Multiple sclerosis: Drug targeting Epstein-Barr virus shows promise
In a clinical trial, a drug targeting the common Epstein-Barr virus showed promise in treating multiple sclerosis (MS). Hernandez and Sorokina/Stoxy
- Researchers are investigating the effects of a drug that targets the Epstein-Barr virus in people with multiple sclerosis (MS) in an ongoing Phase 1 clinical trial.
- The drug improves the symptoms of MS and may even reverse the condition.
- Researchers are now recruiting for a phase 2 clinical trial to further study the drug’s effects.
Multiple sclerosis (MS) is a chronic condition that affects the central nervous system (CNS). It is characterized by the immune system attacking the myelin sheath – the fatty layers that surround nerve fibers and enable them to communicate.
A study published in early 2022 found that being infected with Epstein-Barr virus (EBV), a herpes virus, significantly increases a person’s risk of developing MS. EBV-transmitted immune B cells have also been found in MS patients in several studies.
Researchers still don’t know how EBV may increase MS risk. However, one study suggests that EBV proteins can mimic the human myelin protein and induce an immune response against myelin by CNS antigens.
Therapeutics targeting EBV-infected B cells and plasma cells may be able to improve MS symptoms.
Atara Biotherapeutics, Inc., an allogeneic T-cell immunotherapy company, recently began an ongoing phase 1 clinical trial to investigate an experimental T-cell immunotherapy drug called ATA118 in people with MS. Targets EBV-infected cells.
Of the 24 volunteer trials, 20 showed signs of improvement or halted progression after one year of treatment.
Of the 18 patients who agreed to take the drug for 39 months, 9 achieved sustained disability improvement, and 7 showed signs of reinfection.
trial is underway; However, it will be presented at a conference by Atara on October 13, 2022.
Phase 1 Testing
For the trial, researchers treated 24 patients with MS with varying doses of ATA188 for one year. Improvement began within six months of treatment.
After 12 months, 20 reported either an improvement in their condition or a stagnation in the decline. None of the patients experienced serious side effects.
Of the original 24 trial participants, 18 continued ATA188 treatment for 39 months. Seven achieved continuous disability improvement (SDI) at 12 months and two over an extended treatment period.
The researchers found that seven of those participants also showed signs of reinfection, a natural mechanism. To repair damage to the protective covering around nerve fibers in your central nervous system, which includes the brain and spinal cord,
“When a patient reaches a certain level of advanced disability, it is rare for them to return naturally, and any improvement that is sustained would not be expected from the natural history of the disease,” said Professor of Neurology, Mark Friedman, MD, said. University of Ottawa.
“With progressive MS, spontaneous reinfection is unlikely without therapeutic intervention, highlighting the effect that these MTR data suggest that relapse may be long-lasting. [Expanded Disability Status Scale] EDSS reforms,” he said.
The researchers noted that higher doses led to larger clinical reactions. Of the nine patients who achieved SDI, seven received one of the two highest ATA188 doses in the first 12 months or extended trial period.
They further noted that eight patients who achieved SDI also participated in the extended trial and seven of these reported SDI at all time points.
As of August 2021, the researchers reported no fatal adverse events, although one patient with secondary progressive MS, who initially achieved an SDI, experienced a non-treatment-related relapse at 18 months.
built-in system
Asked how targeting EBV infections could help treat MS, Barbara Geisser, MD, neurologist and MS specialist at the Pacific Neuroscience Institute at Providence St. John’s Health Center in Santa Monica, CA, explained, Medical News Today:
“Most individuals with MS are exposed to EBV. There is a protein on EBV that is similar to the protein in myelin. When the body’s immune system attacks the virus, it also attacks the myelin. Clearing the virus Doing so will reduce the stimulus for immune cells to attack myelin.”
Alex Chapman, Vice President of Corporate Communications and Public Affairs at Atara MNT that A188 may affect two different pathways in the brain that lead to damage to myelin:
“1) disrupt the cell-mediated autoimmune cascade driven by EBV-infected B cells and 2) reduce the production of myelin-targeting antibodies made by EBV-infected plasma cells.
“T cells are able to reach the central nervous system (brain and spinal cord) more easily than larger antibodies. We already have that in our other programs using a different type of EBV T cell for cancer.” There is good clinical evidence of one,” Chapman explained.
The researchers say their findings demonstrate the potential to halt or reverse disability progression by targeting the root cause of MS.
When asked about the study’s limitations, both Chapman and Dr. Gisser said that its sample size was small, and thus, more research is needed.
Chapman said that to address this, Atara is actively recruiting for a randomized, phase 2, double-blind, placebo-controlled trial to further evaluate the efficacy and safety of ATA188 in patients with progressive MS. Can go
