PATIENTS with an incurable condition affecting one in 500 Scots have been offered hope by a world-first trial that could pave the way for treatments to halt its progression.
Scientists have been able to pinpoint the individual nerves that die leading to Multiple Sclerosis symptoms worsening, such as reduced mobility and pain.
There are two types of nerves; excitatory, which simulate the body to do things, and inhibitory, which dampen down a response. It has been previously thought progression of MS was due to both suffering irreparable damage.
However, a study at Edinburgh University, which analysed post-mortem brain tissue samples from people who had MS, found a dramatic reduction in the number of inhibitory brain cells – compared to people without the condition. Conversely, the number of stimulating neurons remained the same – even in people who had MS for decades.
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In MS the protective coating around the nerves, which is called myelin, is attacked by the immune system, leading to damage of the brain and spinal cord.
The available treatments for MS target rogue immune activity, and reduce the damage to myelin.
But to stop disability progression, researchers need to find treatments that can replace lost myelin, and protect nerves from damage.
Professor Anna Williams, who led the study at the MS Society Edinburgh Centre for MS Research, said: “This research is very important because although we have got really good treatments for early stage MS, we don’t have any really good treatments for late
stage and this is when nerves die and when people get disability.
“Nerves come into two groups; ones that stimulate you to do things and ones that dampen down things. We call them excitatory and inhibitory.
“We thought all nerves died but what this showed is it is only the ones that dampen things down.
“We would have predicted it was the excitatory nerves.
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“We did that by looking at the brains of people who had MS, some of whom had lived with it for 30 years.
“It’s really important because what we have tried to do is to stop all nerves dying but we haven’t done very well with that.
“Now, if we know it is these certain ones, we can try to tailor the treatments. We grow nerves in dishes to test drugs but if we are using the wrong ones, which we were, then we are not getting the right drugs.”
Researchers say it may be possible to re-purpose drugs that are already available.
“There are some drugs we want to test which we know are cheap and safe and that’s the next stage,” said Prof Williams.
“The treatments we have for early stage are good, but for those who have fixed disability, are perhaps older when the nerves are dying, we really don’t have treatments
that will change the course of the disease.”
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She said scientists are still trying to establish why people in Scotland have a higher prevalence of MS. Places where Scots migrated to, such as Canada and New Zealand, also have a higher rate.
She said: “Clearly, our genetic make-up is important and also our environment. One of the commonest things people think about is Vitamin D and how much light we get. It might well be part of the story, but we also know people can get MS who are non-white, non- Celtic who live near the equator.”
Dr Emma Gray, assistant director of research at the MS Society, which funded the study, said: “We believe this study represents a vital step in our mission to stop MS.
“Work like this, which is based at our Edinburgh Centre and used samples from the MS Society Tissue Bank, shows how important charity funded research is to the overall research landscape, and we’re proud to have made it possible.”