Medicine by Design

Remyelination and Multiple Sclerosis

There are more teams around the world working on repairing damage caused by MS. The demyelination caused by MS and other diseases is where to body attacks the myelin. Demyelinated areas that show up on MRIs is the scar tissue that is left behind after the myelin has been attacked. The teams that are focused on this area are trying to promote remyelination in the body essentially by telling the body to replace the scar tissue with new myelin. While myelination occurs throughout life, the areas that are damaged by demyelinating diseases do not seem to get repaired in any major way.

Multiple Sclerosis and Medicine by Design

The University of Toronto (UT) has a program called Medicine by Design. According to the university, it is meant to bring together scientists of differing backgrounds to tackle problems in various medical fields. The university’s Medicine by Design page states

Medicine by Design is built on the model of a design studio where scientists, engineers and clinicians converge to conceive, create and test strategies to address critical problems in regenerative medicine.

They first thought about generating neurons to replace the neurons damaged by MS. They then realized that the biggest problem there would be getting the cell in place to replace the damaged cell says Freda Miller, a professor of Molecular Genetics at the University of Toronto.

“Even if you can convince the stem cells to make more neurons, those neurons then have to survive and they have to integrate into this really complex circuitry,” Miller said. “It just made sense to me that if we’re really going to test this idea of self-repair in the brain, we should go after something that’s more achievable biologically.”

The team decided that it would be easier to program stem cells for myelin repair and regeneration.

A different approach

While there is a team in Europe that is working on repairing myelin with a focus on MS. Their approach is to use mRNA to send instructions to the cells to repair the myelin. Dr. Miller’s team is not focusing specifically on MS, but all diseases that can cause demyelination. But any advances that promote remyelination will help many people with differing diseases, or even a different course of the same disease.  For example, Relapsing Multiple Sclerosis and Progressive Multiple Sclerosis. Dr. Miller’s approach is to try to use stem cells to repair the myelin.

“Even a little bit of remyelination could have a big impact. You don’t have to win the whole lottery; you don’t have to have 100 per cent remyelination to have a measurable outcome.” Miller said.

In a study published last year, Miller and colleagues showed that the diabetes medication metformin has the potential to repair brain injury in children who underwent radiation therapy for brain tumors. This study was the first to demonstrate that such brain repair is possible in humans, according to Miller.

“Science is like a playground right now. The approaches we’re using allow us to find so much information on things we could only dream of before.” Miller said.


Having these teams going after the same goal is wonderful. Having them take different approaches to the same problem is ideal. It doesn’t matter who gets to the end first. I would like to see all teams working on this problem to reach their goals. As we know, not all medications work for everyone. Would it be the same with remyelination? For example, could the mRNA vaccine work for some but not the stem cell therapy, and vice versa? We will not have an answer to that until both of these teams finish their research and we get both medications on the market. To me the ideal approach would be to have both teams get their product to market, so to speak, then try to find a way to combine them both into one medication. That way you are attacking the problem two ways at once.


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