ArchiveMarch 2018

Cladribine selectively depletes B cells and induces long term depletion of memory B cells

Last year we suggested that all agents that currently are used to inhibit MS, all target memory B cells. The agents that are highly-effective deplete memory B cells well and those that are not highly-effective don’t. We didn’t have the data on whether cladribine depletes memory B cells, but as cladribine is highly effective in treating relapsing MS. It suggests that they should be...

MS in the News HSCT poster doing the rounds

“Game changing” HSCT data is being reported in the media. This is in response to data being presented at a meeting, which we commented on a few weeks ago.. I saw Roumen Balabanov last week and he wasn’t aware that the abstract below was published. We made a post where the authors had complained about Social media as inaccurate, but I made the point that the authors are happy to...

#Thinkhand – Natalizumab preserves upper limb function in advanced disease

Most people with MS will have discrete episodes of disability – relapses – from which they get better. Unfortunately over time, many people gradually accumulate disability and stop having clear relapses. This shift is often labelled as a shift from ‘relapsing’ to ‘progressive’ disease, and once in the second phase people are often given the label...

Charcot 3: does an anti-viral inhibit MS?

Does an anti-viral inhibit MS? Charcot 1 is still not published (nudge, nudge) but it didn’t work but that didn’t surprise me as the treatment agent prevented virus integrating into the DNA, which was targeting a virus that had already integrated. However there was anecdote of disease remission after taking the drug. It has happened again: Drosu NC, Edelman ER, Housman DE. Could...

Guest Authors: The alternative view

Earlier this week a piece was published in the Annals of Neurology reporting how certain authors are on clinical trials and implying that they could be “guest authors”; celebrated “key opinion leaders” who do not contribute to trial design or execution, or manuscript drafting, but whose name lends gravitas to the study. Today Prof A gives a response to this. First I must say that Prof...

Can interleukin-4 save nerve cells?

Untreated inflammation is bad for the brain. Over time, repeated bouts of inflammation predispose to the gradual loss of nerve cells from the brain and spinal cord. This gradual degenerative process is what we can quantify with brain atrophy and measurements of neurofilament. Loss of nerve projections (axons) begins very early in the inflammatory process, occurs both within and distant from...

Off-Label Use. Is it bad for business? Should it be allowed?

Should we have off-label use of MS treatments, if it competes with pharma interest? There are many that would not contemplate this view.  What do you think?  Rituximab is a CD20 depleting antibody that was originally developed for B cell cancers. Many years ago it was shown that rheumatoid arthritis responded well to deppletion of CD19 and it was only a matter of time before...

More on endogenous retroviruses in MS

Int J Mol Sci. 2018 Mar 9;19(3). pii: E786. doi: 10.3390/ijms19030786. Genetic Determinants of Antibody Levels in Cerebrospinal Fluid in Multiple Sclerosis: Possible Links to Endogenous Retroviruses. Emmer A, Brütting C, Kornhuber M, Staege MS. Abstract The pathogenesis of multiple sclerosis (MS) has not been clarified. In addition to environmental factors; genetic determinants have been...

Is Prof G a guest author or trial junkie?

Has Prof Rev C from Cambridge gone rogue and decided that he doesn’t like the MS World much, as he points the finger at Ten  Neurology Trial Junkies (known by letters of the alphabet)?  This study looks at trial reports and concludes that certain people appear all too often. Is Prof G one of them? Do not read if you easily get offended. Coles A. Authorship of phase 3 trials in...

Education: Whats BTK

Bruton’s tyrosine kinase (abbreviated to BTK) also known as tyrosine-protein kinase BTK is an enzyme that plays a crucial role in B-cell development. However, whilst ProfG has been munching on his chapeau, I’ve been doing some reading and am not ready to let the T cell boys and girls off the hook. More B cell magic…. BTK plays a crucial...

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