Multiple Sclerosis

Posted on Cancer, Multiple Sclerosis

Study identifies natural compound to treat MS

Spinal fluid and multiple sclerosis

Scientists have identified a natural compound that halts the process involved in the progression of certain forms of cancer and demyelinating conditions — those that damage the sheath, known as myelin, that surrounds neurons — such as multiple sclerosis.

A study published today in the Journal of Biological Chemistry identified a plant-derived flavonoid known as sulfuretin, which has been found to inhibit the activity of an enzyme associated with multiple sclerosis (MS) and cancer. This discovery was made in cell tests conducted at Oregon Health & Science University. The next step is to evaluate the compound in animal models to determine its effectiveness and any potential side effects in treating cancer and neurodegenerative conditions like MS.

“We think this is a drug that could impact many different areas,” said Larry Sherman, Ph.D., professor in the Division of Neuroscience at OHSU’s Oregon National Primate Research Center.

The researchers found that sulfuretin, along with a pair of synthetic compounds that were also tested in live cells, inhibited the activity of a particular type of enzyme known as a hyaluronidase,  which naturally degrades hyaluronic acid. That’s important because when hyaluronic acid is broken down into fragments, it is known to cause problems in at least two ways:

  • Forestalls myelin repair: It prevents the maturation of oligodendrocytes, which are cells that produce myelin. Myelin is the protective sheath covering each nerve cell’s axon — the threadlike portion of a cell that transmits electrical signals between cells. Damage to myelin is associated with MS, stroke, brain injuries and certain forms of dementia. In addition, delay in myelination can affect infants born prematurely, leading to brain damage or cerebral palsy.
  • Allows cancer cells to proliferate: In cancerous tumours, hyaluronidase activity can allow cancer cells to proliferate unchecked by normal cellular death. “Now we have an inhibitor that could actually stop that,” said Sherman, who is also a professor of cell, developmental and cancer biology in the OHSU School of Medicine.

The new research focuses on inhibiting a specific type of hyaluronidase, known as cell migration-inducing and hyaluronan-binding protein (CEMIP).

In addition to MS and cancer, CEMIP is implicated in a range of disorders, including osteoarthritis, skin infections, brain injury caused by heavy alcohol use and possibly other neurodevelopment disorders, including Alzheimer’s disease. The study indicates its activity appears to be inhibited by sulfuretin.

Molecules in flowers

The discovery came after years of undergraduates painstakingly screening plant compounds in the lab of co-author Angela Hoffman, PhD, a longtime and now-retired professor of chemistry at the University of Portland.

“Over the years, her students have been grinding up these flowers, extracting molecules and testing to see if any of them blocked hyaluronidase activity,” Sherman said. “Finally, a couple of years ago, they found a promising compound.”

Alec Peters, a graduate student in Sherman’s lab at OHSU, found that this compound blocked CEMIP activity in a tumour cell line and in oligodendrocyte progenitor cells. Oligodendrocytes generate myelin.

Hoffman, a nun and chemistry professor who earlier this year retired from the University of Portland after 35 years to lead her convent, began collaborating with Sherman a decade ago. Over that time, she said, hundreds of undergraduate students worked on breaking down dozens of plants to their molecular essence and then testing to see whether any of the compounds worked to neutralize CEMIP.

The new publication validates the students’ diligent work over many years, she said.

Posted on Multiple Sclerosis

Multiple sclerosis: medication with cognitive behavioral therapy lower fatigue

Combining treatments was not more effective than either intervention delivered individually
Combining treatments was not more effective than either intervention delivered individually.

A University of Michigan-led study of commonly used treatments for people with multiple sclerosis finds that medical and behavioural interventions, and a combination of the two, result in meaningful improvements in fatigue.

The randomized clinical trial compared the effectiveness of modafinil, a wake-promoting medication used to treat sleepiness in people with sleep disorders, and cognitive behavioural therapy, or CBT, in reducing fatigue for over 300 adults with multiple sclerosis whose symptoms interfered with their daily activities.

Overall, investigators found that treatment with either modafinil or CBT alone, delivered over the phone, significantly reduced fatigue over 12 weeks. 

A combination of both treatments, as did each therapy, also worked, but it did not result in better fatigue scores than the independent interventions.  

