Brain Battles Back in Multiple Sclerosis Patients
Study shows effort to repair damaged cells simply falls short
WEDNESDAY, Jan. 16, 2002 (HealthDayNews) -- The body fights valiantly to repair the brain cell damage caused by multiple sclerosis, but some unknown force makes it a losing battle, new research says.
The discovery sheds new light on two methods of treatment, says Bruce D. Trapp, leader of the research team and chairman of the department of neuroscience at the Cleveland Clinic's Lerner Research Institute.
"It indicates that drug therapies could help cells complete the repair process," he says. "Alternatively, therapy by transplanting [new nerve cells to replace the damaged] cells might not be necessary, or it could be done in combination with drug therapy."
Multiple sclerosis, which affects one of every 1,000 Americans, is an inflammatory disease in which myelin, the protective coating around nerve cells in the brain, and supporting cells called oligodendrocytes, which produce myelin, are progressively destroyed. This causes symptoms ranging from numbness in the early stages of the disease to paralysis in the late stages.
Trapp and his colleagues report in tomorrow's issue of the New England Journal of Medicine on their analysis of brain tissue obtained from autopsies of 10 multiple sclerosis patients.
"What our study demonstrates is that the brains of multiple sclerosis patients are producing the oligodendrocytes that are destroyed by the disease process," Trapp says. "In response to that process, the brain makes cells to repair the damage. It makes a significant attempt to do this, but the repair effort falls short."
It is usually a long, losing battle, often with some early success, the study indicates.
"In some cases, there is a complete repair process, especially in the early stages, but the repair effort always fails," Trapp says. However, there is what he calls "a long window for repair" in which medical intervention might help -- up to 15 or 20 years.
Dr. Patricia O'Looney, director of the biomedical research program at the National Multiple Sclerosis Society, calls the new research "very exciting work."
"It is obviously significant to find myelin-producing cells in these lesions," she says. "The cells may be there, but they are not completing the job. A new area of therapy can come from understanding the process better and helping the cells complete the job of myelin repair."
Trapp says his research effort will continue on two paths. One is to identify the source of the new myelin-producing cells, so the mechanism for making them could be manipulated to increase production. The other will be to "develop some therapy that would direct these cells to finish the repair process."
The finding is another chapter in the new field of brain tissue regeneration. In the last few years, the long-standing belief that the adult brain could not produce new nerve cells has been debunked by study after study showing that re-growth is possible.
"In the research, the brain is shown to be reproducing cells, but the effort is just falling short," says O'Looney. "Now that we know the cells are there, the question is how we can stimulate them to complete the job."
What To Do
The research by Trapp's team is at a basic level, with much work ahead to fulfill the hope of new treatment for multiple sclerosis.