A New Biotherapeutic Approach for the Treatment of Multiple Sclerosis

Abstract

Multiple Sclerosis (MS) is a chronic autoimmune disease of the Central Nervous System (CNS) that affects approximately 400,000 people in the United States [1,2], and presents in several forms with the most prevalent being Relapse-Remitting (RR-MS) that affects nearly 85% of all MS patients. RR-MS is characterized by periods of debilitating disease symptoms followed by extended periods of remission. The second most common form is chronic progressive MS, with approximately 15% of the patients presenting with this form; most RR-MS patients develop progressive disease after several decades. This CNS disorder has no known etiology. However, there is prevalence among populations living in higher latitudes, and exposure to vitamin D by sunlight, or lack thereof, has been suggested as a factor in the development of MS [1]. Statistics show that MS affects white women more than women of color, and that MS afflicts women more than men by a 3:1 ratio [1]. Current PharmacotherapyDisease-modifying therapies for RR-MS involve the use of interferon-based immunomodulatory drugs such as glatiramer acetate, fingolimod, teriflunomide and natalizumab, each with its own success rate and list of side effects [2][3][4]. The goal of these drugs is to prolong the time to relapse and reduce brain lesions. Betaseron is an interferon-β-1b preparation and Avonex and Rebif are interferon-β-1a compounds that are currently available as injectable forms of therapy and show some level of effectiveness at reducing the number of acute exacerbations [5,6]. Nonetheless many patients on extended interferon consumption have significant and severe side-effects including injection site necrosis and liver dysfunction [3,5]. Fingolimod has been shown to be effective against RR-MS, but this drug has additional side effects that necessitate caution in widespread use [7,8]. Natalizumab was found effective for patients with highly active forms of MS that were unresponsive to other MS treatments, however, continued used of the drug resulted in increased risk of multifocal leukoencephalopathy [9]. A number of new oral immunosuppressants including rapamycin and laquinimod have been approved by the FDA, with the mode of treatment being the upregulation of T reg and T eff cells [10].Each of these drugs requires medically trained personnel for injections, and has unacceptable side effects, and/or limited efficacy. Thus, new disease-modifying therapies that would work alone, or in combination with standard care, are needed. Side-effects, cost of drug, and issues associated with administration often reduce compliance and limit treatment options for MS patients. New Biotherapy for MSOver the last decade, there has been a surge in awareness of new treatments for MS that include Low Dosages of Naltrexone (LDN). A website based in the United Kingdom, LDNNow, (http://www.ldnnow. co.uk) [11] serves as a reliable source of qualified and peer reviewed knowledge to help patients, family support, clinicians understand this new biotherapeutic approach for treatment of MS and av...