ArchiveNovember 2017

Imaging B cells

B cells are becoming increasingly seen as an important subset of cells and they have been implicated as drivers of progressive MS.  There will be an increasing number of B cell therapies arriving and so being able to assess whether they get rid of B cells in the brain is an important step.  This study reports on the production of an imaging tool.  They use rituximab to image B...

CCSVI may it rest in peace…

Finally, it’s time for CCSVI to rest in peace!  JAMA Neurol. 2017 Nov 18. doi: 10.1001/jamaneurol.2017.3825. [Epub ahead of print] Efficacy and Safety of Extracranial Vein Angioplasty in Multiple Sclerosis: A Randomized Clinical Trial. Zamboni P1, Tesio L2,3, Galimberti S4, Massacesi L5, Salvi F6, D’Alessandro R6, Cenni P7, Galeotti R8, Papini D9, D’Amico R10, Simi S11...

Rumble in the Jungle Part II

The “Rumble in le Jungle” at ECTRIMS2017 turned into a “Bumble in the Immunological jungle” as the Heavyweight clash turned into a love-fest.  UPDATE: Slides added Both contestants had taken too many “peace-pills” rather than defend their corner, both threw in the towel to conclude that T and B cells were both (equally important) central to the problem of...

Have you been involved in shared-decision making?

A recent study published in the British Medical Journal (BMJ) proposes a simple three talk model for shared-decision making in the clinic.  Have you been involved in a shared-decision making process, or have you simply been told what is best for you?  Please have your say. My problem is that in reality, very few MSologists practise shared-decision making. They tend to pay lip...

The good, the bands, and the ugly: do oligoclonal bands mean more brain shrinkage?

Oligoclonal bands (OCBs) are now back in the diagnostic criteria for MS – they can be used to support a diagnosis. If someone has a clinically-isolated syndrome – an episode of symptoms or signs due to demyelination without any evidence of previous events – the presence of OCBs makes it much more likely that they will go on to develop clinically-definite MS. ...

Guest Post: Self-catheterisation

Note: This is a no-nonsense and detailed post on self-catheterisation. As MS progresses we often have to self-catheterise. This presents few problems for some. Others, like me, aren’t so lucky. When I was told I would have to self-catheterise I fell into a state of shock. I had gone to the continence clinic expecting tips on how to strengthen the muscles in my pelvic floor. Following an...

Why does smoking increase your risk of MS?

We don’t understand yet why people get MS. The accepted view is that there is an interaction between risk genes and environmental factors like EBV, smoking, and vitamin D status. Epidemiological studies have helped to identify these risk factors for developing MS, but it is unclear how these factors actually contribute to disease evolution and progression. There is strong evidence that...

LDN does not affect MS

“Low dose naltrexone (LDN) has become a popular off-label therapy for multiple sclerosis (MS). A few small, randomized studies indicate that LDN may have beneficial effects in MS and other autoimmune diseases. If proven efficacious, it would be a cheap and safe alternative to the expensive treatments currently recommended for MS. We investigated whether a sudden increase in LDN use in...

HSCT in MS – what have we learnt?

More and more HSCT procedures (aka bone marrow transplants) are being performed for MS around the world than ever before. Currently, we lack convincing data on the conditioning regimen that best balances efficacy and safety. Patient selection is key and HSCT should be considered as an early option in aggressive cases of inflammatory MS, rather than as salvage therapy in later disease.  Mult...

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