Israeli therapy may slow onslaught of multiple sclerosis

Intravenous Immunoglobulin “significantly lowered” the occurrence of a second attack of MS and reduced inflammation and disease activity.It’s a known fact in the medical community that two out of the top three medications to treat multiple sclerosis were developed in …

Intravenous Immunoglobulin “significantly lowered” the occurrence of a second attack of MS and reduced inflammation and disease activity.It’s a known fact in the medical community that two out of the top three medications to treat multiple sclerosis were developed in Israel. Since 1997, Teva Pharmaceuticals’ Copaxone has been prescribed by American doctors as a treatment for the earlier stages of MS. And Rebif – the commercial name for interferon-beta-1a, a drug developed at the Weizman Institute of Science – is used by approximately 70% of the MS patients worldwide.
Now, an Israeli study has provided some additional hopeful news for those in the early states of multiple sclerosis (MS), among them, some 350,000 Americans.
An Israeli-developed therapy designed to boost the body’s immune system could reduce the risk of a second attack of MS-related symptoms, and may slow the disease and protect the body from nerve damage.
Multiple sclerosis is a chronic, inflammatory disease affecting the brain and spinal cord. The cause is related to damage to myelin, the tissue sheathing the nerve cells in the brain and spinal cord. As a result, people with multiple sclerosis can experience problems with muscle control and strength, vision, balance, sensation, mental function, fatigue, and urinary tract function.

Many cases develop gradually. In some patients, the disease has an on-again, off-again pattern called relapsing-remitting MS, in which symptoms flare up and then disappear. Previous studies have found that the length of time between the first and second occurrences of multiple sclerosis symptoms can be an important predictor of the disease’s progress. The longer the duration between first and second occurrences, the better the prognosis.

Dr. Anat Achiron, director of the Multiple Sclerosis Center at Sheba Medical Center in Tel-Hashomer, Israel, and colleagues tested an approach using an immune therapy called intravenous immunoglobulin.

The researchers wanted to see if the therapy bought more time for people who had had their first multiple sclerosis event. They recruited 91 participants, randomly assigning half the group to receive immunoglobulin intravenously once every six weeks for a year. The rest received a placebo.

Participants had MRI images taken at the study’s beginning and end. They also had neurological tests and physical exams every three months during the course of the experiment.

Immunoglobulin “significantly lowered” the occurrence of a second attack and reduced inflammation and disease activity, the researchers reported in the October issue of the journal Archives of Neurology.

“Intravenous immunoglobulin treatment for the first year from onset of the first neurological event suggestive of demyelinative disease significantly lowers the incidence of a second attack and reduces disease activity as measured by brain magnetic resonance imaging,” the researchers reported.

Since a second attack is required for definitive diagnosis of MS, immunoglobulin “reduced the probability of reaching a definitive diagnosis of MS by 48% within the first year from onset,” they said. Overall, side effects were few and included headache, rash, nausea, and tightness in the chest. All side effects disappeared within 24 hours.

Achiron and her team concluded that intravenous immunoglobulin could be considered a treatment option for patients who have had one multiple sclerosis episode.

OMRIX biopharmaceuticals , an Israeli-based biotechnology company developed the immunoglobulin used in the study. They’ve also developed a vaccine based on immunoglobin against West Nile virus, which is currently being tested in the U.S.

The Multiple Sclerosis Center at Sheba encompasses treatment facilities for 1600 patients with MS from all over Israel. The center is involved in basic Immunologic and Neuro-Molecular Genetic Research, and they also focus on development of Innovative Technologies associated with improved assessment of the multiple sclerosis disease process as well as patients’ quality of life.

Achiron completed her medical education at the Tel Aviv University Sackler School of Medicine, and received M.D. and Ph.D. degrees. After her residency in neurology she became interested mainly in clinical and basic research in multiple sclerosis and established the Multiple Sclerosis Center, a center that has adopted a holistic approach in the treatment and rehabilitation goals for patients.

Her main research interests are related to the molecular, genetic, and immunologic aspects of the disease in relation to innovative therapeutic and diagnostic approaches, like T Cell Vaccination, Immunoglobulin Treatment and m-RNA expression profiles in different disease stages that can lead to the development of new drug targets and specific tailored treatment.

Over the last two years, the researchers at the center have studied T Cell Vaccination as a potential treatment for patients with MS. The preparation of the vaccine was made by isolating the patient’s own myelin-attacking T cells from peripheral blood, expanding the cells to auto-reactive lines, weakening them by irradiation and injecting them back to the patient. Three skin injections of the vaccine are given within six months and no side effects or significant adverse events were noted so far.

The beneficial clinical results of the Vaccination Treatment prompted the team to start an additional double-blind, placebo-controlled trial in MS patients with the first onset of neurologic symptomatology, in order to evaluate whether early T Cell Vaccination could induce long-lasting immunity against myelin-attacking cells and prevent the conversion from probable to definite MS.