Progressive MS Alliance

Salvetti M, Landsman D, Schwarz-Lam P, Comi G, Thompson AJ, Fox RJ. Progressive MS: from pathophysiology to drug discovery.
Mult Scler. 2015 Sep. pii: 1352458515603802.

Progressive multiple sclerosis (MS) will be a major area of research interest for years to come. No treatments exist and success in the field will generalise to other neurological conditions where neurodegeneration coexists with neuroinflammation. The issue is complex, and interdisciplinary approaches – uniting scientists with different competences (neurobiology, immunogenetics, etc.) and ‘mindsets’ (academia and industry) – will be decisive. 

The International Progressive MS Alliance is catalysing this process through various initiatives, the most recent of which was a meeting where scientists from academia (also outside the MS field) and from industry reviewed data and strategies to determine the next steps towards the translation of current knowledge into effective therapies.

Key findings are:
(i). Concerted efforts are essential to prioritise pathogenetic mechanisms according to impact on the disease and druggability.
(ii). Combination therapies will probably be needed, possibly early in the disease, along with new trial designs and treatment schedules.
(iii). Drug screenings are a pragmatic approach hopefully enriched by the use of neural and oligodendrocyte progenitors differentiated from induced pluripotent stem cells (iPSCs).
(iv). The field of network biology will increase our ability to predict therapeutic targets.
(v). Genome-wide association studies (GWAS) must try to identify variants associated with disease progression.

What are your thoughts about these targets? 

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  • Very heartening, but on the other hand, it does make clear to me how knowledge of and research into progressive MS is only just getting off the starting blocks. But it is at least well underway now.

    "Combination therapies will probably be needed, possibly early in the disease, along with new trial designs and treatment schedules."

    In the case of PPMS, treating "early in the disease" may have meant treating a decade before noticeable symptoms began? I always worry about people with PPMS being left out. For example, in my case – I may not walk very well any more, permanent damage has been done, but I value all that I still have.

  • Good initiative but as spoken above it seems that the understanding and treatments for Progressive forms of MS are still in its infancy … As for combination therapy I totally agree, I am trying to make my "holistic neuroprotection," eating Brazil nuts by taking Cysteine , Coenzyme Q10, until neuros and the Pharmaceutical Industry "be convinced" that Emerson need Neuroprotective … Now this part of GWAS is a bit like no.Calheiros needles, there are more than 160 genes conferring susceptibility to MS , soon will be well 300, and understanding how they interact to still be "a Pandora's box." In addition genetic tests are very expensive still, it would be interesting countries to have a genetic database of individuals with complex diseases (but of course this is a risk in bioethics, however, and facilitate searches in surveys) .. Would not it be better if focus on what is known about the genes of the Human Histocompatibility Complex?

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