klotho were also found in MS.

Until researchers found the perfect pill to boost Klotho, I have two recommendations: exercise more and cut down on stress. Exercise had been found to improve Klotho’s levels [4], while chronic stress had been associated with low Klotho levels [5]. A number of supplements (omega 3, zinc, vitamins E and D, resveratrol, etc) also show some potential to increase Klotho in animal studies, but not yet confirmed in human studies.

3. Antipsychotic drugs used for the treatment of schizophrenia like risperidone or clozapine decrease the severity of animal model of MS. Will likely see clinical trials in the future [6].

4. NDC-1308, a small molecule (structurally related to estrogen and functioning through the estrogen receptors) can help repair myelin, based on animal studies. Long term use of NDC-1308 treatment showed significant improvement in myelination (a 44% and 18% increase in hippocampal and cortical myelination, respectively [7]).

 

Genetic markers predict your response to Glatatimer Acetate (Copaxone)- Finally !

Really exciting news.Anyone considering taking Copaxone should read this. 

Taking a genetic test can help you identify if you are a good responder or not to certain drugs (for example some antidepressants, chemo drugs or some meds used for heart disease, acid blockers, cholesterol lowering agents can be tested). About a year ago I was looking if there is anyway to predict the response to Copaxone, based on the genetic testing. I remember seeing work done by the pharma company Teva, but with no results.Finally, this research/patent application shows there is hope. Some genes had been identified to predict the response to this drug. [8].  

Supplements and Therapies That Could Help Relieve Symptoms of MS

Cacao.Cacao is rich in flavonoids and had been previously researched for improving fatigue. Scientists are now evaluating the consumption of a single drink of flavonoid-rich cocoa taken each morning over a 6-week period for improving mobility and functioning by modifying fatigue. The results will be published in june-july 2018 [9].

Fish oil & Olive oil. Consuming fish oil and olive oil can help those with RR-MS. This study (Clinical, controlled, randomized, double-blind trial) was conducted in people with MS who were treated with Interferon beta 1-b [10].

Oral standardized frankincense extracts shows potential to help treat RRMS [11]. Previous studies [12] , Including a phase II trial [12] conducted in people with MS also showed benefits. A key mechanism of action: decreases inflammation and autoimmunity (Th17 driven autoimmunity)

Lion’s Mane (Hericium erinaceus) has neuroprotective and neuroregenerative properties, Has anti-inflammatory qualities and promotes nerve growth factor gene expression and neurite (axon or dendrite) outgrowth.  Two clinical studies showed that this supplement has an excellent safety profile [13].

Vitamin D. Healthy levels of vitamin D are essential for overall health, and there is a lot of research of how important is for MS as well. This new study further confirms that vitamin D deficiency is more prevalent in MS compared with healthy controls. Researchers suggest that correcting this deficiency should be part of the MS treatment  [14].

Reflexology. A Turkish study found that reflexology can help improve fatigue and anxiety associated with MS [15].

Markers that could help diagnose and/or evaluate the progression of MS

I wrote in another article about how often MS is misdiagnosed. Anything that could help to increase the accuracy of a correct diagnosis is welcomed. Scientists are exploring many options and how to use other markers of the disease to better improve the accuracy of the diagnosis.

Osteopontin (OPN) is an extracellular matrix protein involved in various functions such as bone remodeling, wound healing, vascular and inflammatory conditions and is expressed in many immune cells.  It had been previously researched in MS, as OPN gene expression is increased in brain lesions in individuals with MS. Furthermore, studies found higher levels of OPN in the cerebrospinal fluid in those with MS compared with healthy controls. OPN as a cerebrospinal fluid and blood biomarker for multiple sclerosis: A systematic review and meta-analysis shows that OPN could be used as a marker of MS. Osteopontin could not only help with diagnosis but also provide info about the progression of MS [16]. This is great!

Adiponectin it is a potential biomarker to predict worse prognosis and disease progression. Adiponectin is a hormone involved in regulating glucose levels as well as fatty acid breakdown, already considered a marker for obesity and diabetes [17]. It is also involved in neuroinflammation, therefore could be a good candidate to predict the progression of MS.

Exercise helps improve MS symptoms

A single-blinded randomized controlled trial shows that 10 weeks of core stability training can significantly help improve balance [18]. 

Another study (randomized controlled, using Combined exercise training) was found beneficial to improve fatigue, balance and functional exercise capacity in individuals with MS. A key mechanism of action: Exercise raises BDNF, which promotes neurogenesis (BDNF is often lower than normal in MS) [19]

Caution if you take or consider taking alemtuzumab. Studies reporting adverse reactions associated with from alemtuzumab. Serious life threatening autoimmune anemia [20]. Researchers suggest adding Coombs’ tests to the screening panel required for alemtuzumab treatment. Alemtuzumab autoimmune kidney disease [21].

 

If you suffer from other conditions, as well as MS, try to manage them as much as you can. Comorbidities (especially ischemic heart disease or epilepsy had been  linked with more disability in MS [22].