“Fatigue is one of the most common and debilitating symptoms of multiple sclerosis, yet there is still uncertainty about how available treatments should be used or how medication-based treatments compare to behavioural treatments in the real world,” said first author Tiffany J. Braley, M.D., M.S., director of the Multiple Sclerosis/Neuroimmunology Division and co-founder of the Multidisciplinary MS Fatigue and Sleep Clinic at University of Michigan Health.

“This research offers new evidence to show that both CBT and modafinil are comparably effective for MS fatigue, which could shape treatment approaches to one of the most challenging symptoms experienced by people with multiple sclerosis.”

Of nearly 3 million people with multiple sclerosis worldwide, up to 90% experience fatigue. Nearly half describe it as their most disabling and impactful symptom.

The research used a real-world approach that more closely resembled clinical practice than traditional clinical trials. It included stakeholders with MS who helped design the study.

More than 60% of participants in each study group reported clinically meaningful improvement in fatigue, which was measured using the Modified Fatigue Impact Scale.

“These treatments, individually and as a combination, should be considered as potential options for people with multiple sclerosis with chronic, problematic fatigue,” said senior author Anna L. Kratz, PhD, professor of physical medicine and rehabilitation at U-M Medical School.

Collaborators at a secondary study site, the University of Washington, contributed to this pragmatic trial.

“This study focused intently on patient-centred outcomes, and our findings highlight the importance of shared decision-making about treatment selection, considering patient characteristics and broader treatment goals,” Braley said.

Trial participants who received only CBT maintained lower fatigue scores at an additional follow-up appointment 12 weeks after the study treatments ended.

CBT has shown robust and durable effects on fatigue in previous research.  

“While many people with multiple sclerosis have limited access to behavioural health care like CBT, offering the treatment through telehealth can help reach more patients,” Kratz said.

“Our study shows that CBT is a feasible treatment that teaches fatigue management skills that can be employed indefinitely, with enduring benefits that last well beyond the treatment period.”

Although the three treatment assignments worked similarly well overall, participants’ sleep habits, or “sleep hygiene”, affected how well the treatment worked for fatigue.

Those with poor sleep hygiene tended to have better fatigue outcomes with CBT, and participants with excellent sleep hygiene showed better fatigue outcomes with modafinil.

“Using wake-promoting medications such as modafinil could worsen sleep quality in patients whose sleep problems are behavioral,” Braley said.

“As sleep disturbances also contribute to fatigue in people with MS, it is important to avoid selecting fatigue treatments that could worsen sleep. Behavioural treatments such as CBT that include sleep education may be preferable for people with MS who have poor sleep habits.”

Posted on Cancer, Multiple Sclerosis

Do people with Multiple Sclerosis have an increased risk of cancer?

New Drug Could Help Multiple Sclerosis Patients Better Manage Symptoms

A new study has found some cancers to be slightly more frequent in people with multiple sclerosis (MS) than in people without MS. Types of cancers found to have a small increased risk include bladder, brain and cervical cancers. The study does not prove that MS increases a person’s risk of cancer. It only shows an association.

With MS, the body’s immune system attacks myelin, the fatty, white substance that insulates and protects the nerves. MS is chronic and can be unpredictable and disabling.

“People with MS undergo an increased number of tests to monitor MS, making it more likely to detect other diseases,” said study author Emmanuelle Leray, PhD, of Rennes University in France. “We found an association between some types of cancer and MS, which may have different explanations depending on a person’s age and the types of cancer. Overall, our study found the increased risk of cancer was quite small.”

Researchers reviewed ten years of data in the French national healthcare database for the study. They identified 140,649 people with MS and matched them for factors such as age, sex, and residence to 562,596 people without MS. All participants were cancer-free three years before the study. They were followed for an average of eight years.

During the study, 8,368 people with MS and 31,796 people without MS developed cancer.

Researchers determined that there were 799 cancers per 100,000 person-years for people with MS and 736 cancers per 100,000 person-years for people without MS. Person-years represent the number of people in the study and the amount of time each person spends.

Researchers found people with MS had a 6% increased risk of developing any type of cancer regardless of age, sex and residence. They also found cancer risk was higher in those under 55 and lower in people 65 and older when compared to people without MS.

