NurseWeek

Bad MS drug helps scientists anyway

By Astara March
Health24News
October 4, 2000


	You've read the article. Now tell us what you think. Related sites National Institute of Neurological Disorder and Stroke Nature Medicine The National Multiple Sclerosis Society

Washington (H24N). Researchers at Stanford University and the National Institutes of Health (NIH) who were testing the effect of a new compound on multiple sclerosis (MS) halted their trials because the compound caused numerous adverse reactions, but the nature of those reactions yielded valuable insights into the disease itself.

Roland Martin, MD, of the NIH’s National Institute of Neurological Disorders and Stroke, and Lawrence Steinman, of the Stanford University School of Medicine, reported in the October issue of Nature Science that they had stopped their joint Phase II clinical trials of a compound called an altered peptide ligand (APL) because it actually increased subjects’ MS symptoms and also caused itching, nausea, abdominal pains, fever, and cluster-type headaches.

The researchers constructed the compound to resemble a portion of the myelin sheath that surrounds the nerves and is destroyed by inflammation and subsequent scarring during multiple sclerosis attacks. The point of the experiment was to send this compound into the bloodstream and get it to act like a soldier with a white flag of truce by bringing anti-inflammatory Th2 helper cells back to the myelin sheaths to protect them and calm down the disease’s crippling inflammatory episodes. Instead, the APL activated Th1 cells causing inflammation and made patients’ symptoms worse as well as other uncomfortable side effects.

Although the researchers were disappointed that they had to halt the trials, they are intrigued by what happened. According to Nature Medicine, both Martin and Steinman are now trying to identify the mechanism that made the sheath-mimicking ligand partner Th1 instead of Th2. Through this process they feel they will gain an increased understanding of how multiple sclerosis works. Neither has abandoned the use of APL to treat MS, and believe it has promise once the basic mechanisms of the disease are fully understood.