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Q&A May

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Latest stories

Normal white matter…not so normal

Normal appearing white matter is not so normal in MS so this study speaks to the real MSers and inflammation is just an after thought and our neuros have been barking up the wrong tree. However, not too quick in this study they find abnormalities in the myelin and nerves requiring more energy…but they find some evidence of inflammation and the correlation is r=0.7-0.9, which is real...

CD40 Ligand blockade. How does it work?..Blocking T cells….inhibiting B cells? or Influencing EBV?

Banging on the SH1 I have been banging on about B cells for what seems like the last decade, but when ever I suggest that MS drugs may be working by targeting B cells, the reviewers say “What about T cells? Because the drugs all work through T cells! and I am scared of reading your thoughts, if you don’t mention T cells, T cells, T cells”. It is not surprising as the...

COVID making impact

Silly season is looming and the research assessment coming up in a few years time and we will be throwing thousands at the metrics to get impact so should we make some claims. Years ago we said that ocrelizumab was being dosed too frequently and that we could dose less frequently and maintain effidacy. Covid came along and proved that view over and over again….is that Impact? Guerrieri S...

Siponimod in SPMS – baseline patient characteristics

Currently, Siponimod stands alone as the only licensed immunomodulatory therapy in Secondary Progressive MS (SPMS). With its success we have learnt a lot about what works and what doesn’t work in this subgroup. Definitely one of its pivotal findings was that efficacy is greater in active rather than non-active SPMS. This particular finding has also been reproduced in the HSCT clinical...

More evidence that T cells and T regs aren’t that great in MS?

Yep I am taking a provocative stance, just to illustrate a point…because we have been hearing over and over again that T regulatory cells control MS, but one can say where is the evidence? Who cares about EAE as we know that is T cell mediated and there blockade of interelukin 2 via genetic means leads to inflammatory effects? However it has been suggested that T regulatory T cells promote...

Its all abit more complex, why the spinal cord?

In animals with autoimmunity, the spinal cord is more involved than the brain and many years ago it was shown that microglia are more likely to be class II positive (activation marker) in the spinal cord and therefore they are more likely to activate T cells and so it is would go it is more likely that lesions would develop in the spinal cord. Wind the clock forward about 40 years and you get the...

CD8 T cells

Flip Flop Flip Flop….No wonder you are confused. We can’t make our mind up what is important. One week its CD4 next week its CD8. So at some point we will have a trial that aims to deplete CD8 in a specific way….Will it be a good thing and it be the answer I guess I daont know for definate but plenty of agents have impact in MS without having a major impact on CD8. The fear is...

Do Grade E’s….live longer. Should you sleep in tents?

In a book by Huxley called a Brave New World the jobs and reproduction capacity is controlled by the State, the Grade As get the best jobs and can so their oats and the Grade Es get you clean the bins and are made in a test tube and oxygen starved to ensure enough brain capacity is lost….Not quite right well it should be and you get the point anyway…..Maybe old age… But old age...

Today is TriMS day

The seventh meeting will take place on Thursday 25 May 2023 on the theme BTK inhibitors: an exciting new era in MS therapy. It seems like the organisers don’t want you there, health care pros only….it’s the rules Pharama has the maketeers that can talk to you and the neuros and the sciency lot that provide info to your neuros This triMS...



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