World first MS treatment unveiled
NEW Queensland research suggests that controlling Epstein-Barr virus (EBV) infection – the most common cause of glandular fever – may be beneficial in treating multiple sclerosis (MS), a chronic inflammatory demyelinating disease of the brain and spinal cord affecting more than 23,000 Australians.
The study led by Professor Michael Pender with collaborators at the QIMR Berghofer Medical Research Institute, The University of Queensland School of Medicine, and the Royal Brisbane and Women’s Hospital describes the use of a new treatment that boosts CD8 T cell immunity to EBV using a technique known as 'adoptive immunotherapy'.
While the treatment was conducted in a single person with secondary progressive MS, the promising results suggest that it could potentially be a useful treatment for progressive forms of MS and other chronic autoimmune diseases. There are currently no disease-modifying treatments available for progressive MS patients.
The researchers administered a six week treatment course to a 42 year old man with secondary progressive MS. The treatment had no adverse effects and within two weeks of commencing treatment the patient began to experience clinical improvement. These improvements were sustained up to the most recent follow-up 21 weeks later.
Results of the study were published in the international Multiple Sclerosis Journal. The treatment involves collecting immune cells known as T cells from the patient’s blood, growing them in the laboratory with an EBV vaccine and then transferring the cells back to the patient by intravenous infusion.
The treatment was developed by Professor Rajiv Khanna of the QIMR Berghofer Medical Research Institute to treat patients with EBV-related malignancy and does not require the use of any drugs. This is the first use of this treatment, known as EBV-specific adoptive immunotherapy, to treat progressive MS.
Professor Pender said: “The beneficial effect of boosting immunity to EBV by this treatment highlights the importance of impaired immunity to EBV in the development of MS. We believe the treatment corrects the impaired CD8 T cell immunity that allowed EBV infection to cause MS.”
The Brisbane patient, Mr Gary Allen, suffered what he now knows was his first MS attack in 1994 which led to a clinical diagnosis of relapsing-remitting MS in 2000 and later progressed into secondary progressive MS.
Since 2008 Gary has been unable to walk or transfer himself without assistance, but has remained working full-time from home. Following the treatment, Gary experienced a significant reduction in fatigue and painful spasms, an improvement in thinking, memory, attention and hand function, and increased productivity at work. There was also reduced disease activity on his MRI brain scan. At the latest follow-up Gary also had improvement in leg movement. Gary said the treatment enabled him to perform everyday tasks more easily such as actively assisting with showering, dressing and shopping, and spending more time with his son.
“It’s impossible to overstate the significance of the improvements I’ve enjoyed – whether you look at my work at Griffith University, time with family or resurgent social life, it’s been an amazing change for the better,” he said.
Professor Pender said that the symptom improvement was backed up by other evidence such as the reduction in disease activity on brain scans and reduction in antibodies in the cerebrospinal fluid.
Professor Pender receives funding from the Trish Foundation and MS Research Australia.
“Treatments for progressive MS are one of the greatest needs,” commented Dr Matthew Miles, Chief Executive of MS Research Australia. “We are delighted with the results of Professor Pender’s research and congratulate him on this outcome.”
This breakthrough study has profound implications globally for understanding the cause of MS and for the treatment of MS, particularly in its progressive phase, for which currently there is no effective disease-modifying therapy.
A clinical trial is now needed to determine safety and therapeutic efficacy across the clinical spectrum of MS.