Addition of antibiotics to MS therapy could slow down progression of the disease

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Researchers from Louisiana State University in the U.S. are suggesting that the addition of antibiotics to standard drug therapy for multiple sclerosis, may slow down the progress of the disease.

The researchers believe the antibiotic possibly hinders the action of an enzyme that destroys certain cells in the nervous system.

Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating disease that affects the central nervous system.

It usually occurs in young adults and is more common in women than men and affects 2.5 million people worldwide.

MS usually affects genetically susceptible individuals but it's trigger remains unclear.

The inflammation affects parts of the brain causing a degeneration of brain tissue and in the most common type, relapsing-remitting MS, patients experience attacks of symptoms such as muscle weakness and spasms followed by periods of symptom-free remission.

Many patients with relapsing-remitting MS are often prescribed the medication interferon which boosts the immune system and fights viruses, but some still experience relapses and may continue to develop new areas of damaged brain tissue (lesions) which are visible on magnetic resonance imaging (MRI).

Dr. Alireza Minagar and colleagues conducted a small trial involving 15 patients with an average age of 44.5 years with relapsing-remitting MS who had been taking interferon for at least six months and were experiencing symptoms and developing new brain lesions.

The researchers suspect these unpredictable attacks may be triggered by an inappropriate response to viral or bacterial infections, with symptoms appearing and disappearing in a random manner.

For a four month period the patients were given a 100mg a day of doxycycline, a member of the tetracycline family of antibiotics, to take in addition to their regular dose of interferon.

The patients underwent monthly neurological examinations, MRI's to detect brain lesions and blood tests to monitor their safety.

At the end of this period brain scans revealed that brain tissue damage was reduced by at least 25% in nine of the patients and there were also signs that disability levels had improved.

While the antibiotics are not expensive and are easily available, which would make them an attractive treatment for MS if they were shown to be beneficial, some critics say the study was small, and no comparison was made with patients who did not take doxycycline.

The research will appear in the February 2008 print issue of Archives of Neurology, one of the JAMA/Archives journals.

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