"Two" much of a good thing

We all know - don’t we? – that the insulating material (myelin) surrounding the axons in the nervous system helps the efficient transfer of signals from one neuron to the next. Unfortunately, this myelin also contains molecules that are inhibitory to regenerating axons that come into contact with it. So researchers have developed an antibody to masks these inhibitory molecules and help damaged axons to regenerate.

Given early after injury, antibody treatment produces functional improvement in animal models. Similarly, rehabilitative training produces functional improvements. So what happens when you combine treatment with rehab? Does the combination result in even better function? NO! In fact Michele Starkey (SfN2009 Program# 176.16) found combining the two treatments, of antibody and rehab, early after injury results in a far worse functional outcome than either of the monotherapies. Why this should be we don’t know but it is clear that you can never assume that combining two safe and effective strategies will always result in positive outcome.

[The anti-NOGO antibody is being developed by Novartis and is currently in clinical trial]