ArchiveMarch 2018

The MS Establishment

The recent commentary by Alasdair Coles and riposte by Jack Antel has sparked a prickly debate about the role of a relatively small number of academic neurologists, who are also known as KOLs (key opinion leaders), in relation to MS clinical trials and their subsequent publications.  Coles highlights 25 people in particular as dominating the MS space. I am one of them. Some of the points he...

Neuroafilament as a biomarker for brain damage

Are there alternatives to MRI imaging to detect changes? Neurofilament is an internal nerve protein and if you find it in biological fluids, it suggests that you have nerve damage and the root cause of this may be ongoing active inflammation. So it comes are no surprsie that there is a correlation between MRI lesion activity and neurofilament and the more neurofilamet detected the more likely is...

Guest post: Alasdair Coles on An Instinct for Kindness

Prof G asked me to listen to An Instinct for Kindness and offer some comments. As I was mulling over what I might say, I read the posts about the play on this blog: some appreciative, some angry, some disturbed.  I received a similar range of responses to a lecture I once gave to people with MS on “life and death in multiple sclerosis”. I too feel uncomfortable about death. I did not enjoy...

NEDA after ocrelizumab

No-evidence of disease activity (NEDA) means  No Clinical Relapse No New Lesion activity No progression of EDSS ProfG works some magic with Oreclizumab to make it better than any other chemical DMT. What’s he done? Ocrelizumab has become the first treatment for PPMS but there have been complaints that the trials was loaded with people with active disease and so it would respond to...

Familial MS

Keeping it in the family. Brain Behav. 2017 Dec 19;8(1):e00899. doi: 10.1002/brb3.899. eCollection 2018 Jan. Familial multiple sclerosis and association with other autoimmune diseases. Pytel V, Matías-Guiu JA, Torre-Fuentes L, Montero P, Gómez-Graña Á, García-Ramos R, Moreno-Ramos T, Oreja-Guevara C, Fernández-Arquero M, Gómez-Pinedo U, Matías-Guiu J. Objectives: Autoimmune diseases (AID) follow...

Trying to emulate the Cleveland Clinic at Barts-MS

I have just spent two days attending the 2018 or third Cleveland Clinic Neurological Institute MS Summit on ‘MS Treatment Strategies’. I had to give a talk on composite outcomes in trials and clinical practice. I am not sure why I was asked to cover this topic as I would not rate myself as being an expert on MS-related outcome measures. As promised I have made my slides...

B regulatory cells promote remyelination

First we had T regulatory cells promoting remyelination.  In this report it is the turn of the B regulatory cells to do the same thing Tanabe S, Yamashita T. B-1a lymphocytes promote oligodendrogenesis during brain development.Nat Neurosci. 2018 Mar 5. doi: 10.1038/s41593-018-0106-4. [Epub ahead of print] During brain development, the immune system mediates neurogenesis, gliogenesis and...

Estimating the future Prognosis

If you live in the UK, If you haven’t done this yet, why not sign up to the UK MS register. Dennison L, Brown M, Kirby S, Galea I. Do people with multiple sclerosis want to know their prognosis? A UK nationwide study.PLoS One. 2018;13(2):e0193407.BACKGROUND: Multiple sclerosis (MS) has a varied and uncertain trajectory. The recent development of analytical processing tools that draw on...

Is MOG the important autantigen in MS, like it is in EAE

MS is an autoimmune disease…isn’t it. Where is the proof?   There is plenty of circumstantial evidence and there is clearly autoimmunity in MS, but is it the chief problem “Of course it is” I hear many of my colleagues say. Look at EAE, that is autoimmunity and that’s MS isn’t it. Animal studies were centred around autoimmunity to myelin basic protein...

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