It is thought that hookworms may play a role in damping down the immune system, which is overactive in people with MS, the most disabling neurological condition in young adults.

The £400,000, three-year project funded by the MS Society, aims to determine whether infection with a small and harmless number of the worms can lead to an improvement on the severity of MS over a 12 month period.

If the trial is successful, the worms have the potential to provide a simple, cheap, natural and controllable treatment for MS.

The WIRMS (Worms for Immune Regulation in MS) study is led by Professor Cris Constantinescu and Professor David Pritchard and is a randomised, placebo controlled, phase 2 study in people with relapsing remitting MS and will be carried out at multiple centres up and down the country.

The 25 worms are microscopic and are introduced painlessly through a patch in the arm. They are then flushed out after nine months.

Professor Constantinescu, said: “People are really interested in this form of potential therapy because it’s a natural treatment. It’s been tested for safety and we now need to study the potential benefits and any side effects.”

Jayne Spink, Director of Research at the MS Society said: “It sounds like science fiction, but it has been shown in a previous small study that people with MS who also had gut parasite infections had fewer relapses.

“Over time, parasitic worms have evolved to be able to survive an immune system attack and have been linked to a reduction in the severity of the symptoms of MS, which can be debilitating.

“If the theories can be shown to be accurate, using hookworms as a future treatment option may prove to be science fact.”

MS affects more than 85,000 people in the UK and several million worldwide. Symptoms range from loss of sight and mobility, fatigue, depression and cognitive problems that often come on as attack – or relapses. There is no cure and few effective treatments.

Dorothy Sutton, 58, from Awsworth, has lived with MS for 32 years and is a Helpline volunteer for the MS Society. She said that although the treatment sounded unusual, anything that could potentially to help alleviate the symptoms of MS is a positive step.

“We have to explore every avenue of research to find treatments for MS. As long as it’s safe and effective in helping the horrible symptoms, I don’t think people mind where it comes from.”

The Division of Clinical Neurology at The University of Nottingham’s Medical School is a strong research-led unit which draws heavily on its close relationship with people with MS to inform its work.

Led by Professor Cris Constantinescu, the department features two academic and one NHS Neurology Consultants that are affiliated with the Neuroscience Directorate of Nottingham University Hospitals (NUH) NHS Trusts.

Notes::

* Patients taking part are given 25 worms – a nine month treatment – then medicine to kill off the worm, which then pass harmlessly through the body. This gives total eradication and an MRI scan at 12 months confirms this.

* The worms are microscopic and given painlessly through a patch in the arm.

* The trial is a multi-centre study being carried out in Nottingham, Derby, Leicester, Stoke, Sheffield and total intended recruitment is 72 patients, 36 hookworm and 36 placebo.

* A final result of the trial will be available in 2011/2012

The University of Nottingham is ranked in the UK’s Top 10 and the World’s Top 100 universities by the Shanghai Jiao Tong (SJTU) and Times Higher (THE) World University Rankings.

More than 90 per cent of research at The University of Nottingham is of international quality, according to RAE 2008, with almost 60 per cent of all research defined as ‘world-leading’ or ‘internationally excellent’. Research Fortnight analysis of RAE 2008 ranks the University 7th in the UK by research power. In 27 subject areas, the University features in the UK Top Ten, with 14 of those in the Top Five.

The University provides innovative and top quality teaching, undertakes world-changing research, and attracts talented staff and students from 150 nations. Described by The Times as Britain’s ‘only truly global university’, it has invested continuously in award-winning campuses in the United Kingdom, China and Malaysia. Twice since 2003 its research and teaching academics have won Nobel Prizes. The University has won the Queen’s Award for Enterprise in both 2006 (International Trade) and 2007 (Innovation – School of Pharmacy), and was named ‘Entrepreneurial University of the Year’ at the Times Higher Education Awards 2008.

The MS Society

* The MS Society (http://www.mssociety.org.uk) is the UK’s largest charity dedicated to supporting everyone whose life is touched by MS, providing respite care, an award-winning freephone helpline (0808 800 8000), specialist MS nurses and funds more than 50 vital MS research projects in the UK.

* MS is commonly diagnosed between the ages of 20 and 40 and is more common in women than men by a ratio of 3:1.

