University of Edinburgh team identify possible trigger of devastating spinal cord inflammation

A report published in this month’s Lancet Neurology shows how a novel ultrasensitive assay can help define an important new side effect of interferon-α therapy. January 2020.

Interferon-α is a molecule which protects the body against viruses and can be used as a treatment for cancer, infections and immune diseases. A new report, led by Dr David Hunt (UKDRI, IGMM, Anne Rowling Clinic), and involving Professor Yanick Crow and Professor Andrew Jackson (IGMM), describes how a serious disease of the spinal cord, called neuromyelitis optica spectrum disorder (NMOSD), can develop in people who have very high interferon-α concentrations in their blood.

Assessing patients referred to the Scottish NMOSD clinic at the Anne Rowling Clinic in Edinburgh, the team identified two cases of NMOSD which developed after interferon-α treatment, and a further two patients who developed NMOSD in the context of diseases which cause the body to produce too much of its own interferon-α. Interferon-α levels have been very difficult to measure in the past, but Professor Crow and research teams from the Institut Pasteur in Paris have developed a new method of measuring interferon-α which was used in the study and helped identify the link between interferon-α and spinal cord inflammation. This test, called Single Molecular Array (SIMOA), can detect tiny amounts of interferon-α protein and is the most accurate blood test to date.

These findings have two important implications. Firstly they suggest that interferon-α can trigger the development of NMOSD, and this is a potentially significant drug safety concern. Although this is a very rare risk, it is important that people who are prescribed interferon-α are aware of this serious side effect, since NMOSD can be treated effectively if diagnosed early. The study team have proposed that this side effect, and its early warning signs, are clearly signalled on the drug’s information sheet. Secondly these findings might help us understand how interferon-α plays a role in generating antibodies which can damage the nervous system. This could, in turn, help us treat conditions like NMOSD in the future. Furthermore, the work highlights the value of the SIMOA technology that is now available in Edinburgh through Dr Hunt and Professor Crow.

Links

Article at The Lancet Neurology https://doi.org/10.1016/S1474-4422(19)30445-4

Dr David Hunt Website

Prof Yanick Crow's Research Group Website

CGEM webstory on SIMOA technology Website