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Well-known antidepressant could be used against multiple sclerosis


Efficacy discovered in a completely different disease: antidepressant against MS

According to health experts, multiple sclerosis (MS) is the most common inflammatory disease of the central nervous system. The disease is not curable. Researchers have now discovered that a well-known drug used for a completely different condition could also help against MS.

Incurable disease

Multiple sclerosis (MS) is the most common inflammatory disease in the central nervous system. Despite intensive research, the disease is still considered incurable. Nevertheless, researchers are cautiously optimistic about the future. Thanks to new drugs, MS is becoming more and more manageable. In addition, certain plant peptides can stop the course of MS, as scientists found. According to research, multiple sclerosis can also be slowed down with the right diet. And a team of researchers has now found that a well-known drug used for a completely different disease could also help against MS.

Antidepressant clomipramine against MS

The antidepressant clomipramine could also help against the symptoms of multiple sclerosis (MS), especially against the progressive form, which is without relapses. So far there are hardly any medications for this type of MS.

This is what scientists around Prof. Dr. V. Wee Yong from the University of Calgary (Canada) and Dr. Simon Faissner from the Ruhr University Bochum found out.

In order to arrive at their result, they screened 1,040 generically available drugs and found one of them that could be used for multiple sclerosis therapy based on preclinical studies.

They have now published their results in the journal "Nature Communications".

Other mechanisms

There are now twelve drugs approved for the relapsing phase of multiple sclerosis; however, there are few therapeutic approaches for progressive forms.

“The mechanisms that cause damage in progressive MS are sometimes different from those in relapsing MS. Therefore, we need other therapeutic approaches for the latter, ”said Simon Faissner in a message.

The postdoctoral fellow at the Neurological University Clinic at the St. Josef Hospital in Bochum carried out his work for the study during a research stay at the University of Calgary, funded by the Prize for Clinical Research from the Medical Faculty of the Ruhr University.

Potential side effects already known

The team worked with approved drugs for which potential side effects have already been documented.

From these, the researchers selected 249 well-tolerated drugs that can safely enter the central nervous system, where chronic inflammation occurs in progressive MS.

In cell cultures, they tested which of the 249 substances can protect nerve cells from the damaging effects of iron. Because cell damage in multiple sclerosis releases iron, which in turn damages nerve cells.

After these tests, 35 candidates remained, which the researchers analyzed for further properties, such as whether they could reduce damage to the mitochondria - the power plants of the cells - or reduce the activity of white blood cells that attack the isolation of nerve cells in MS. The drug clomipramine turned out to be very promising.

Preclinical studies have been successful

The scientists then investigated the substance in mice with a disease that is comparable to relapsing-shaped multiple sclerosis in humans.

The treatment completely suppressed the neurological failures, there was less nerve cell damage and inflammation.

In another test, they treated mice with a disease similar to progressive MS in humans. Here, too, there was an effect if the researchers started the therapy immediately when the first clinical signs of the disease appeared.

In contrast to animals treated with a placebo, symptoms such as paralysis were reduced.

Clinical trials planned

Simon Faissner has been back from Canada in Bochum since January 2017 and works in the group of Prof. Ralf Gold to identify other drugs that may protect against MS and to better understand the mechanisms behind the progressive course.

"Based on the promising preclinical data, our long-term goal is to investigate clomipramine and other drugs from screening in clinical studies on patients," explains Faissner.

"One advantage of generically available drugs is that there is sufficient clinical experience with regard to the potential for side effects."

Phase 1 studies, i.e. studies of tolerability in healthy volunteers, therefore do not have to be carried out.

Progressive multiple sclerosis

Multiple sclerosis is the leading cause of neurological disability in young people in the Western world.

In the disease, the own white blood cells damage the covering of the nerve cells, the so-called myelin sheath.

This leads to neurological deficits, which in 85 percent of patients go into episodes and can lead to visual disturbances, paralysis or numbness.

The majority of patients experience a gradual worsening, the progression, after 15 to 20 years. In ten percent of the patients, the disease progressed from the beginning without the occurrence of relapses. (ad)

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