Teams at the Karolinska Institute and The University of Tokyo have separately disclosed new targets for multiple sclerosis. Intervention in their pathways could yield new MS therapeutics if the pathways can be targeted more specifically than the standard therapies of steroids and interferon-β.MS is an autoimmune disease that causes neurological inflammation and demyelination. Recent studies have shown that dysfunctional T helper type 1 (TH1) and TH17 cells cause autoreactivity, which can prompt the immune system to attack the myelin sheath around neurons. 1 Thus, many groups are focused on identifying the pathways that lead to the aberrant T cell activation.In a paper published in Science Translational Medicine, a Karolinska team reported that increased levels of Vav 1 guanine nucleotide exchange factor (VAV1), a protein involved in T and B cell activation, are associated with MS. 2 Meanwhile, the University of Tokyo researchers identified microsomal prostaglandin E synthase-1 (PTGES; mPGES-1) as a target involved in the development of pathogenic T cells. That study was published in the Proceedings of the National Academy of Sciences. 3 "There are existing therapies that do work to some extent, but in MS, there is still an unarguable unmet medical need. We need safer, better treatments. These studies could represent new ways of moving towards those treatments," said Hideki Garren, EVP, COO, CSO and cofounder of autoimmune company Bayhill Therapeutics Inc.
Homing in on VAV1The Karolinska team previously showed that a region on rat chromosome 9 played a role in the development of experimental autoimmune encephalomyelitis (EAE), a rodent model of MS. Now, Tomas Olsson, professor of neurology at the institute, and colleagues have shown that Vav1 houses the locus.In rats, Vav1 mutations were more strongly associated with EAE than wild-type Vav1.To translate the animal results into human disease, the team conducted a case-control study comprised of 7 independent cohorts and a total of 12,735 individuals. The study showed that the rs2546133-rs2617822 haplotypes in the first intron of VAV1 were strongly associated with the disease. Both haplotypes led to increases in VAV1 mRNA expression.VAV1 mRNA also was increased in mononuclear cells from MS patients, and the increase correlated with higher levels of inflammatory cytokines such as tumor necrosis factor (TNF) and interferon-γ (IFNG; IFN-γ) in peripheral blood and cerebrospinal fluid.Taken together, the results suggest that upregulation of VAV1 is linked to the inflammatory autoimmune component of the disease and that decreasing levels of the protein or the mRNA could help treat MS."It would be of interest to explore, by high throughput screening, low molecular weight drugs that might dampen VAV1 activity, " said Olsson.Olsson did say that additional studies will need to look at the biology of VAV1 variants and their role in regulating the disease.Brian Lawson, assistant professor of immunology and microbial sciences at The Scripps Research Institute, agreed. "They i...