Multiple sclerosis patients who have albuterol, a medication used to treat asthma and some respiratory diseases, added to their treatment appear to benefit with improved clinical outcomes, say researchers in an article published in Archives of Neurology.
Multiple sclerosis is a long-term (chronic) inflammatory disease in which the myelin – the coating of nerve cells in the white matter of the CNS (central nervous system) – degenerates. Multiple sclerosis patients have high levels of inteleukin-12, a compound that encourages the generation of a type of helper T cell linked to myelin degeneration.
Alubterol sulfate, which is commonly used for the treatment of constricted airways within the lungs (bronchospasm), might lower levels of interleukin-12, the authors explain.
Samia J. Khoury, M.D., Brigham and Women’s Hospital and Harvard Medical School, Boston, and team examined the effects of albuterol treatment when added to glatiramer acetate for patients with relapsing-remitting multiple sclerosis.
The trial involved 44 patients with multiple sclerosis. They were randomly selected into two groups:
- Albuterol group – they received daily subcutaneous 20-milligram injections of glatiramer acetate plus an oral dose of 4 milligrams of albuterol daily, for two years (subcutaneous means under the skin)
- Placebo group – they received daily subcutaneous 20-milligram injections of glatiramer acetate plus an oral dose of 4 milligrams of a placebo daily, for two years
They were all examined by a neurologist at the start of the study, and then again at 6, 12, 18 and 24 months – blood samples were taken at the beginning, and then again at 3, 6, and 12 months. MRI (magnetic resonance imaging) scans of the brain were done at the beginning, then at 12 and 24 months.
Thirty-nine of the 44 patients took part in the trial long enough to contribute to an analysis.
The researchers found that:
- Assessments of functional status – improvement was observed in the albuterol group compared with the placebo group at 6 and 12 months, but not at 24 months.
- The patients in the albuterol group experienced a delay in the time of their first relapse, compared to the patients in the placebo group.
- Blood tests – interleukin-13 and interferon-gamma production, two inflammatory markers, were lower in both treatment groups, with a treatment effect on interleukin-13 observed at the 12-month time point.
Adverse events (undesirable side effects) were mild, with just three moderate or severe events that were seen as treatment related (including reaction at the glatiramer acetate injection site, leg weakness and chest tightness).
The authors concluded:
We conclude that treatment with glatiramer acetate plus albuterol is well tolerated and improves clinical outcomes in patients with multiple sclerosis,” the authors write. “The combined regimen seems to enhance clinical response during the first year of therapy.
The term Multiple Sclerosis comes from the Latin multus plus plica meaning “fold”, and the Greek sklerosis meaning “hardening”.
With MS the central nervous system (CNS) is attacked by the person’s own immune system. That is why MS is known as an auto-immune disease. The CNS includes the brain, spinal cord and optic nerves.
Nerve fibers are surrounded by myelin, which protects the nerve fibers. Myelin also helps conduct electrical signals, also termed impulses – i.e. myelin facilitates a good flow of electricity along the nervous system from the brain.
The myelin of a patient with MS disappears in several areas (multiple areas). This leaves a scar (sclerosis). Multiple Sclerosis means Scar Tissue. The areas where there is either not enough or no myelin are called plaques or lesions. As the lesions get worse the nerve fiber can break or become damaged.
When a nerve fiber has less myelin the electrical impulses received from the brain do not flow smoothly to the target nerve – when there is no myelin the nerve fibers cannot conduct the electrical impulses at all. The electrical impulses are instructions from the brain to carry out actions, such as to move a muscle. MS is the disability to get your body to do what your brain wants it to.
Click here to read about multiple sclerosis in more detail.
Samia J. Khoury, MD; Brian C. Healy, PhD; Pia Kivisäkk, PhD, MD; Vissia Viglietta, PhD, MD; Svetlana Egorova, PhD; Charles R. G. Guttmann, MD; Josiah F. Wedgwood, MD, PhD; David A. Hafler, MD; Howard L. Weiner, PhD; Guy Buckle, MD; Sandra Cook, RN; Susheel Reddy, PhD
Arch Neurol. 2010;67(9):1055-1061. doi:10.1001/archneurol.2010.222
Written by Christian Nordqvist