Researchers then looked at cancer types. People with MS had a 71% increased risk for bladder cancer, a 68% increased risk for brain cancer, and a 24% increased risk for cervical cancer. However, they also had a 20% lower risk of prostate cancer, a 10% lower risk of colorectal cancer and a 9% lower risk of breast cancer.

“While our study found a higher risk for brain cancer, it may be due in part to earlier detection in those with MS since they regularly have brain scans which may detect cancers earlier, before a person has symptoms,” said Leray. “Frequent urinary tract infections in people with MS and the use of immunosuppressant drugs may contribute to their higher risk of bladder and cervical cancers.”

Leray added, “The lower risk for colorectal and breast cancers may be due in part to fewer people with MS getting screened for cancer in older age when they may be experiencing more MS symptoms. More research is needed, including studies examining how cancer screenings may play a role.”

Posted on Diabetes, Multiple Sclerosis

Can we ‘recharge’ our cells? A break through for MS folks and diabetics?

MoS₂ nanoparticles

A microscopic look into a cell with MoS₂ nanoparticles Credit Dr Akhilesh Gaharwar/Texas A&M Engineering

We might take a vacation or relax at the spa when we need to recharge. But what if we could recharge at the cellular level, fighting against ageing and disease with the microscopic building blocks of the human body?

The ability to recharge cells diminishes as humans age or face diseases. Mitochondria, often called the cell’s powerhouse, are central to energy production. When mitochondrial function declines, it leads to fatigue, tissue degeneration, and accelerated ageing. Activities that once required minimal recovery now take far longer, highlighting these organelles’ role in maintaining vitality and overall health.

While current treatments for ailments related to ageing and diseases like type 2 diabetes, Alzheimer’s, and Parkinson’s focus on managing symptoms, Texas A&M researchers have taken a new approach to fighting the battle at the source: recharging mitochondrial power through nanotechnology.

Nanoflowers

Led by Dr. Kanwar Abhay Singh, a biomedical engineering postdoctoral associate in the Gaharwar Laboratory at Texas A&M, the team has developed molybdenum disulfide (MoS₂) nanoflowers. Named because of their flower-like structure, these nanoparticles contain atomic vacancies that can stimulate mitochondrial regeneration, helping cells generate more energy.

“These findings offer a future where recharging our cells becomes possible, extending healthy lifespans, and improving outcomes for patients with age-related diseases,” said Dr. Akhilesh Gaharwar, Tim and Amy Leach Professor and Presidential Impact Fellow in the Department of Biomedical Engineering at Texas A&M.

According to Gaharwar, the nanoflowers could offer new treatments for diseases like muscle dystrophy, diabetes, and neurodegenerative disorders by increasing ATP production, mitochondrial DNA, and cellular respiration. They discovered that the atomic vacancies in the nanoflowers stimulate the molecular pathways involved in mitochondrial cell replication.

Research collaborators include Texas A&M faculty and students. From the Department of Biophysics and Biochemistry, Dr. Vishal Gohil provided insights into the mechanisms that could drive the improvement of mitochondrial function.

“This discovery is unique,” Dr. Gohil said. “We are not just improving mitochondrial function; we are rethinking cellular energy entirely. The potential for regenerative medicine is incredibly exciting.”

Other Department of Biomedical Engineering contributors include Dr. Hatice Ceylan Koydemir, assistant professor, and Dr. Irtisha Singh, an affiliate assistant professor in the Department of Molecular and Cellular Medicine. Singh contributed computational analysis that revealed key pathways and molecular interactions responsible for the energy boost.

A Profound Discovery

“By leveraging advanced computational tools, we can decode the hidden patterns in cellular responses to these nanomaterials, unlocking new possibilities for precision medicine,” Singh said. “It’s like giving cells the right instructions at the molecular level to help them restore their own powerhouses — mitochondria.”

The next steps for the research team include identifying a method for delivering the nanoflowers to human tissue, with the goal of eventual clinical application.

“In science, it’s often the smallest details that lead to the most profound discoveries,” Gaharwar said. “By focusing on the unseen — like atomic vacancies in nanomaterials — we are uncovering new ways to solve big problems. Sometimes, the real breakthroughs come from digging deeper and looking beyond the obvious.”