Improving treatment for people with multiple sclerosis

New findings by researchers at Thomas Jefferson University show how an inexpensive, off-patent compound can improve functioning in people with multiple sclerosis, a chronic neurodegenerative disease that affects vision, muscle coordination, and cognitive function.

Current treatments for the autoimmune disorder are appropriately designed to dampen patients’ overreactive immune systems. The new study, published in IBRO Neuroscience Reports, added a compound called N-acetylcysteine to ongoing treatment and demonstrated better outcomes in a majority of patients.

N-acetylcysteine (NAC), targets oxidative stress, thus targeting the biological pathway that contributes to nerve damage in multiple sclerosis. In addition, NAC is a widely available drug that has minimal side effects. (It’s available as an oral supplement, though in medical settings, it’s given intravenously and considered a drug.)

“Every hospital has it,” says Daniel Monti, MD,  professor and chair of the Department of Integrative Medicine and Nutritional Sciences. “It’s used in Tylenol overdose cases, in which oxidative stress is one of the contributors to liver failure.”

The drug works by raising levels of glutathione, a naturally occurring antioxidant. People with multiple sclerosis often have lower levels of these protective compounds. “You could say we’re replenishing rather than supplementing,” Dr. Monti says.

In pilot studies with N-acetylcysteine, multiple sclerosis patients reported positive effects such as better cognition, less fatigue, and lower anxiety. The current study measured changes in brain function with positron emission topography (PET imaging).

Using PET imaging, the team saw improved functional connectivity in the brain. “It’s a measure of how different parts of the brain are working together,” says Andrew Newberg, MD, director of Jefferson’s PET/MRI imaging program and an integrative medicine faculty member alongside Dr. Monti. “Multiple sclerosis is breaking connections and NAC helps reestablish them. In short, it helps the brain work better.”

It turns out that NAC has also shown promise in other neurological diseases such as Parkinson’s. It crosses into the brain to increase glutathione levels. Dr. Monti emphasized, “There’s so little downside, because it’s such a safe compound.”

The researchers say larger scale studies are needed to confirm their findings and to determine optimal dosing regimens. Dr. Monti is encouraged to continue this line of research, such as testing the compound in people with traumatic brain injury. “So far, NAC has been a winner,” he says.

By Jill Adams