Jeffrey I. Greenstein, M.D.
December 8, 2016
Dear Friend and Supporter,
As we approach the end of the year, I would like to give you an update on our research efforts at MSRI.
Dr. Yuenmu Chen joined us in September, bringing with him a wealth of experience in Molecular Biology and Molecular Pharmacology. He has already made a major contribution to our capacity to perform experiments using both his expertise and technical ability. I look forward to a long-term working relationship to FIND, STOP, and CURE MS.
A few months ago we completed a collaborative project with 9 other US MS Centers analyzing the effect of Tecfidera (an oral MS therapy) on circulating immune cell levels. This is the largest number of patients who have been studied by assessment of these cells. Among other findings, we confirmed data from smaller studies demonstrating an approximate 50% reduction in the number of T cells (one kind of immune cell). I believe that the drop in cell counts, which happens after 1 month of treatment, is most likely due to an unusual toxic effect of the drug on these cells, which causes them to die off. The decreased number of these cells adds risk for the development of Progressive Multifocal Leukoencephalopathy (PML) – a series and frequently fatal brain infection by the JC virus (below). Data from the study have been presented at the Consortium of MS Centers Meeting in the USA and the European Committee on Research and Treatment of MS in London. The manuscript describing the data from this study is in preparation for publication. We also continue to work on our data which will add additional information about this complication of treatment.
PML is a very serious complication of a number of immune therapies in both MS and other autoimmune diseases. It also complicates therapy for leukemia and lymphoma and it occurs in 3-5% of HIV/AIDS patients. A better understanding of this virus would lead to making treatments safer.
We have continued to work on the JC virus in the lab with a focus on the virus and immune cells, as they may spread the virus to the brain. This project has been funded by Biogen. We have developed a sensitive detection method to identify the JC virus in immune cells. We are also examining which factors may promote full replication of the virus, as this would increase the risk of PML considerably. Conversely, we may find a way to block the virus more effectively. We hope to have enough completed to publish the data in a few weeks. All pretty unexpected, and turns the field on its head a bit. We have had to go got considerable length to prove this beyond a reasonable doubt, as there will be skeptics and they will only be satisfied with incontrovertible data.
While we continue with the JC virus study we also continue with our efforts to uncover the cause of MS. There are blogs on our website which give more detailed information about dysfunction of the immune system in MS and there is a new one coming on the JC virus if you would like a more in depth view of the science.
Although we have made substantial progress and are now able to attack major unsolved health problems, the research comes with heavy costs. So far, these costs have paid great dividends. In order to achieve our goals I would request you consider continued support to help us accomplish our mission as we go into another year.
My best wishes for the Holidays.