United Press International - Monday, 24 September 2001
Bruce Sylvester

Researchers have been surprised that drugs used to fight human immunodeficiency virus also appear to be effective in stopping the progression of this form of ALS, according to two related articles in the Sept. 25 issue of Neurology, the scientific journal of the American Academy of Neurology.

"This is exciting news, because if this form of ALS caused by HIV is treatable, then other forms of ALS may be treatable as well," said Dr. Burk Jubelt, professor of neurology at the State University of New York Upstate Medical University in Syracuse. Jubelt wrote the editorial published with the Neurology articles.

"But more research needs to be done to confirm these results and determine whether there are other viral causes of ALS," he said.

ALS is a progressive disease of the central nervous system and there are no approved drugs to stop or reverse the process. It was named after the Yankee baseball great Lou Gehrig.

The Food and Drug Administration has approved one drug Rilutek or riluzole that slows the disease. Working its way toward FDA approval is Myotrophin or somatomedin C, a recombinant insulin-like growth factor that also may help slow the disease.

In one of the Neurology studies, French researchers report tracking 1,700 HIV-infected subjects over a 13-year period. Six of the subjects developed ALS, a much higher ALS rate than in the general population.

"Causes other than HIV for the motor neuron disease were ruled out," said study author Dr. Antoine Moulignier, a researcher at the Adolphe de Rothschild Foundation in Paris. After receiving HIV drugs, two of the patients recovered completely, three improved and one stabilized. Moulignier said more research is needed to discover how HIV causes this apparently treatable form of ALS.

In the other report, a case study written by Dr. Daniel MacGowan, assistant professor of neurology at Albert Einstein College of Medicine in New York, a 32-year-old woman who had ALS-like symptoms also tested HIV-positive. After a regimen of HIV drugs, the woman recovered completely from the ALS symptoms.

"For the first time we have a patient with a motor neuron disease who has responded to anti-viral therapy," MacGowan told United Press International. "It looks like it was the protease inhibitor used to treat the HIV that had the impact on the patient's ALS. We speculate that the protease inhibitor might have stopped the death of motor nerve cells in the spinal chord caused by the disease. This hypothesis will form the basis of further research."

(Reported by Bruce Sylvester from West Palm Beach, Fla.)
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