Breakthrough in multiple sclerosis as scientists reverse the condition with immune cell transplant

Glandular fever immune cells may hold the key to treating multiple sclerosis, scientists say.

In a small trial, MS patients received T-cell implants that target the virus that causes glandular fever.

Brain scans suggested disease progression was slowed or even reversed in some patients.

Ppatients who achieved results also showed ‘lasting improvement in their disability’, including the ability to walk with less pain.

T cells were taken from people who had recovered from the Epstein-Barr virus, which has been touted as a possible cause of MS.

The American scientists who did the research admit the study was small and couldn’t rule out the placebo effect – when someone feels better just because they expected it to.

But it could mark a significant advance in experts’ understanding of MS, which is currently incurable and can only be managed with medication.

Scientists still don’t know exactly what causes the disease which affects around 130,000 people in the UK and more than 900,000 Americans.

Immune cells designed to fight glandular fever may hold the key to reversing multiple sclerosis, scientists have claimed. Pictured: An illustration of the Epstein-Barr virus, which causes glandular fever

WHAT IS MULTIPLE SCLEROSIS?

Multiple sclerosis (known as MS) is a disease in which the immune system attacks the body and causes nerve damage to the brain and spinal cord.

It is an incurable disease that lasts a lifetime. Symptoms can be mild in some, and in others more extreme, resulting in severe disability.

MS affects 2.3 million people worldwide, including around one million in the US and 100,000 in the UK.

It is more than twice as common in women as in men. A person is usually diagnosed in their 20s and 30s.

The disease is more often diagnosed in people of European descent.

The cause is unclear. There may be associated genes, but it is not directly hereditary. Smoking and low vitamin D levels are also linked to MS.

Symptoms include fatigue, difficulty walking, vision problems, bladder problems, numbness or tingling, muscle stiffness and spasms, balance and coordination problems and problems thinking, learning and planning.

The majority of sufferers will have episodes of symptoms that go away and come back, while some have them that get progressively worse over time.

Symptoms can be managed with medication and therapy.

The condition shortens the average life expectancy by about five to 10 years.

It comes after a major study by Harvard scientists of 1 million soldiers found that EBV may be the main cause of multiple sclerosis (MS) – with EBV patients 32 times more likely to develop it .

The crippling condition is caused by a person’s immune system attacking nerve cells, leading to symptoms such as fatigue and difficulty walking.

Progressive multiple sclerosis occurs in one in 10 patients and involves a steady deterioration of condition over time without relapse. There are very few treatment options.

The new T cell therapy was created by the American company Atara Biotherapeutics, based in San Francisco, California.

It involves extracting immune cells called ATA188, which are found in people who have successfully fought off Epstein-Barr.

It is given to people by injections.

The American Immunotherapy Society tested the drug on the first 24 MS patients for a year in 2017.

The patients were from the United States and Australia and received different doses of the immunotherapy drug to assess its effects.

The cells were donated by people who had suffered an EBV infection and were immunologically matched to the patients – to avoid rejection.

Eighteen participants continued the trial for more than three years as of August 2021, seven of whom have already shown signs of improvement.

Researchers used CT scans to examine nerve damage in the brain resulting from MS and assessed patients’ physical status using the Expanded Disability Status Scale (EDSS).

The results were presented at a conference on March 22.

It is unclear exactly how the regular doses were given to the patients, or how much of the drug was injected into them.

Twenty of the first 24 who received the injections saw their condition improve or stabilize after one year.

After three years, nine also showed improvements when measured using brain scans.

Professor Mark Freedman, a neurologist at the University of Ottawa who was not involved in the trial, said a natural reversal of progressive multiple sclerosis is incredibly rare, suggesting that the therapy being tested by Atara was at source of improved results.

He said: ‘Once a patient reaches a certain level of advanced disability, it is rare for it to come back naturally, and any lasting improvement would not be expected from the natural history of the disease.

“With progressive MS, spontaneous remyelination without therapeutic intervention is unlikely, highlighting the impact that these MTR data suggest, suggesting that remyelination may underlie the prolonged and sustained improvement in the EDSS.”

But others have suggested more research is needed before people get too excited about the treatment.

The phase I trial was not tested against a control variable, with researchers admitting the results could be caused by the placebo effect.

Clare Walton, head of research at the Multiple Sclerosis Society UK, told New Scientist: “It is encouraging that they have seen improvements in MTR

“But we’ve seen some promising treatments in phase I or even phase II, but then when you do the big randomized trials, they don’t show any results.”

Atara is currently conducting an 80-person phase II trial, which is the next step in the drug development process.

Dr. Manher Joshi, Atara’s Chief Medical Officer, said: “There is growing strong evidence that EBV-infected B cells and plasma cells play a critical role in the pathogenesis of multiple sclerosis.

“These data on progressive MS, the population with the highest unmet need, underscore the potential to halt or reverse the progression of disability by precisely targeting what may be a root cause of MS.”

A study published in Nature in January showed that proteins produced by EBV are very similar to human proteins produced by the nervous system.

About 95% of people alive today have been infected with EBV, which causes mononucleosis

The virus is also thought to cause several autoimmune diseases, including chronic fatigue syndrome and encephalomyelitis.

Immune systems can become confused when EBV attaches to nerves and begins to attack the body’s own cells rather than the virus.

Because the virus can lie dormant in the body for long periods of time undetected and occasionally reactivate, this immune response can occur repeatedly.

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