Monday, 23 March 2015

Another remyelination target

Way SW, Podojil JR, Clayton BL, Zaremba A, Collins TL, Kunjamma RB, Robinson AP, Brugarolas P, Miller RH, Miller SD, Popko B.Pharmaceutical integrated stress response enhancement protects oligodendrocytes and provides a potential multiple sclerosis therapeutic.Nat Commun. 2015 ;6:6532. doi: 10.1038/ncomms7532.

Oligodendrocyte death contributes to the pathogenesis of the inflammatory demyelinating disease multiple sclerosis (MS). Nevertheless, current MS therapies are mainly immunomodulatory and have demonstrated limited ability to inhibit MS progression. Protection of oligodendrocytes is therefore a desirable strategy for alleviating disease. Here we demonstrate that enhancement of the integrated stress response using the FDA-approved drug guanabenz increases oligodendrocyte survival in culture and prevents hypomyelination in cerebellar explants in the presence of interferon-γ, a pro-inflammatory cytokine implicated in MS pathogenesis. In vivo, guanabenz treatment protects against oligodendrocyte loss caused by CNS-specific expression of interferon-γ. In a mouse model of MS, experimental autoimmune encephalomyelitis, guanabenz alleviates clinical symptoms, which correlates with increased oligodendrocyte survival and diminished CNS CD4+ T cell accumulation. Moreover, guanabenz ameliorates relapse in relapsing-remitting experimental autoimmune encephalomyelitis. Our results provide support for a MS therapy that enhances the integrated stress response to protect oligodendrocytes against the inflammatory CNS environment.

Guanabenz (pronounced GWAHN-a-benz, sold under the trade name Wytensin) is an alpha agonist of the alpha-2 adrenergic receptor that is used as an antihypertensive drug. It is used to treat high blood pressure (hypertension). This inhibits oligodendrocyte loss and inhibts EAE which rather suggests that there is some immunomodulatory effect.


  1. This drug seems to protect oligodendrocytes by diminishing the inflammatory environment. How is this different than the DMTs that all show anti-inflammatory action in EAE? In RRMS remyelination occurs but with reduced thickness of myelin surrounding the axon, does this drug just show increased oligo survival or will it lead to enhanced remyelination? On the surface, it seems controlling the inflammatory environment has taken MS research to this current level but is it enough to reverse damage via repair?

  2. Assuming it works, would this be applicable to the progressive forms of MS? I've read that there is usually little to no visible inflammation in those disease courses.


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