Results from a clinical trial led by Dr Nick Cunniffe (Medicine 2006 and Clinical Neurosciences PhD 2018) suggest that a common diabetes drug taken with an antihistamine can partially repair damage in the nervous system in people with multiple sclerosis (MS).

Nick’s research is focused on boosting the body’s mechanisms for repairing myelin, the protective fatty coating around nerve cells which is damaged in MS. His team discovered that six months of treatment with a combination of the diabetes drug metformin and the antihistamine clemastine leads to myelin regeneration in damaged nerves.

“I am increasingly sure that remyelination is part of the solution to stopping progressive disability in MS,” says Nick.

“We still need to research the long-term benefits and side effects before people with MS consider taking these drugs. But my instinct is that we are on the brink of a new class of treatments to stop MS progression, and within the next decade we could see the first licensed treatment that repairs myelin and improves the lives of people living with MS.”

MS arises when the immune system attacks the myelin sheath around nerves in the brain and spinal cord, which slows or stops the electrical signals passing along these nerves. Early symptoms include tingling, numbness, a loss of balance, and vision problems; progressive MS can result in tremors, speech problems, muscle stiffness and spasms.

According to the MS Society, which funded the research, there are more than 150,000 MS patients in the UK, with 135 diagnosed each week, mostly in their 30s and 40s.

“We should be measured in our response to this result,” adds Nick. “My conclusion is that the drugs have a biological effect to promote remyelination, but the effect was smaller than we had hoped, and people did not feel better on these drugs over six months.

“We are not disheartened by that, because the benefit of remyelination is to insulate and protect nerves from degenerating in the long term. Therefore, a reduction in progressive disability from these drugs might take several years to become apparent.

“The next step is to see what happens to patients in the years after the trial, because I suspect that people who were given the remyelinating drug even for six months may experience long-term benefits. We also need to continue to research novel drugs that target remyelination mechanisms with more potency.”

In addition to his work as an academic neurologist at the University of Cambridge, Nick supervises neuroscience to medical students at Gonville & Caius College. It is an affiliation he enjoys maintaining, looking back fondly on his own education at Caius.

“The person at Caius who had the greatest influence on me was Professor Roger Carpenter,” Nick adds. “He inspired my passion for neuroscience at an early stage and introduced me to teaching at the College – something I’ve enjoyed and continued since 2010.

“Caius set me firmly on the path to neuroscience research, and I remain deeply grateful to the College for that foundation.”