What makes MS research so complex?
As of April 2018 Fampyra, a medication taken to treat MS, is no longer covered under standard health insurance policies. (The Dutch television programme TROS Radar recently discussed this here. The news was a blow for MS patients, who use this expensive medication to combat symptoms of their affliction.
In other words, it is time we paid some attention to this disease, which hits its patients hard. What causes MS? What makes it so hard to develop MS medication? Why are experiments involving monkeys more effective than experiments using other animals? And what exactly is BPRC's research all about?
What is Fampyra and why is it no longer covered under standard health insurance policies?
Fampyra stimulates excitation conduction through the nerves, thus improving motor functions, among other things. In other words, the medication does not affect the disease process itself, but does help alleviate the symptoms that prevent the patient from functioning properly in daily life. However, a difference of opinion regarding the drug's efficacy has arisen between the National Health Care Institute (Zorginstituut Nederland), which decides which medications are covered under standard health insurance policies, on the one hand, and MS patients and their treating medical specialists on the other hand. Neurologists estimate that about 40% of MS patients benefit from Fampyra treatment.
What do we know about MS?
MS is a major neurological disorder affecting approximately one in one thousand young adults in the Netherlands. The cause of MS is unknown, but most scientists agree that the immune system plays a major part in the disease. Patient examinations and animal models have shown that the immune system causes inflammation in the brain and spinal cord, which causes the insulating covers of nerve the cells (called myelin) to be damaged.
Reasonably good results can be obtained by taking immunosuppressant drugs in the early stages of the disease, when occasional flare-ups (attacks) occur. During the later, chronic progressive stage, when the myelin and nerves are increasingly damaged beyond repair, these drugs are much less effective, or completely ineffective.
Why do we need monkeys for our research?
It is becoming increasingly evident that studies involving laboratory mice and rats do not have great predictive power with regard to new MS therapies for humans. In over 90% of clinical trials for new therapies, the promising effects observed in animal models were not observed in MS patients. Worse, some of these therapies actually caused the patients to experience unexpected adverse reactions.
Experimental models in monkeys are much more promising in research on the cause and pathogenesis of MS. This is particularly true for experimental models in marmosets, because they are much more immunologically identical to humans than mice or rats. Therefore, these animal models play a vital role at BPRC in bridging the gap between mice and humans, who are nowhere near as immunologically identical.
What does BPRC's research focus on?
BPRC has conducted research on the pathomechanisms of MS for the past twenty-five years. Our researchers seek to convert newly acquired knowledge into better therapies and the restoration of damage. Our current research projects mainly focus on the role played by B cells and the Epstein Barr Virus in the progressive stage of the disease, for which there is presently no effective treatment. Our research involves the use of a unique disease model in marmosets. We can develop disease-specific therapies on the basis of insights we have obtained from our exploratory research.