Excerpts from the article linked below:
A new study out of Germany gives it a shot, offering up three MS subtypes based on immune markers found in patients’ blood — each group with slightly different disease progression.
Most recently, Wiendl set out to prove a hypothesis he’s been building for years: that MS patients have immunological signatures in their blood that match certain versions of the same disease.
With collaborators at a half dozen institutions across Germany, Wiendl, a professor of neurology at the University of Münster, launched a multi-center cohort study of 500 patients with early-stage MS. Those newly sick people were a right fit because the “immunological derailment has happened, but it’s not yet spread out and diverged,” he said. Plus, patients hadn’t undergone treatments that changed their immune systems.
And Wiendl, with all his years of research, tried to wipe his mind clean of all presuppositions he had about the disease and go in agnostic. The team assessed the quantity and quality of various immune cell populations, not favoring any in particular. And then they let an algorithm determine whether certain cell populations, or a combination of them, were more prevalent in these MS patients.
and could help predict how patients’ disease progresses. They don’t know exactly how stable the subtypes are over longer periods of time, or if treatment changes it. But Wiendl said cellular signatures were found over time in the handful of patients who went untreated, “including up to nine years within one individual,” the authors note in the study.
These differing subgroups could suggest the disease arises through a multitude of immune system pathways. Not only that, Wiendl said, but the groups responded differently to treatments over time — potentially a valuable insight for drug developers and clinicians.
For example, the inflammatory E3 group for the most part didn’t respond to treatment with interferons, commonly used disease-modifying therapies first approved for MS in 1993. But these patients did improve by taking monoclonal antibodies, such as alemtuzumab (Sanofi Genzyme’s Lemtrada) and ocrelizumab (Genentech’s Ocrevus).
The ability of the endophenotypes to predict a patient’s future condition needs to be checked by other researchers, and in a different population, said Alberto Ascherio, who led a pivotal study linking MS to previous Epstein-Barr infection and was not involved in the German study. He called the new study “interesting” for those in the field and said that endophenotypes could, in theory, help to personalize treatment.
But the science isn’t there yet, Ascherio added. Personalized medicine in MS is still a “fashionable word that is more a marketing pitch than a reality.”
Wiendl said he hopes other researchers can use the study’s data to test and confirm how well different MS treatments work for patients with these immune signatures, and to find other potential therapies. Wiendl also programmed an app with the data, and said he is developing a test to help others discriminate between the E subgroups. His spinoff company has patented the endophenotypes.
Ideally, one day there will be a simple test to classify patients and help doctors find the most effective treatment, Wiendl said.
“We really want to transform patient care and not just open the door,” he said.
https://www.statnews.com/2024/03/27/...atment/
A new study out of Germany gives it a shot, offering up three MS subtypes based on immune markers found in patients’ blood — each group with slightly different disease progression.
Most recently, Wiendl set out to prove a hypothesis he’s been building for years: that MS patients have immunological signatures in their blood that match certain versions of the same disease.
With collaborators at a half dozen institutions across Germany, Wiendl, a professor of neurology at the University of Münster, launched a multi-center cohort study of 500 patients with early-stage MS. Those newly sick people were a right fit because the “immunological derailment has happened, but it’s not yet spread out and diverged,” he said. Plus, patients hadn’t undergone treatments that changed their immune systems.
And Wiendl, with all his years of research, tried to wipe his mind clean of all presuppositions he had about the disease and go in agnostic. The team assessed the quantity and quality of various immune cell populations, not favoring any in particular. And then they let an algorithm determine whether certain cell populations, or a combination of them, were more prevalent in these MS patients.
and could help predict how patients’ disease progresses. They don’t know exactly how stable the subtypes are over longer periods of time, or if treatment changes it. But Wiendl said cellular signatures were found over time in the handful of patients who went untreated, “including up to nine years within one individual,” the authors note in the study.
These differing subgroups could suggest the disease arises through a multitude of immune system pathways. Not only that, Wiendl said, but the groups responded differently to treatments over time — potentially a valuable insight for drug developers and clinicians.
For example, the inflammatory E3 group for the most part didn’t respond to treatment with interferons, commonly used disease-modifying therapies first approved for MS in 1993. But these patients did improve by taking monoclonal antibodies, such as alemtuzumab (Sanofi Genzyme’s Lemtrada) and ocrelizumab (Genentech’s Ocrevus).
The ability of the endophenotypes to predict a patient’s future condition needs to be checked by other researchers, and in a different population, said Alberto Ascherio, who led a pivotal study linking MS to previous Epstein-Barr infection and was not involved in the German study. He called the new study “interesting” for those in the field and said that endophenotypes could, in theory, help to personalize treatment.
But the science isn’t there yet, Ascherio added. Personalized medicine in MS is still a “fashionable word that is more a marketing pitch than a reality.”
Wiendl said he hopes other researchers can use the study’s data to test and confirm how well different MS treatments work for patients with these immune signatures, and to find other potential therapies. Wiendl also programmed an app with the data, and said he is developing a test to help others discriminate between the E subgroups. His spinoff company has patented the endophenotypes.
Ideally, one day there will be a simple test to classify patients and help doctors find the most effective treatment, Wiendl said.
“We really want to transform patient care and not just open the door,” he said.
https://www.statnews.com/2024/03/27/...atment/
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