Multiple sclerosis affects more than 30,000 Australians. Most have relapse-remitting MS (RRMS), known for having flare-ups and recovery that in turn damage and repair insulating layers protecting nerves in the brain and spinal cord. Researchers are collaborating with NIF to study the cycles of attack and remission – and determine if a novel therapy can help.
RRMS flare-ups involve demyelination, a process in which immune cells attack myelin, the protective coating around nerve fibres. Damaged myelin slows or prevents signals travelling between the brain, spinal cord, organs and limbs.
Curtin University’s Dr Virginie Lam leads research into promoting the flipside to that process, remyelination – repair that is part of the RRMS remission phase and can halt disease progression.
A focus is protecting fatty molecules called lipids that are abundant in myelin.
Dr Lam is testing a lipid-based therapy with antioxidant, anti-inflammatory and cell-controlling properties that shows promise in enhancing remyelination.
The Western Australia NIF node supports the research with in vivo MRI to monitor the amount and health of myelin levels in preclinical MS models for up to 16 weeks.
The research is a collaboration with Professor John Mamo, Director of the Curtin Health Innovation Research Institute, Dr Michael Bynevelt, a neuroradiologist at WA Health and the University of Western Australia, and NIF Fellows Dr Tim Rosenow and Dr Sjoerd Vos.
It involves use of some of Australia’s most advanced MRI technology, an ultra-high field preclinical research MRI scanner at the University of Western Australia.
It is important national infrastructure supporting preclinical research for modelling disease mechanisms and testing early drug candidates, ahead of plans to move into human imaging and clinical trials.
The NIF platform can determine the structure and health of myelin in the specific brain regions that are most important in MS. Critically, this can be done non-invasively, allowing repeated measurements over time.
This enables Dr Lam’s team to monitor the health of myelin and brain function, study pathways needed for healthy brain function, and track the effects of the therapy.
“Imaging is important for determining the efficacy of the therapy we are researching,” Dr Lam says.
“The therapy we are using is a purified form of a lipid which makes up a large portion of myelin.
“The myelin lipid in the therapy is not found in high quantities in the foods we eat, so we need to boost that through a purified supplement form.
“There is no cure for RRMS and little is known about the mechanism for myelin repair.
“We want to better understand the underlying processes – and at the same time determine our therapy’s success – in restoring myelin function, enhancing remyelination and preventing or slowing MS progression.”
Four weeks into the study, interim results have already shown increased myelin in the brain and reduced demyelination in an important part of the brain that is prone to demyelination in MS, the corpus callosum, Dr Lam says.
The findings come as peak body MS Australia publishes research in February 2023 showing the number of Australians living with MS is increasing at a significant and accelerating rate – up from 25,607 in 2017 to 33,335 in 2021.
Total costs for all people with MS in Australia have increased substantially in the same period, from $1.75 billion to $2.5 billion, with an annual per-person cost that is $20,000 above the next highest comparable complex chronic disease, Parkinson’s.
People with RRMS are typically diagnosed in their 20s and 30s – earlier than other forms of MS.
Common RRMS symptoms include fatigue, numbness, vision problems, spasticity or stiffness, bowel and bladder issues, and problems with learning, memory or information processing.