Decades of research into nerve physiology, MS tissue damage and the biology of glial cells – the numerous brain cells that support nerve cells – have been laying the groundwork for finding ways to restore normal function in individuals with MS.
Nervous System Repair and Protection teams funded by the Society’s Promise: 2010 initiative took this research to the next level, placing nerve tissue-protective treatments in clinical trials by the year 2010.
Other research on this topic focuses on the micro-environment of the brain and conditions conducive to stimulating natural repair, and the potential for cell therapies. Exploring glia, which include cells in the nervous system that make nerve-insulating myelin, is a cornerstone of MS research. Myelin appears to be the main target of the immune attack in MS. The cells that make myelin—oligodendrocytes—also are lost in MS. Researchers study aspects of myelin that make it an immune target, and ways that some brain cells can contribute to the immune attack. They are also looking at factors that are important to the growth and development of oligodendrocytes and myelin, to find ways of promoting myelin repair.
Read more about myelin as an immune target and nervous system repair efforts in our brochure, “Research Directions.”
The aim of repairing the nervous system is to achieve an actual reversal of the damage caused by MS and to restore function. When myelin is damaged or destroyed, electrical conduction along the nerve fiber is impaired or stopped. Decades of research on myelin and myelin-making cells make it clear that natural myelin repair occurs, and key molecules and growth factors are being identified that may serve as targets for stimulating myelin repair.
In recognition that during the course of MS the nerve fibers, or axons, are also damaged, a new research focus has emerged: in order to repair the nervous system, we must learn how to regenerate axons as well as myelin. Insights into complex mechanisms involved in nervous system development now make it feasible to aggressively address the task of repairing axons as well as myelin in MS.
Approaches to repairing the nervous system are varied. Some are aimed at inducing the body’s own cells to more adequately carry out the repair function. Another approach is to introduce replacement cells from a different source. Research into the potential of cell therapy is proceeding rapidly, using cells obtained from a variety of adult and non-adult sources. It is currently not clear which source of cells, if any, will be of value in treating people with MS. Similarly, if more than one source proves to be valuable, it is not clear which will be best.
International consensus on the future of stem cell transplantation research for people with MS was published in 2010, based on a summit held in London in May 2009 which was organized by the MS Societies in the UK and USA, and supported by the MS Society of Canada, Italy, France, Australia and the MS International Federation. Read more about this effort.
In conjunction with the efforts to repair axons are new efforts to protect them from degeneration in the first place. For example, it is not clear whether axonal degeneration in MS results from a direct attack on axons by the immune system or, alternatively, if the loss of myelin by itself is enough to cause axonal degeneration (i.e., whether myelin has a protective effect on axons which is lost in the MS disease process). The protection of axons from these and other insults are a new area of intense research efforts in MS.
A few examples of repair studies recently funded by the National MS Society:
- To accelerate the commercial development of MS treatments, the Society is funding research at the Universities of Cambridge and Edinburgh, UK through Fast Forward, LLC, to screen for compounds that can stimulate myelin repair in MS. Myelin is the substance that surrounds nerve fibers and is a target of the immune attack on the brain and spinal cord in MS. Read more here.
- Researchers, from Johns Hopkins University and other institutions across the country, found that thinning of the back layer of the eye may represent a window to global damage occurring in the nervous system, and suggest that this tool may be useful for tracking nerve protection in clinical trials involving people with MS. Read more here.
- Researchers transplanted stem cells derived from human skin into the brains of mice with a disorder that prevents them from growing new myelin, the insulating material that surrounds nerve fibers and which is damaged in MS. They found that the transplanted cells developed into myelin-making cells that formed new myelin quickly and efficiently. Read more here.