Could Estriol Be the Elixir for MS?
Could Estriol Be the Elixir for MS?
LOS ANGELES, CA — March 23, 2007 — It has long been common
knowledge that pregnant women with multiple sclerosis experience a
sharp drop in the disease’s symptoms during the course of their
pregnancy.
Some years back, Rhonda Voskuhl, MD, director of UCLA’s Multiple
Sclerosis Program, and her colleagues discovered the cause. They
found that a female sex hormone called estriol, which is produced
during pregnancy, was responsible for the suppression. Four years
ago, Voskuhl followed that discovery with a pilot study in which 10
non-pregnant women with MS were given estriol, yielding what she
described as “pretty remarkable” results — an 80% drop in
inflammatory lesions in the brain, a hallmark of the disease.
This month, Voskuhl begins a much larger trial of estriol, one that
will involve 150 patients at multiple locations over the next two
years. The prospects, she said, are exciting.
Multiple sclerosis is an autoimmune disease of the central nervous
system that attacks the tissue surrounding the brain’s nerve fibers.
This tissue, called myelin, can be thought of as the insulation
wrapped around an electrical wire. When the myelin is damaged, the
nerve’s ability to send signals to and from the brain is interfered
with, resulting in symptoms common to MS, including problems with
balance, memory, vision loss and more.
Currently, anti-inflammatory drugs used to treat MS lessen the
symptoms and slow the progression of the disease. But they must be
given by injection daily, weekly or monthly — depending on the drug —
and are expensive, costing between $12,000 to $24,000 a year.
Estriol is a hormone produced by the placenta that is virtually
undetectable until pregnancy, when it progressively increases. It is
thought that its role is to suppress a woman’s immune system when she
is pregnant, so that the fetus will not be seen by the body as a
foreign “invader.”
“The beauty of estriol is that it can be given as a pill, not a shot,
and also that it’s not a new drug; it has decades of safety behind
it,” said Voskuhl, who holds the Jack H. Skirball Chair for Multiple
Sclerosis in the UCLA Department of Neurology. For years, estriol has
been in widespread use in Europe and Asia as hormone replacement
therapy for women with menopausal symptoms. The fact that the pill
already exists, she said, should dramatically reduce the cost of
treatment.
Most important of all, though, is that the drug potentially provides
a one-two punch against MS, both reducing the ability of immune cells
to attack the brain, as well as making the brain more resistant to
damage if any immune cells do make it through. “It’s a two-pronged
approach an anti-inflammatory prong to reduce the attacks, but also a
neuroprotective prong to make the brain suffer less damage in case of
an attack,” said Voskuhl.
In all, seven institutions from around the nation will be involved in
the two-year study. The investigators plan to recruit 150 women who
have not previously been treated for MS. They will be given either
estriol along with Copaxone, an MS drug currently in use, or a
placebo along with Copaxone. “That way, no one will receive less than
the standard of care,” Voskuhl said. The team will measure relapse
rates over the course of the trial.
Initial funding of $667,000 for the trial is being provided by the
Southern California Chapter of the National Multiple Sclerosis
Society. The total cost of the trial is expected to be $4.7 million.
For more information about the trial, please contact the UCLA MS
program at (310) 825-7313.
SOURCE: University of California, Los Angeles, Health Sciences
