Rebooting your immune system?

OneNews had a strange-looking story about multiple sclerosis tonight, with lots of footage of one British guy who’d got much better after treatment, and some mentions of an ongoing trial. With the trial still going on, it wasn’t clear why there was publicity now, or why it mostly involved just one patient.

I Google these things so you don’t have to.

So. It turns out there was a new research paper behind the publicity. There is an international trial of immune stem cell transplant for multiple sclerosis, which plans to follow patients for five years after treatment. The research paper describes what happened for the first three years.

As the OneNews story says, there has been a theory for a long time that if you wipe out someone’s immune system and start over again, the new version wouldn’t attack the nervous system and the disease would be cured. The problem was two-fold. First, wiping out someone’s immune system is an extraordinarily drastic treatment — you give a lethal dose of chemotherapy, and then rescue the patient with a transplanted immune system. Second, it didn’t work reliably.

The researcher behind the current trial believes that the treatment would work reliably if it was done earlier — during one of the characteristic remissions in disease progress, rather than after all else fails. This trial involves 25 patients, and so far the results are reasonably positive, but three years is really to soon to tell whether the benefits are worth the treatment. Even with full follow-up of this uncontrolled study it probably won’t be clear exactly who the treatment is worthwhile for.

Why the one British guy? Well,

The BBC’s Panorama programme was given exclusive access to several patients who have undergone the stem cell transplant.

The news story is clipped from a more in-depth current-affairs programme. That BBC link also shows a slightly worrying paranoid attitude from the lead researcher

He said: “There has been resistance to this in the pharma and academic world. This is not a technology you can patent and we have achieved this without industry backing.”

That might explain pharma, but there’s no real reason for the lack of patents to be a problem for academics. It’s more likely that doctors are reluctant to recommend ultra-high-dose chemotherapy without more concrete evidence. After all, it was supposed to work for breast cancer and didn’t, and it was theorised to work for HIV and doesn’t seem to. And at least in the past it didn’t work reliably for multiple sclerosis.

All in all, I think the OneNews story was too one-sided given the interim nature of the data and lack of availability of the treatment.  It could also have said a bit more about how nasty the treatment is.  I can see it being fine as part of a story in a current affairs programme such as Panorama, but as TV news I think it went too far.