Research: Action of Mitoxantrone


Burns SA, Lee Archer R, Chavis JA, Tull CA, Hensley LL, Drew PD. Mitoxantrone repression of astrocyte activation: Relevance to multiple sclerosis. Brain Res. 2012 Aug 2. [Epub ahead of print]

Mitoxantrone has been approved by the FDA for the treatment of multiple sclerosis (MS). However, the mechanisms by which mitoxantrone modulates MS are largely unknown. Activated astrocytes produce nitric oxide (NO), TNF-α, and IL-1β, molecules which can be toxic to central nervous system (CNS) cells including oligodendrocytes, thus potentially contributing to the pathology associated with MS. MCP-1 is a chemokine believed to modulate the migration of monocytes to inflammatory lesions present in the CNS of MS patients. IL-12 and IL-23 have been demonstrated to play critical roles in the pathogenesis of experimental autoimmune encephalomyelitis (EAE), an animal model of MS, by contributing to the development of CD4(+) T cell lineages termed Th1 and Th17, respectively. The current study demonstrates that mitoxantrone inhibits lipopolysachharide (LPS) induction of NO, TNF-α, IL-1β, and MCP-1 production by primary astrocytes. Mitoxantrone also inhibited IL-12 and IL-23 production by these cells. Furthermore, mitoxantrone suppressed the expression of C-reactive protein (CRP). Finally, we demonstrate that mitoxantrone suppressed LPS induction of NF-κB DNA-binding activity, suggesting a novel mechanism by which mitoxantrone suppresses the expression of proinflammatory molecules. Collectively, these studies demonstrate that mitoxantrone represses astrocyte production of potentially cytotoxic molecules, as well as molecules capable of altering T-cell phenotype. These in vitro studies suggest mechanisms by which mitoxantrone may modulate inflammatory diseases including MS. 

Mitoxantrone infusion bag 

As we are very aware, a lot of mechanisms of action of the drugs we use in current practise are not totally understood. And it is not only “aggressive” drugs, even paracetamol effect can be challenging. Mitoxantrone is not licensed for multiple sclerosis in UK, but it is used off license when MS is aggressive and other drugs do not work. There is a limit to how much mitoxantrone one person can take, as the risks of cardiotoxicity and acute myeloid leukemia are more frequent with each infusion.

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1 comment

  • Cardiotoxicity could be reduced by using Pixantrone……which is not availible for MSers up to this day…

    But somewhere I read, that the company who invented this drug is up for a Phase I and Phase II trial for MSers.

    Maybe ProfG or the MouseDoctos knows more?

    Mitox has helped me a lot with an aggressive an highly active MS with relapse after relapse (I am located in Germany). Too bad it only can be used up to a certain lifetime limit.
    Yes, I am aware of a secondary Leukemia.

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