Well, isn’t this just a joy to read at the breakfast table? Multiple sclerosis, the life party crasher of the autoimmune world, is here to remind us that our nervous system can be a right diva! Roughly 50,000 people in Spain are living with this sneaky condition, which decides to infiltrate your brain like an uninvited guest at a wedding—except instead of stealing your cake, it steals your ability to walk. Fantastic!
Now, the core of the matter: relapsing-remitting multiple sclerosis (let’s call it RR-MS for brevity’s sake, or we might need a nap after pronouncing it!). The management of RR-MS is akin to a whack-a-mole game in a carnival—treat one flare-up, and another pops right up with a cheeky grin! The front-line treatments usually involve hefty doses of glucocorticoids, specifically methylprednisolone. Sounds like a spell from Harry Potter, doesn’t it? But instead of conjuring up magic, it risks sending you on a rollercoaster of side effects like osteoporosis, hypertension, and suddenly thinking that 3 AM is a perfectly reasonable time to watch infomercials about ab machines.
But hold onto your britches, folks! A recent study from the Institute of Biomedicine of Seville has thrown a delicious curveball into the mix: melatonin! Yes, the sleepy hormone that makes you snuggle into your duvet at night could potentially be a game-changer for MS. It’s like discovering that your old pair of slippers can guide you to the nearest pizza shop!
This research has shown that pairing melatonin with methylprednisolone can protect a whopping 90% of test subjects from MS symptoms. This isn’t just a happy coincidence; this combination can reduce the necessary dose of corticosteroids by up to four times. Just imagine how your doctor’s face would light up if you walked in and said, “Guess what? I need less of the potion that turns me into a hot mess!”
Professor Carrillo, the head honcho of this fantastic study, assures us that not only does melatonin play well with corticosteroids, but it also gives the immune system a gentle nudge to stop gatecrashing the central nervous system. It’s like the bouncers of your body saying, “Oi, CD4+ T cells, time to hit the road!”
Let’s not stop here; there’s a cherry on top! There’s a clinical trial in the works named MELATOMS-1—no, I’m not pulling your leg here—set to evaluate melatonin in patients with primary progressive multiple sclerosis (the nasty, aggressive cousin of RR-MS). This trial is a bit of a big deal, kind of like the summer blockbuster you didn’t know you needed.
In a world where quality of life is as precious as your morning coffee, the potential for melatonin to enhance treatment efficacy and reduce the cranky side effects is the kind of news we need. After all, who wouldn’t want to skip that nasty side dish when serving up medications?
So, let’s keep our fingers crossed for the MELATOMS-1 trial, and may the odds be ever in our favor! Because right now, it looks like we might just have found a new superhero to join the fight against the villainous MS.
Multiple sclerosis (MS) is an autoimmune neurodegenerative disease of unknown origin, which is considered the main cause of non-traumatic disability in young adults, affecting approximately 50,000 people in Spain. It is characterized by the infiltration of encephalitogenic cells into the central nervous system (CNS), causing the appearance of multifocal areas of demyelination and ultimately leading to neurodegeneration. The most common form of the disease, relapsing-remitting multiple sclerosis (RR-MS), presents with acute inflammatory episodes that generate varying degrees of disability, followed by partial or complete recovery.
In this sense, the first-line treatment for RR-MS relapses consists of the administration of a high dose glucocorticoidsespecially methylprednisolone, for a period of three to five consecutive days. However, this approach has limitations. Methylprednisolone, although effective, can cause significant side effects, including osteoporosis, hypertension, and sleep disturbances. In addition, some patients develop hypersensitivity to corticosteroids, which further complicates their treatment and management. In fact, a study has indicated that prolonged use of corticosteroids may contribute to bone fragility and the risk of fractures in patients with MS, especially in those who are treated chronically.
Now, a recent study carried out by the Molecular NeuroImmunoEndocrinology research group of the Institute of Biomedicine of Seville (IBiS) and the University of Seville has highlighted the potential of melatonin as a complementary treatment in relapsing-remitting multiple sclerosis (MS). RR). Published in the scientific journal Autoimmunity, the results show that the combined use of melatonin and corticosteroids (methylprednisolone) It provides protection to 90 percent of the animals studied, achieving a significant reduction in neuroinflammation. Furthermore, this combination allows the necessary dose of corticosteroids to be considerably reduced to obtain the desired therapeutic effect.
Reduce neuroinflammation
The study by the Molecular NeuroImmunoEndocrinology group, led by Professor Antonio Carrillo Vico, has shown that the joint administration of melatonin and methylprednisolone protects 90 percent of the animals studied from developing symptoms of multiple sclerosis. Furthermore, co-treatment with melatonin allowed reduce the dose of methylprednisolone up to four timeswhich represents a significant decrease in the side effects associated with prolonged use of corticosteroids. Melatonin is also known for its safety profile and low risk of adverse effects, which makes it an attractive candidate to be used in combination with existing treatments.
“This finding is of great relevance, since we have not only verified the effectiveness of melatonin to enhance the effect of corticosteroids, but we also observed that melatonin alone can improve the resolution of an outbreak of the disease and enhance the effect.” of corticosteroids in a subsequent relapse,” said Carrillo.
Melatonin works by reducing the infiltration of pathogenic immune cells, such as CD4+ T cells, B cells, macrophages, and dendritic cells, into the central nervous system, helping to limit neuroinflammation. Furthermore, melatonin treatment stimulates the production of anti-inflammatory markerswhich contributes to less destruction of myelin and, therefore, to better protection of nerve fibers.
The results of this preclinical study, together with previous research by the group, have established the foundations for the development of a clinical trial in humans called MELATOMS-1. This trial, coordinated by the IBiS team in collaboration with the Virgen del Rocío University Hospital (HUVR) and the Virgen Macarena University Hospital (HUVM) of Seville, aims to evaluate the use of melatonin in patients with primary progressive multiple sclerosis ( PP-MS), the most aggressive form of the disease, for which there is only one drug currently approved in Spain.
“The potential of melatonin to reduce inflammation and the dose of corticosteroids in multiple sclerosis could mean a significant improvement in the quality of life of patients,” Carrillo highlighted. The MELATOMS-1 trial is a multicenter, randomized, double-blind, placebo-controlled study, the purpose of which is evaluate the safety and efficacy of melatonin in patients with primary progressive multiple sclerosis (EM-PP) who are already receiving treatment with ocrelizumab. This approach seeks to determine whether melatonin can act as a complementary treatment to improve clinical outcomes and reduce disease progression in this very aggressive form of multiple sclerosis.
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