DOCUMENT

Professor Anne La Flamme is a senior immunologist at the Malaghan Institute at Victoria University of Wellington, where she leads the multiple sclerosis (MS) research programme. Her research focusses on optimising current treatments and finding new drugs to improve the lives of people living with MS. In 2018 the Foundation awarded a project grant to Associate Professor Bronwyn Kivell, from the School of Biological Sciences, to evaluate the effectiveness of the drug nalfurafine in an MS model. In 2020 Professor La Flamme, Associate Professor Kivell and Professor Thomas Prisinzano of the University of Kentucky received funding from the New Zealand Innovation Booster Fund to co-found a spin-out company, Rekover Therapeutics, with the aim of trialling nalfurafine in MS patients. Multiple sclerosis: itch-drug could offer new hope Multiple sclerosis (MS) is an autoimmune disease that causes the fatty insulation layer surrounding nerves (myelin) to degenerate, resulting in a loss of movement, feeling and cognition. New Zealand has one of the highest rates of MS in the world, with over 3500 cases nationwide. There is no cure for MS and the development of new treatments has been a challenge due to the complexity of the disease. Professor La Flamme explains: “MS causes nerve degeneration via a process of demyelination. That is, the myelin sheaths, which protect the nerves and enable fast and efficient signaling, are destroyed. Essentially the immune system is misdirected to attack its own tissue. This destruction manifests in a variety of different symptoms of MS including motor, cognitive, and sensory dysfunction.” All current disease modifying therapies in MS target the immune system, which means they are only truly effective for the relapsing-remitting version of MS, which is caused by infiltrating immune cells. They have not been found to provide significant benefit for progressive MS. All forms of MS are caused by demyelination, thus there have been significant efforts internationally to not only prevent demyelination but to promote the regeneration of the myelin sheaths. “Finding a therapy that enhances remyelination during MS has become the newest holy grail in MS research as this type of therapy would provide benefit to all people with MS, both relapsing- remitting and progressive,” says Professor La Flamme. More commonly used to treat itching in patients with kidney failure, nalfurafine is already in clinical use and has proven to be a very safe and well-tolerated medication. Using two experimental models of MS, the team has shown that the drug is also effective at remyelination. They have received approval to proceed with clinical trials in MS patients to uncover the potential of this drug in treating MS. “Based upon our promising preclinical work, we are preparing to test the use of nalfurafine to promote remyelination in MS in a randomised, controlled clinical trial. We are excited to see the application of our Neurological Foundation-funded research toward improving the lives of all people with MS.” 1. Denny L, Al Abadey A, Robichon K, Templeton N, Prisinzano TE, Kivell BM, La Flamme AC. Nalfurafine reduces neuroinflammation and drives remyelination in models of CNS demyelinating disease. Clin Transl Immunology. 2021. 10(1):e1234. 8 Headlines Professor Anne La Flamme will be speaking as part of the Brain Matters series on 13 October at the Whanganui War Memorial Centre. Further details and registration can be found at neurological.org.nz