Repairing Myelin in Multiple Sclerosis: Clemastine Treatment Reveals Promising Results

2023-06-20 17:00:00

Multiple sclerosis is an autoimmune disease that affects the central nervous system. Lesions due to dysfunction of the immune system lead to motor, sensory, cognitive, visual or even sphincter disturbances. The treatments make it possible to reduce inflammatory flare-ups and improve the quality of life of patients, but do not prevent the progression of the pathology.

Multiple sclerosis treatment: myelin repair

In a recent study published in the journal PNAS, researchers from the Institute of Neuroscience at the University of California in San Francisco (United States) observed that clemastine, a drug treatment, might repair certain lesions caused by multiple sclerosis. Previously identified as a potential treatment for the condition, clemastine is an over-the-counter antihistamine.

Patients with multiple sclerosis lose myelin, the protective insulation that surrounds nerve fibers. Within the brain, water trapped between thin layers of myelin cannot move as easily as water floating between brain cells. Thanks to this characteristic of myelin, American researchers have developed an imaging technique to examine the levels of myelin before and following the administration of clemastine. They called it the myelin water fraction, which characterizes the ratio of myelin water to the total amount of water in the brain.

“This is the first example of brain repair documented by MRI for a chronic neurological disease”

During the research, the researchers recruited patients with multiple sclerosis. They divided them into two groups: the first received clemastine for the first three months of the study and the second group only received the drug between the third and fifth month.

The scientists then used the water fraction of myelin as a biomarker. They then noticed that the myelin water increased in the first group that received the drug and that it continued to increase following the treatment was stopped. As for the second group, the myelin water fraction indicated a reduction in myelin water in the first part of the study when the volunteers were on placebo, before experiencing an increase when the subjects benefited from clemastine.

For the study authors, this increase in myelin water following treatment revealed myelin repair in patients affected by multiple sclerosis. “This is the first example of brain repair documented by magnetic resonance imaging (MRI) for a chronic neurological disease,” said Dr. Ari Green, lead author of the study and medical director of the Multiple Sclerosis Center. and neuroinflammation from the University of California, San Francisco. Before specifying: “Clemastine can only be partially effective at the doses that we can use (…) This drug can be sedating, which can be particularly undesirable in patients with multiple sclerosis. We hope that better drugs will be developed, but clemastine turned out to be the tool to show that remyelination is possible.”

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