* MS is the result of damage to myelin – the protective sheath surrounding nerve fibres of the central nervous system – which interferes with messages between the brain and the body. For some people, MS is characterised by periods of relapse and remission while for others it has a progressive pattern.

Source: Professor Cris Constantinescu
University of Nottingham
Read full article here: http://www.medicalnewstoday.com/articles/141010.php

WebMD Health News

Reviewed by Louise Chang, MD

Feb. 26, 2009 — An experimental drug called fampridine may improve walking in some people with multiple sclerosis.

Researchers report that news in the Feb. 28 edition of The Lancet.

They studied 301 U.S. and Canadian adults with multiple sclerosis (MS). At the study’s start, the patients were timed as they walked a distance of 25 feet.

After that, the patients spent a week just taking a placebo pill, and then they took either fampridine or a placebo twice daily for 14 weeks. After that, they spent their last month in the study not taking fampridine or the placebo.

During the study, patients taking fampridine were more likely than those taking the placebo to meet the study’s benchmark for the timed walk, to improve their walking speed, and to note greater improvement in walking.

For instance, 25% of the fampridine patients improved their walking speed, compared to 5% of patients taking the placebo.

“We provide evidence that treatment with fampridine produces clinically meaningful improvement in walking ability in some people with multiple sclerosis,” write the researchers, who included Andrew Goodman, MD, of the University of Rochester.

More research is needed to confirm the findings, Goodman’s team notes.
The researchers report two serious side effects that might have been linked to fampridine. One case was a patient who experienced severe anxiety; the other case was a patient who had a seizure during sepsis, a severe infection.

The study’s results are “intriguing,” but a better understanding of the drug’s risks and benefits, and which patients are the best candidates for fampridine, are needed, according to an editorial published with the study.

The editorialists — who included Alan Thompson, FRCP, FRCPI, of University College London’s Institute of Neurology — note that the results were clinically meaningful but only apply to a subset of patients, and that fampridine may not be right for patients with a history of seizures.

Goodman’s study was funded by Acorda Therapeutics Inc., which makes fampridine and has submitted fampridine for FDA review.

February 27, 2009 — Smoking cigarettes at a young age increases the risk of developing multiple sclerosis (MS), researchers warn. The study findings were released February 20 by the American Academy of Neurology (AAN) in advance of its presentation in April at the upcoming AAN 61st Annual Meeting, in Seattle, Washington.

Investigators found that early smokers — those who started experimenting with cigarettes before the age of 17 years — were more than twice as likely to develop MS compared with nonsmokers.

“Early smoking is an independent risk factor for MS,” lead author Joseph Finkelstein, MD, from Johns Hopkins University, in Baltimore, Maryland, told Medscape Neurology & Neurosurgery.

More Than 2 Times the Risk

The study is part of an initiative by the Multiple Sclerosis Center of Excellence, which was established by the Veterans Health Administration.

Investigators looked at more than 30,000 subjects from the 2002 National Health Interview Survey. Of these, there were 87 MS patients.

Researchers divided patients into 3 groups — nonsmokers, early smokers, and late smokers. As part of the case-control design of the study, investigators randomly selected 5 controls for each of the 87 MS patients (n = 435).

During an interview, Dr. Finkelstein pointed out that in several epidemiological studies, environmental factors have been found to play a prominent role in the development of MS. While many studies have suggested that smoking is a major risk factor, such work has not addressed the risk of early vs late exposure to cigarettes.

In the population-based analysis, 19.3% of people were early smokers. This number was even higher for MS patients, at 32.6%. Based on the Wald χ2 statistic, this difference was statistically significant (P < .04).

While controlling for sex, race, age, marital status, education, income level, and region, the researchers found early smokers were much more likely to develop MS.

Risk of Developing MS Compared With Nonsmokers

Late smokers did not show an elevated MS risk as compared with nonsmokers. “Our study does not condone smoking in any way,” Dr. Finkelstein emphasized during an interview.

“We are currently conducting the same analysis in other areas such as chronic obstructive pulmonary disease, cardiovascular disease, and cancer, and we have very good reason to believe that smoking is an important risk factor.”

The researchers have disclosed no relevant financial relationships.

American Academy of Neurology 61st Annual Meeting. Released February 20, 2009.