Two drugs used in skin creams for treating athlete’s foot and eczema have been shown to reverse multiple sclerosis (MS). The surprise discovery could pave the way to ground-breaking new therapies for the auto-immune disease.
Scientists found that the anti-fungal agent miconazole and the steroid clobetasol both restored movement to mice paralysed by a rodent version of MS. In laboratory tests they prompted inactive mouse and human stem cells to regenerate myelin, the protective insulation-like coating around nerve fibres that is destroyed by the disease.
Robert Miller, a member of the US team from Case Western Reserve University whose findings appear in Nature journal, said: “It was a striking reversal of disease severity in the mice. The drugs that we identified are able to enhance the regenerative capacity of stem cells in the adult nervous system. This truly represents a paradigm shift in how we think about restoring function to MS patients.”
With both drugs widely used, a way must be found to use them safely as internal human treatments before clinical trials can be considered.
Researchers are confident this problem can be solved, but have warned patients not to jump the gun .
Lead scientist Paul Tesar, from Case Western Reserve School of Medicine, said: “We appreciate that some patients or their families feel they cannot wait for the development of specific approved medications, but off-label use of the current forms of these drugs is more likely to increase other health concerns than alleviate multiple sclerosis symptoms.”
MS occurs when the immune system attacks myelin, thereby disrupting the passage of nerve signals. As the disease progresses, it produces symptoms ranging from mild numbness or tingling to full- blown paralysis. Occasionally, it can prove fatal.
Although current treatments can slow progression of MS and reduce its symptoms, the disease remains incurable.
One new approach is to focus on special stem cells called oligodendrocyte progenitor cells (OPCs) that mature into cells that produce myelin.
While other scientists have looked at ways of replacing lost stem cells using transplantation techniques, the Case Western team set out to find a way of stimulating inactive OPCs.
After screening 727 potential drug candidates, they identified two − miconazole and clobetasol – that coaxed the OPCs to form oligodendrocytes and repair nerve fibres stripped of myelin.
“We know that there are stem cells throughout the adult nervous system that are capable of repairing the damage caused by multiple sclerosis, but until now we had no way to direct them to act,” said Tesar. “Our approach was to find drugs that could catalyse the body’s own stem cells to replace the cells lost in multiple sclerosis.”
As well as testing the drugs on mice affected by MS, the scientists also observed their effect on human OPCs in the laboratory. The response was similar to that seen in mouse cells, with miconazole exerting the most potent effect.
Co-author Fadi Najm, also from Case Western, said: “We have pioneered technologies that enable us to generate both mouse and human OPCs in our laboratory. This uniquely positioned us to test if these drugs could also stimulate human OPCs to generate new myelinating cells.”