At the moment, treatments help alleviate the symptoms of relapsing-remitting MS, the milder, more common form of the disease (Photo: LINDSEY PARNABY/AFP/Getty)
The first really effective treatment for multiple sclerosis (MS) could be available within five years after researchers raised hopes that they had discovered the holy grail of MS therapy.
Scientists have identified a natural mechanism in the body that could be boosted with an existing diabetes drug to protect against the nerve damage at the centre of the disease.
This would not only halt progression of MS but may partially reverse it as well, they say.
At the moment, treatments help alleviate the symptoms of relapsing-remitting MS, the milder, more common form of the disease although these do little to slow its progression.
Meanwhile, there are no treatments for the more serious form of the condition, known as Primary Progressive MS.
This is an incredibly important discovery one we believe could finally bridge the gap in MS treatment, said Don Mahad, of the University of Edinburgh.
Despite major advances in scientific understanding of MS in the past two decades, there is still no treatment to protect nerve fibres although that could be about to change, Dr Mahad said.
Such protection is the holy grail in MS treatment not only for the relapsing form of MS, which has various options available, but for progressive forms too, where treatment continues to lag behind, he said.
Tests on mice and human cells in a lab suggest the Pioglitazone diabetes drug would be a highly effective treatment.
The drug is now being trialled in humans and Dr Mahad is hopeful that it could be available on the health service within four to five years although he cautions more research is needed to confirm early findings.
Emma Gray, of the MS Society, which part-funded the research, said finding treatments for everyone with MS is now a very real prospect.
We can see a future where nobody needs to worry about MS getting worse.MS treatment could in the near future look completely different, Dr Gray said.
To stop multiple sclerosis from progressing we need treatments that protect nerves from damage a goal that has proved elusive.
In MS the protective coating that surrounds nerves, known as myelin, is damaged and nerves become less energy efficient as a result. Not having the energy they need makes nerves vulnerable to further damage and causes disability over time.
But for the first time researchers have discovered a natural mechanism in the body that tackles this issue. Our discovery shows that nerves respond to myelin damage by increasing the movement of mitochondria the cell powerhouse, which produces energy to the area of damage, said Don Mahad, of Edinburgh University. The researchers are calling the response ARMD, which stands for axonal response of mitochondria to demyelination.
Remarkably, we were able to enhance ARMD and protect these vulnerable nerves using the readily available diabetes drug pioglitazone, said Dr Mahad.
Over the last few decades there have been huge strides in our understanding of MS, and there are now over a dozen effective treatments for people with relapsing MS but these only address damage caused by the immune system. In order to truly stop MS and treat everyone, we need to find ways to both protect nerves from further injury and repair damaged myelin, Dr Mahad said. This is where the new discovery comes in.
The study was welcomed by experts not involved in the research.
This is an important study for our understanding of multiple sclerosis [and] might be an important step towards the development of neuroprotective treatment strategies a major unmet need in multiple sclerosis, said Professor Martin Kerschensteiner of the University of Munich.
The paper, published in Acta Neuropathologica, involved scientists from 15 universities and hospitals around the world.
They include Wellcome Trust-MRC Cambridge Stem Cell Institute, Queen Mary University of London, University of College London, Biomedical Primate Research Centre in the Netherlands, the Mayo College of Medicine and Science in Rochester, US, and the Ohio State University.
The MS Society said that more than 130,000 people in the UK live with the condition, which can be relentless, painful and disabling.
Like any responsible medical association, the MS Society takes great care not to raise false hopes where treatments are concerned.
So when it announces new research with the headline Holy Grail discovery to prevent disability in multiple sclerosis you know its something to take seriously.
Not that the discovery will automatically lead to a breakthrough MS treatment as the society would be the first to acknowledge since many more tests are required to confirm early promise.
But there is definitely a high degree of excitement around the development.
A further stroke of luck is that a potentially effective drug is already available for diabetes.
This reduces the need for extensive safety trials and should speed up the process by which the drug should become available assuming it is found to be effective in large human trials.
All going well and that is by no means a certainty we could see the drug being prescribed for MS within five years, researchers say.