Mar. 3—The breakthrough technology deployed to vaccinate against COVID-19 also has led to a promising new approach to preventing the progression of multiple sclerosis.
That's an especially welcome development in a region with high rates of the unpredictable, inscrutable and often debilitating nervous system disease, according to one local neurologist.
"It is exciting, definitely exciting," said Dr. Yashma Patel, an MS specialist at Valley Neurology in Spokane Valley.
So far, the new MS vaccine has been the subject of only a handful of studies in mice, the results of which were published last month in the highly regarded journal Science. But though they were limited, the results may also open up a new path toward successfully treating a difficult-to-manage disease, according to Patel and Dr. Annette Wundes, director of the Multiple Sclerosis Center at the University of Washington.
While acknowledging that it's "obviously still very early on," Wundes said the approach analyzed in the Science study "allows a completely new way of dealing with MS."
MS occurs when the immune system attacks the central nervous system, damaging the myelin that sheathes and protects nerve cells in the brain and spine. When that happens, it can interfere with or prevent the transmission of messages within the nervous system, leading to the unpredictable onset of symptoms that can include fatigue, weakness, difficulty walking and cognitive problems.
Existing approaches to combating the disease fall into two main camps, according to Wundes.
One approach is "chemo-like," she said, in that you're attempting to suppress the immune system so it relents in its attacks on the nervous system. While such immunosuppressive therapies can limit the misguided attacks on the myelin, they can also reduce a patient's defenses against a host of very real threats of disease infection.
The other approach, Wundes said, involve modulating the immune system or, put simply, "strengthening the good guys and weakening the bad guys" to reduce the severity and effectiveness of the immune system's attacks on the nervous system.
"We have made huge strides in treating in MS," Wundes said, "but to a varying degree, (those treatments) come at the price of higher risk as well."
Current therapies also "don't stop (the disease) and don't fix anything," Patel said.
But the new approach could do exactly that: prevent the disease's progression and improve existing symptoms without affecting normal functioning of the immune system. It may also stop the disease from ever taking hold in the first place.
A key to achieving these groundbreaking results is messenger RNA, or mRNA, vaccine technology, which has been in development for three decades but was first successfully deployed late last year in a series of new COVID-19 shots.
"When you get a vaccine, any traditional vaccine, you're given a small amount of a virus, either a live virus or dead virus," Patel explained. That injection triggers the immune system to make antibodies so "your body fights it off" and prevents you from getting a full-blown infection, she said.
But mRNA vaccines take a fundamentally different approach.
Instead of giving you a virus, Patel said, they inject mRNA, which is "essentially a code" that "tells your body how to make" an antigen that triggers the production of antibodies that ward of infection.
One of the successful mRNA COVID-19 vaccines is Comirnaty, which the German biotechnology company BioNTech created with the American firm Pfizer. BioNTech's CEO, Dr. Ugur Sahin, is behind the effort to employ the same mRNA vaccine technology to combat MS.
The study Sahin published with a team of fellow researchers found that mice administered the MS shot produced an antibody that prevents the immune system from attacking the myelin.
"Basically, what they found is the mice who got the vaccine didn't display any further symptoms of MS and didn't see any further damage to the myelin," Patel said. "It would basically stop any progression of MS."
But while the research published last month is promising, far more work remains to determine whether that promise can be fulfilled.
"It's hard to say, though, how far it will go," said Patel, who noted other therapies that have worked well in mice were either ineffective or dangerous in humans.
Wundes agrees that, while the research is "promising and exciting," it's "obviously still early on."
She said the vaccine will have to work its way through a number of phases before scientists even try treating MS patients with it. She said it will likely be the subject first of further studies in animals and in humans without MS to determine its safety, before it is tried in MS patients to determine its efficacy.
Wundes also said, though, the article published in Science indicates that researchers did "a really good job" of looking thoroughly at the vaccine's effect on the mice who were given it.
She also said the success of mRNA vaccines for COVID-19 boosts the odds that the MS vaccine will work.
Now that the new vaccine-delivery technology is in use, Wundes said, it can be "adapted very quickly to new targets."
"And if you can apply it to autoimmune disease," she said, "that would obviously be very fantastic."
The benefits would be felt disproportionately in the places where MS is most common: northern Europe, western Canada and here in the Pacific Northwest.
"It does seem like everybody knows somebody with MS," Patel said of the Spokane area.
Wundes said "there's probably a rationale behind" the high rates in these areas, including the high presence of northern European heritage, a lack of sunshine and "some other poorly defined environmental factors."
Ultimately, though, no specific cause of MS has been identified. And that means preventing the disease is essentially impossible. Unless, that is, the vaccine works.