Attacking Two Brain Disorders on Multiple Fronts
Date: November 1, 2011
Multiple sclerosis (MS), though usually not fatal, can be debilitating enough to rob even young people of the ability to lead productive, enjoyable lives. That keeps Johns Hopkins neurologist Peter Calabresi working hard on a two-pronged strategy to combat the disease, in which the body’s own immune cells attack the fatty myelin sheaths around parts of the cells in the brain and spinal cord.
One approach is to block the damaging immune cells in the brain—but without blocking all immune cells, which would leave the brain vulnerable to infections. Calabresi and colleagues have already identified a protein that, if targeted by a blocking agent, would stop all the MS-causing immune cells while leaving alone 90 percent of other immune cells. “That’s getting us much closer to the selectivity we need,” he says.
The other strategy: repair the damage to the myelin. Calabresi and others have zeroed in on a brain “progenitor cell”—a stem-like cell that can develop into a brain cell—that’s capable of regenerating the myelin. He and colleagues are now looking at a hormone that promotes the action of these cells. And he’s also collaborating on a variety of new imaging techniques to spot myelin damage and track repair. “That would give us a window on how well a drug is working, which will speed up our progress,” he says.
Meanwhile, Hopkins neurologist Carlos Pardo-Villamizar is investigating new strategies to fight transverse myelitis (TM), which produces many of the same symptoms as MS, though it’s caused by inflammation confined to the spinal cord. Working out of what was the world’s first dedicated TM center, Pardo-Villamizar is trying to find combinations of drugs that can suppress the immune system activity that causes the inflammation. He’s collaborating with colleagues to develop other strategies, including electrical stimulation of muscle groups and special exercises, to help patients recover more quickly from the impairments brought on by TM.
Also critical, he says, is finding new ways to tell the disorder apart from MS and other diseases that can seem similar. He and colleagues are currently hunting for proteins and antibodies in patients’ spinal fluid that can serve as biomarkers. “If we can find the fingerprints that tell us which disease we’re dealing with, we often know how to treat it,” he says.
- Challenge: Find better treatments and diagnostic tools for multiple sclerosis and transverse myelitis
- Approach: For MS, selectively block immune cells and promote repair to brain-cell sheaths; for TM, suppress inflammation and find tell-tale antibodies
- Progress: Potential drugs are showing early promise in MS, and new techniques are helping patients recover more quickly from TM