Treatment with the phosphodiesterase type-4 inhibitor rolipram fails to inhibit blood-brain barrier disruption in multiple sclerosis

Bibiana Bielekova, Nancy Richert, Thomas Howard, Amy N. Packer, Gregg Blevins, Joan Ohayon, Henry F. McFarland, Claus Steffen Stürzebecher, Roland Martin

Research output: Contribution to journalArticle

Abstract

Rolipram, a prototypic phosphodiesterase-4 inhibitor, is highly effective in suppressing Th l autoimmunity in multiple animal models, including experimental autoimmune encephalomyelitis. In addition, rolipram has been extensively studied as a potential neuroprotective agent. Based on its anti-inflammatory activity, we tested the efficacy of rolipram in suppressing inflammatory disease activity in multiple sclerosis in a proof-of-principle phase I/II open-label clinical trial. Enrolled MS patients were evaluated by monthly MRI and clinical examinations during 3 months (four MRIs) of pretreatment baseline and 8 months of rolipram therapy. The primary outcome was a change in contrast-enhanced lesions between baseline and the last 4 months of rolipram therapy. Previously defined biomarkers of rolipram-mediated immunomodulation were evaluated during the study. The trial was stopped prematurely because the drug was poorly tolerated and because of safety concerns: we observed an increase, rather than decrease, in the brain inflammatory activity measured by contrast-enhanced lesions on brain MRI. At the administered doses rolipram was active in vivo as documented by immunological assays. We conclude that the reasons underlying the discrepancy between the therapeutic efficacy of rolipram in experimental autoimmune encephalomyelitis versus multiple sclerosis are at present not clear.

Original languageEnglish (US)
Pages (from-to)1206-1214
Number of pages9
JournalMultiple Sclerosis
Volume15
Issue number10
DOIs
StatePublished - 2009
Externally publishedYes

Keywords

  • Autoimmunity
  • Blood-brain barrier
  • Clinical trial
  • Multiple sclerosis
  • Phosphodiesterase-4
  • Rolipram

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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  • Cite this

    Bielekova, B., Richert, N., Howard, T., Packer, A. N., Blevins, G., Ohayon, J., McFarland, H. F., Stürzebecher, C. S., & Martin, R. (2009). Treatment with the phosphodiesterase type-4 inhibitor rolipram fails to inhibit blood-brain barrier disruption in multiple sclerosis. Multiple Sclerosis, 15(10), 1206-1214. https://doi.org/10.1177/1352458509345903