The first tentative signs of promise in treating multiple sclerosis with simple oral doses of a common protein have been reported by a research team in Boston.
The treatment, aimed at stopping the patients' immune-system cells from attacking their nerve cells, was not dramatically effective, but was encouraging enough to warrant a bigger, more extensive study, the researchers said yesterday. The larger study, involving more than 200 patients, is planned to start this year.
The hints of success suggest this approach, called oral tolerization, may eventually be useful in early treatment of other auto-immune diseases, including rheumatoid arthritis, diabetes and an eye disease called uveitis, said neuroimmunologist Howard Weiner.
His study involved 30 MS patients, half on the treatment and half on placebos. Those being treated received daily doses of the protein myelin, extracted from cows. Myelin is the insulation-like sheath that surrounds nerve fibers. In multiple sclerosis, it is thought that cells of the immune system mistakenly attack myelin, hampering the flow of nerve impulses and causing disease.
Among the 15 persons given myelin daily, six had no MS attacks during the yearlong trial. Among those getting placebos, 12 had MS attacks. In addition, the number of white blood cells attacking myelin declined in patients who got the treatment.
The results were reported in the journal Science by Dr. Weiner and six colleagues at Brigham and Women's Hospital and at Harvard School of Public Health, both in Boston.
Unfortunately, the results were clouded because men responded better than women, and patients with a certain immune system genetic marker fared worse. The treatment and placebo groups did not contain equal numbers of each sex, and of people with and without the genetic marker. As a result, it was hard to tell whether it was the treatment itself, gender, genetic inheritance or some combination of these that helped the treated patients.
Oral tolerization is based on the idea that feeding a patient the substance that the immune system is attacking somehow blinds it, making it more tolerant.