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On August 26, 2024, an article titled "Repurposing of Glatiramer Acetate to Treat Cardiac Ischemia in Rodent Models" was published in Nature Cardiovascular Research. The study highlights the potential of Glatiramer Acetate (GA), a drug commonly used to treat multiple sclerosis (MS), in repairing heart damage in mice and rats following heart attacks or heart failure.

Glatiramer Acetate is a synthetic random copolymer composed of four amino acids and is widely used for treating multiple sclerosis. GA was initially designed to mimic the myelin basic protein, a self-antigen, and has shown effectiveness in animal models of MS. However, numerous studies have revealed its broad immunomodulatory and anti-inflammatory effects, impacting both innate and adaptive immune responses. Given these properties, researchers from the Weizmann Institute of Science in Israel hypothesized that GA could potentially mitigate the pathological inflammatory processes associated with myocardial injury, prevent the progression of heart damage, and improve cardiac outcomes.

The study found that Glatiramer Acetate was indeed effective in treating heart damage in mouse models. The treated mice exhibited improved cardiac function and reduced scar tissue in the heart. In addition to its known immunomodulatory effects—evident in the context of myocardial inflammation—GA also promoted the survival of cardiomyocytes from ischemia-induced death, reduced fibrosis, and enhanced angiogenesis. In vitro and ex vivo experiments demonstrated the paracrine effect of stromal cells on cardiomyocytes. Interestingly, in a rat model of heart failure, short-term GA treatment led to improved left ventricular systolic function, enhancing the heart's pumping ability and inhibiting the progression of interstitial fibrosis, further confirming the cardioprotective benefits of GA.

Glatiramer Acetate is not the first drug to be repurposed for new uses. The concept of "old drugs, new uses" has a long history in medicine, with many such drugs still proving to be among the most effective treatments today.

Aspirin: Initially used clinically for its pain-relieving and fever-reducing properties, aspirin has since been found to reduce the recurrence of stroke, treat cerebral thrombosis, prevent myocardial infarction, prevent thrombosis after heart valve surgery, prevent venous thrombosis, treat dysmenorrhea, manage diabetic retinopathy, prevent Alzheimer's disease, and possibly lower blood sugar and prevent cancer.

Statins: Statins, including atorvastatin, the most potent lipid-lowering drug in the world, not only inhibit cholesterol synthesis but also increase bone density and prevent fractures.

Thalidomide: Infamously known as a sedative and anti-nausea drug from the 20th century, thalidomide was initially used to treat morning sickness in pregnant women but was later found to cause severe birth defects, leading to its withdrawal. However, with substantial trial data supporting its effectiveness in treating multiple myeloma, thalidomide was reintroduced for this purpose. Subsequent research has also found that thalidomide can aid in treating AIDS and may be effective against gastrointestinal bleeding caused by vascular malformations.

Given this history, it should come as no surprise if Glatiramer Acetate is eventually repurposed as a treatment for heart damage. The current trials have shown promising potential for GA as a repurposed drug for treating cardiac injuries. However, these studies have only been conducted on animal models, and much more clinical evidence is needed to confirm GA's efficacy in treating heart damage in humans. This process may take considerable time before the therapeutic benefits of GA for heart damage can be definitively established.

Reference:

Aviel, G., Elkahal, J., Umansky, K.B. et al. Repurposing of glatiramer acetate to treat cardiac ischemia in rodent models. Nat Cardiovasc Res (2024). https://doi.org/10.1038/s44161-024-00524-x