Harnessing Secondary Metabolites in MS Treatment

Multiple sclerosis (MS) is a chronic, primarily inflammatory disorder of the central nervous system that affects around 2.5 million people worldwide. The disease is characterized by immune-mediated demyelination, axonal damage, and dysfunctions in multiple CNS functions. Despite the expanding repertoire of anti-inflammatory disease-modifying treatments, finding drugs to treat progression remains the greatest unmet need for people with MS. Drug repurposing is an attractive strategy to address this need, as it allows for the identification of new therapeutic uses for existing drugs, potentially reducing development time and cost.

Secondary Metabolites in MS Drugs
Secondary metabolites are compounds produced by living organisms that are not directly involved in the primary metabolic pathways necessary for growth, development, and reproduction. However, these compounds often have important biological activities and can be used for various therapeutic purposes. In the context of MS drugs, secondary metabolites can play a crucial role in modulating the immune response and reducing inflammation.

One example of a drug with secondary metabolites used in MS treatment is glatiramer acetate. This drug is an immunomodulatory agent that works by binding to the major histocompatibility complex class II molecules, altering the immune response and reducing the production of pro-inflammatory cytokines. The secondary metabolites in glatiramer acetate are thought to contribute to its immunomodulatory effects, making it an effective treatment option for relapsing-remitting MS (RRMS) and clinically isolated syndrome (CIS).

Another drug with secondary metabolites used in MS treatment is dimethyl fumarate. This drug is an immunomodulatory and neuroprotective agent that works by inducing lymphocytopenia, reducing inflammation, and promoting the survival of neurons and oligodendrocytes. The secondary metabolites in dimethyl fumarate are thought to contribute to its immunomodulatory and neuroprotective effects, making it an effective treatment option for RRMS.

Effects on Disease
The use of secondary metabolites in MS drugs can have significant effects on the disease course and progression. For instance, glatiramer acetate has been shown to reduce the frequency of clinical relapses and the number of new or enlarging T2 hyperintense lesions in RRMS patients. Dimethyl fumarate, on the other hand, has been shown to reduce the annualized relapse rate, the number of new or enlarging T2 hyperintense lesions, and the risk of disability progression in RRMS patients.

Moreover, the use of secondary metabolites in MS drugs can also have beneficial effects on the overall quality of life of patients. For example, both glatiramer acetate and dimethyl fumarate have been associated with improvements in fatigue, cognitive function, and overall health-related quality of life in RRMS patients.

Conclusion
In conclusion, secondary metabolites play a crucial role in the mechanism of action of several MS drugs, contributing to their immunomodulatory and neuroprotective effects. These drugs have been shown to reduce the frequency of clinical relapses, the number of new or enlarging T2 hyperintense lesions, and the risk of disability progression in RRMS patients, as well as improve their overall quality of life. Therefore, the repurposing of existing drugs with secondary metabolites holds great promise for the development of new and effective treatments for MS.

Reference:
Cunniffe, N., Vuong, K. A., Ainslie, D., Baker, D., Beveridge, J., Bickley, S., ... & Coles, A. (2021). Systematic approach to selecting licensed drugs for repurposing in the treatment of progressive multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry, 92(3), 295-302.
Rispoli, M. G., Valentinuzzi, S., De Luca, G., Del Boccio, P., Federici, L., Di Ioia, M., ... & Tomassini, V. (2021). Contribution of metabolomics to multiple sclerosis diagnosis, prognosis and treatment. International Journal of Molecular Sciences, 22(20), 11112.
Zadeh, A. R., Ghadimi, K., Ataei, A., Askari, M., Sheikhinia, N., Tavoosi, N., & Falahatian, M. (2019). Mechanism and adverse effects of multiple sclerosis drugs: a review article. Part 2. International journal of physiology, pathophysiology and pharmacology, 11(4), 105.