Multiple Sclerosis is a disease with no known cause. However, a runaway train can sometimes be safely returned to its station, never to venture out again.
Finding an engineer who can steer the train back to the rest position, is better than a team of “well trained philosophers” who can stand on the tracks yelling “stop” while being run over by the high speed express.
Suffice it to say, we know millions of facts about Multiple Sclerosis but have no cure. Yet in recent years, we have borrowed from British physicians, semi-clueless centuries ago, who learned that while they didn’t quite know what congestive heart failure was, they could treat it fairly well in some middle agers in the Middle Ages by the addition of the foxglove plant which contains what we now understand to be digitalis.
Serendipity was what allowed Dr. William Withering at that time to come upon the foxglove therapy that was then called dropsy because of the tendency of such patients to collapse.
Lithium and Penicillin were also discovered to be effective based upon discoveries that were not based on a modern understanding of biopsychiatric illness intervention or infectious disease eradication.
This brings us to the uses for Tetracyclines: from http://www.smart-drugs.com/product-info/info-tetracycline.html
Infections resulting from micro-organisms that are sensitive to Tetracycline, in particular:
- Bacterial pneumonia and bronchial pneumonia
- Acute infections in the urogenital area and renewal of acute phase
- Surgical infections (infections of soft tissue, osteomyelitis)
- Acute and subacute infections of the intestinal tract, bacterial and amoebic dysentery, dysenteric syndrome in adults and children
- Acute and subacute endocarditis
- Epidemic cerebrospinal meningitis and purulent meningitis in general
- Problems related to ear, nose and throat (tonsillitis, otitis, sinusitis, mastoiditis), eyes (conjunctivitis, blepharitis, trachoma), gynecological disorders (adnexitis, metritis, cervicitis, vulvovaginitis) and skin disorders (furuncolisis, impetigo, acne)
Amazingly, as you see, none of these bacterial disease relate to MS, which is of course not proven to be caused by any known microbe.
This is where the combination of train driving without really knowing all about trains, trying certain agents for certain diseases and getting lucky and stumbling upon novel causes for substances found in nature adds up to a recent promising report.
It seems one of the tetracyclines, a semi-synthetic form called doxycycline, when combined in Relapsing and Remitting MS patients with interferon beta-1a showed significant reductions in clinical relapses, brain lesions and disability scores.
Alireza Minagar, MD, a former colleague of mine who is now at Louisiana State University, reported this in the 12/1007 edition of the Archives of Neurology. Rather than utilizing an anti-bacterial effect, doxycycline, like another tetracycline studied in similar studies called minocycline, may be working in MS via its anti-inflammatory effect by blocking matrix metalloproteinases (MMPs) in the brain that are inflammatory. MMPs also block the anti-inflammatory effects of beta-interferon so decreasing their amounts, will allow more beta seron to be available to control the inflammatory cascade.
Minagar need not know everything about MS, but in the common RRMS version of the disease, I hope the railroad has one less runaway train.