Researchers stop neuromyelitis optica attacks with new therapy

October 9, 2012

Mayo Clinic researchers have identified a new therapy for patients with neuromyelitis optica that appears to stop inflammation of the eye nerves and spinal cord. NMO is a debilitating central nervous system disorder that is often misdiagnosed as multiple sclerosis (MS). In the study, patients with severe symptoms of the disease, also known as NMO, were given eculizumab, a drug typically used to treat blood disorders.

While not a cure, the therapy Mayo Clinic researchers used in the study to halt attacks could potentially lead to longer attack-free periods for the thousands of NMO worldwide. The research is being presented Oct. 9 at the Annual Meeting in Boston.

NMO manifests itself in attacks that can cause blindness in one or both eyes, weakness or paralysis in the legs or arms, painful spasms, loss of sensation, and bladder or bowel dysfunction from damage. Attacks may be reversible, but can be severe enough to cause permanent visual loss and problems with walking. NMO can affect children as young as 2 and adults as old as 90. It is more prevalent in females than males, but affects all racial and ethnic groups. Immunosuppressants are the first line of treatment for NMO.

Mayo Clinic researchers have been international leaders in NMO diagnosis and treatment. In 2004, Mayo Clinic researchers discovered the antibody NMO-IgG—the first serum for any form of inflammatory demyelinating brain disease. A year later, they identified the target of the antibody as the water channel aquaporin 4. These discoveries helped physicians better understand the cause and potential treatments for NMO.

Mayo researchers studied 14 NMO patients with active and severe disease symptoms, defined as two attacks in the previous six months, or three within the past year. When the NMO-IgG antibody binds to its target on brain cells, it activates complement, a substance that can kill or injure these . Patients were treated with eculizumab, an antibody that stops complement from being activated. All 14 study participants received the treatment intravenously every two weeks for one year.

"Disability in NMO is attack related and these attacks are usually severe. If untreated, they can have devastating, irreversible effects on function," says lead author Sean Pittock, M.D., a Mayo Clinic neurologist. "If we can stop the attacks in NMO—and it appears we can—then we can hopefully prevent disability and allow patients to maintain function and a good quality of life.

Twelve patients were symptom free throughout the year of treatment. Two patients had one attack each, but these were mild and considered by the investigators to be "possible, not definite" attacks. One experienced mild back pain but had no new findings on neurologic examination or MRI scan of the spinal cord. The other experienced mild visual blurring in the right eye but also was receiving antibiotic therapy for a presumed urinary tract.

Because NMO has only recently been identified as a syndrome distinct from MS, knowing how many people have it is difficult. Mayo is studying NMO's prevalence. Mayo Clinic's Neuroimmunology Laboratory so far has detected the antibody in roughly 3,500 U.S. patients.

"We've learned there are many people who fit within the NMO spectrum who, in the past, were believed to have MS," says co-author Dean Wingerchuk, M.D., a neurologist at in Arizona. "In addition, distinguishing NMO from MS is important for preserving the validity of therapeutic trials for MS by not enrolling patients with NMO."

Explore further: Research improves diagnosis and potential treatment of neuromyelitis optica

Related Stories

Research improves diagnosis and potential treatment of neuromyelitis optica

December 2, 2011
Mayo Clinic researchers have identified critical steps leading to myelin destruction in neuromyelitis optica (NMO), a debilitating neurological disease that is commonly misdiagnosed as multiple sclerosis (MS). The findings ...

Low vitamin D levels may be associated with recurrent inflammatory spinal cord disease

November 14, 2011
Vitamin D levels are significantly lower in patients with recurrent inflammatory spinal cord disease, according to a study published Online First by Archives of Neurology.

Mayo Clinic finds tool to predict disability timeline for progressive MS patients

April 12, 2011
Many patients with progressive multiple sclerosis (MS) worry how quickly the disease will progress. Now, by noting the presence of certain markers in a commonly performed diagnostic test, Mayo Clinic researchers can predict ...

Study shows halting an enzyme can slow multiple sclerosis in mice

April 30, 2012
Researchers studying multiple sclerosis(MS) have long been looking for the specific molecules in the body that cause lesions in myelin, the fatty, insulating cells that sheathe the nerves. Nearly a decade ago, a group at ...

Recommended for you

Two Group A Streptococcus genes linked to 'flesh-eating' bacterial infections

September 22, 2017
Group A Streptococcus bacteria cause a variety of illnesses that range from mild nuisances like strep throat to life-threatening conditions including pneumonia, toxic shock syndrome and the flesh-eating disease formally known ...

Ecosystem approach makes urinary tract infection more treatable

September 22, 2017
The biological term 'ecosystem' is not usually associated with urinary tract infections, but this should change according to Wageningen scientists.

Residents: Frontline defenders against antibiotic resistance?

September 22, 2017
Antibiotic resistance continues to grow around the world, with sometimes disastrous results. Some strains of bacteria no longer respond to any currently available antibiotic, making death by infections that were once easily ...

Superbug's spread to Vietnam threatens malaria control

September 21, 2017
A highly drug resistant malaria 'superbug' from western Cambodia is now present in southern Vietnam, leading to alarming failure rates for dihydroartemisinin (DHA)-piperaquine—Vietnam's national first-line malaria treatment, ...

Investigators may unlock mystery of how staph cells dodge the body's immune system

September 21, 2017
For years, medical investigators have tried and failed to develop vaccines for a type of staph bacteria associated with the deadly superbug MRSA. But a new study by Cedars-Sinai investigators shows how staph cells evade the ...

A dose of 'wait-and-see' reduces unnecessary antibiotic use

September 21, 2017
Asking patients to take a 'wait-and-see' approach before having their antibiotic prescriptions filled significantly reduces unnecessary use, a University of Queensland study has shown.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.