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New test customizes treatment for multiple sclerosis

by Anissa Anderson Orr

Jingwu Zhang, MD, PhD

Slowly and unpredictably, multiple sclerosis forces the immune system to attack a patient’s healthy tissue, causing a wide and varying range of symptoms including blurred vision, slurred speech, tremors, extreme fatigue, paralysis, and blindness.

Since the disease often progresses at a snail’s pace, and some symptoms come and go, determining which medication makes a difference in an individual patient can take years.

Researchers with the Baylor College of Medicine in Houston - The Methodist Hospital Multiple Sclerosis Center have developed a new diagnostic technique that will allow multiple sclerosis doctors to customize treatment for their patients.

“We are developing new assays, like gene chip analysis, that help clinicians to better diagnose and treat their patients with MS,” said Jingwu Zhang, MD, PhD, director of research for the center.

From a simple blood test, researchers can tell which of the U.S. Food and Drug Administration-approved treatments for multiple sclerosis will work best on each individual patient. Currently, glatiramer acetate (Copaxone) or beta-interferon (Avonex, Betaseron) are both approved treatment of the disorder. Each is designed to reduce the number of attacks or relapses a patient has with multiple sclerosis.

Zhang and his research team took about a year to develop the test. They have identified 30 to 40 different genes that are regulated by both medications. While other researchers have identified single genes that are regulated by MS medications, Zhang believes he is the first to assemble a large number of genes together in one format.

A patient who has more genes that are regulated by beta-interferon will respond better to that drug. One who has a majority of genes regulated by glatiramer acetate will respond better to that one.

The test costs less than 10 percent of the typical microarray test, which can average about $1,500, and it requires just five cubic centimeters of blood to process.

Zhang is applying for a patent for the test, and is offering it as a service to patients of the center’s Maxine Mesinger Multiple Sclerosis Clinic, which opened Sept. 9, 2003. The clinic is located on the first floor of BCM and Methodist’s Neurosensory Center building, while Zhang’s lab is on the third floor, a convenient arrangement for both patients and researchers.

Clinic patients also benefit from unique access to multiple sclerosis research studies conducted at BCM including stem cell transplantation and national trials testing new MS drugs. A strong emphasis in basic research forms the foundation of all the center’s clinical trials. Zhang’s lab is currently exploring the mechanisms behind multiple sclerosis, in particular focusing on the role of T-cells and the role of viral infections in multiple sclerosis.

“The more we understand about multiple sclerosis and how it works, the better we can diagnose and treat patients with the disease,” Zhang said.

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