The antidepressant clomipramine may also alleviate symptoms of multiple sclerosis (MS), specifically in its progressive form, i.e. when it occurs without relapses or remissions. As yet, drugs for this type of MS have been virtually non-existent. Researchers screened 1,040 generic therapeutics and, based on preclinical studies, identified one that is suitable for the treatment of multiple sclerosis. They published their results in the journal Nature Communications.
Today, twelve drugs have been approved for the treatment of relapsing-remitting multiple sclerosis; for the progressive types, on the other hand, only a few therapy approaches exist. "The mechanisms causing damage in progressive MS are not always the same as in relapsing-remitting MS. This is why the latter requires different therapeutic approaches," says the lead author.
The team worked with approved drugs, the side effects of which have already been amply documented. From among those drugs, the researchers selected 249 well-tolerated therapeutics that enter the nervous system safely; this is where chronic inflammation occurs in progressive MS. Using cell cultures, they tested which of the 249 substances are capable of protecting nerve cells from the damaging influence of iron. In MS patients, iron is released due to cell damage, damaging nerve cells in turn.
Following those tests, 35 potential candidates were identified; the researchers subsequently analysed them with regard to additional properties: investigating, for example, if they can reduce damage to mitochondria - the powerhouses of the cells - or if they minimize the activity of leucocytes that attack the insulation of nerve cells in MS patients. In the process, the drug clomipramine proved promising.
In the next step, the researchers analyzed the substance in mice suffering from a disease comparable with relapsing-remitting multiple sclerosis in humans. The therapy suppressed the neurological disturbances completely; as a result, damages to the nerve cells and inflammation were minimized.
In a subsequent test, they treated mice with a disease that resembles progressive MS in humans. Here, too, the therapy proved effective, provided the researchers applied it immediately after the first clinical symptoms became apparent. Symptoms such as paralysis were thus reduced - unlike in control animals that were treated with placebo drugs.
http://news.rub.de/english/press-releases/2017-12-20-medicine-antidepressant-may-help-combat-course-multiple-sclerosis
https://www.nature.com/articles/s41467-017-02119-6
Antidepressant to treat multiple sclerosis?
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