February 04, 2021 1:15 PM

Immune Cells Suggest Men and Women with ALS May Benefit from Different Treatment

Effective treatments for ALS have eluded scientists for decades. A new examination of the immune system shows the appeal of personalized medicine for future care.

drawing of brain in blue ink with yellow badge that says lab note in blue ink
Credit: Stephanie King

A new study finds the immune systems for male and female patients with ALS, or amyotrophic lateral sclerosis, react differently to the disease.

Researchers say it’s the first step toward finding specific treatments for subsets of patients that could be more effective than the one-size-fits-all options currently available or in the pipeline.

“We know that the immune system is clearly linked to ALS onset and progression,” says Eva L. Feldman, M.D., Ph.D., the Russell N. DeJong Professor of Neurology and director of the ALS Center of Excellence at Michigan Medicine. “This is important as there are many existing and FDA-approved, immune-based drugs that could be repurposed to treat ALS. But we need to figure out which groups of patients - like men or women, old or young - could benefit from each drug.”

To examine the immune system in ALS, Feldman and lead author Benjamin Murdock, Ph.D., an assistant professor of neurology, honed in on neutrophils, which are a type of white blood cell that respond to infections and damaged tissue. Higher levels of these cells were associated with faster disease progression and death in women. A total of 269 Michigan Medicine patients with ALS (120 women and 149 men) participated in the study.

“This research is an important first step in what we hope will open new doors to ALS treatment,” said co-author Stephen Goutman, M.D., M.S., director of the Pranger ALS Clinic and an associate professor of neurology. “There are also other types of cells in the immune system – like natural killer cells and T cells – that we are scheduled to explore next to see how they function in different groups of ALS patients. We’re quite excited about this work.”

Feldman says past clinical trials have often shown promise, but weren’t effective in a large enough percentage of general participants to warrant additional trials.

Paper cited: “Amyotrophic Lateral Sclerosis Survival Associates with Neutrophils in a Sex-specific Manner,” Neurology-Neuroimmunology & Neuroinflammation. DOI: 10.1212/NXI.0000000000000953