ArchiveMay 2019

Getting rid of MRI as an outcome measure in trials may be feasible

Blood neurofilament light as a potential endpoint in Phase 2 studies in MS Maria Pia Sormani, Dieter A. Haering, Harald Kropshofer, David Leppert, Uma Kundu, Christian Barro, Ludwig Kappos, Davorka Tomic, Jens Kuhle Objectives To assess whether neurofilament light chain (NfL) could serve as an informative endpoint in Phase 2 studies in patients with relapsing–remitting multiple sclerosis (RRMS)...

What has getting old got to do with MS?

The brain and spinal cord were not necessarily designed by evolution to last longer than approximately 35 years. It is only relatively recently that as a species we have extended our lifespans. Once you go beyond approximately 35 years of age there is a gradual loss of nerve cells, axons and synapses. This explains why as we get older we notice the effects of ageing; reduced vision, loss of...

Going round the guts to get to the brain.

MAdCAM-1-Mediated Intestinal Lymphocyte Homing Is Critical for the Development of Active Experimental Autoimmune Encephalomyelitis. Kuhbandner K, Hammer A, Haase S, Terbrack E, Hoffmann A, Schippers A, Wagner N, Hussain RZ, Miller-Little WA, Koh AY, Stoolman JS, Segal BM, Linker RA, Stüve O. Front Immunol. 2019;10:903 Lymphocyte homing into the intestine is mediated by binding of leukocytes to...

Autoimmunity and Alemtuzumab (CAM-Thy)

Secondary Autoimmunity after alemtuzumab, is one of the problems associated with this drug. It was suggested that autoimmunity occurred in people who repopulated their T cells from memory cells compared to getting new ones from the thymus. So the suggestion was that if you make more cells from the thymus you get a more diverse T cell repertoire you get less autoimmunity. The Cambridge group...

Paediatric-onset MS

As you are aware approximately 3% of people with multiple sclerosis develop their first symptoms in childhood and adolescence. As the incidence and prevalence of MS are increasing we are seeing more children and adolescents with the disease. Why? Relative to MS in adults, most neurologists and other healthcare professionals are unfamiliar with the diagnostic evaluation, clinical course, outcome...

HSV-2 encephalitis with Ocrelizumab

The effect of DMTs on lymphocytes causing lymphopenia (from E Fox et al. Neuol Clin Pract Feb 2019) Why does this not come as a surprise to all and sundry, the report of a potentially harmful infection following immunosuppressive treatment, but this time from the new kid on the block, ocrelizumab (Ocrevus). Not to sound cliched, but if you hadn’t seen this one coming, well then the rest is...

Information asymmetry

Outside the field of medicine, for example in law and economics, information asymmetry deals with the study of decisions where one party has more or better information than the other. This asymmetry creates an imbalance of power in decision making and transactions, which can sometimes cause these decisions or transactions to go awry and cause a breakdown in trust or market failure as worst-case...

Generalised EBV vaccine a step closer?

EPO2229 – Preliminary phase 1 safety of ATA188, a pre-manufactured, unrelated donor (off-the-shelf, allogeneic) Epstein-Barr virus (EBV)-targeted T-cell immunotherapy for patients with progressive multiple sclerosis (MS) Background and aims Epidemiological and serological evidence suggest EBV infection is associated with MS pathogenesis. Previously, we showed that treatment with an...

Cladribine, is cladribine, is cladribine

News from the European Academy of Neurology 2019. Our data is reproducible and oral cladribine does what we said it does. EPO1241 Changes in Lymphocyte subpopulations in Highly Active Multiple Sclerosis patients during Cladribine treatment.M. Ruggieri, C. Gargano, A. Iaffaldano, A. Manni, P. Iaffaldano, D. Paolicelli, M. Trojano; Bari/IT Background and aims: Background: Cladribine tablets 3...

Want some sleep? Take cannabis or maybe read a review about cannabis

The use of cannabinoids for sleep: A critical review on clinical trials.Kuhathasan N, Dufort A, MacKillop J, Gottschalk R, Minuzzi L, Frey BN. Exp Clin Psychopharmacol. 2019 May 23. doi: 10.1037/pha0000285. [Epub ahead of print] Cannabis and its pharmacologically active constituents, phytocannabinoids, have long been reported to have multiple medicinal benefits. One association often reported by...

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