ArchiveJuly 2019

Is DMF the new GA?

Glatiramer acetate has had more mechansims than most people have had hot dinners :-), without really asking the question how it works but does it work well enough? However, is dimethyl fumarate DMF moving in the same territory. Dimethyl fumarate was first described to be an anti-oxidant working via Nrf2. Work in Nrf2 knockout questioned this and then we had GPR105 and a CD8 dependent mechanisms...

HSCT in MS, more a remission than a cure

In a prose to seduce the weary palate, the British neurologist, I recollect saying: “What should be the aims of HSCT treatment? At worst, remission. At best, a cure“. I may just have to eat my words… In a small study from Uppsala University (n=45), Larsson et al. report the effects of HSCT on neuronal damage (using neurofilament levels) and inflammation (IgG index and...

OXO is not about gravy

If ProfG was in it for the money, he would have filed a patent before disclosing the combination of treatments:-(. However that could have meant the £96 a year extra cost to the NHS could have been substantially more. The OXO is not a well known Gravy Granule, it is a study aims to combine ocrelizumab with oxcarbazepine Why PPMS. Well many good reasons. In the NHS primary progressive MS can mean...

I’m wrong…it’s all T cells

A new study finds a another T cell subtype for MS This time the cell expresses Granulocycte macrophage growth factor and a chemokine recepter called CXCR4. There is a relatively new detection system and they have looked in the MS brain and found this one. Yes yes its T cells, It’s T cells I give up. They found a CD4 T cell is that surprising? So off we go and do a new set of EAE studies...

ARRIVE- REVERSE & ARRIVE AGAIN. Animal Experiments

The ARRIVE guidelines are a set of reporting suggestions for reporting animal work. These follow on from the CONSORT guidelines about reporting clinical trials in humans. The aim was to improve the transparency of animal studies to help them be more reproducible and translatable. According to the authors the ARRIVE 2010 have not been fully adopted, will the 2019 revision improve this? I suspect...

Is too much Vitamin D Bad for you? Part II. If you are a Rodent Apparently Yes

High dose vitamin D exacerbates central nervous system autoimmunity by raising T-cell excitatory calcium. Häusler D, Torke S, Peelen E, Bertsch T, Djukic M, Nau R, Larochelle C, Zamvil SS, Brück W, Weber MS. Brain. 2019 Jul 13. pii: awz190. We have had a discussion on the merits of Vitamin D and making models of MS worse. We have said that the vitamin D council suggests that too much...

MS on the Up

Estimating the prevalence of multiple sclerosis using 56.6 million electronic health records from the United States. Briggs FB, Hill E. Mult Scler. 2019 Jul 24:1352458519864681 BACKGROUND/OBJECTIVE: In 2019, the 2010 U.S. multiple sclerosis (MS) prevalence was robustly estimated (265.1-309.2/100,000) based on large administrative health-claims datasets. Using 56.6 million...

Is too much vitaminD bad for you?

I noticed DrK tweeted on this and suggested that I have a look. The implications are that a middling amount is beneficial, but too much vitamin D is bad for you because it affects calcium levels in T cells. This may be lapped-up, because no doctors would think that you should be eating vitamin D capsules like smarties (Sugar coated chocolate sweets). Of course one says No s**t Sherlock, we...

A cost too high? The cost-effective analysis (CEA) of our current DMTs

‘Primum non nocere’ – Do no harm; the Hippocratic injunction. It could be argued that perhaps were are too ready to dose our expectant patients with the next golden ticket in MS. Mayhap, withdrawal of the long list of medications that they are already on, can prove to be just as efficacious? Yet, I am not a great supporter of masterful inactivity on the part of the physician...

I’m on treatment, why am I getting worse

Today someone asked “Selma Blair today tweeted she is getting sicker with her MS. Given her personal wealth and access to the best treatments. And we now have treatments that effectively shutdown ms in rrms. Also given she has had plasma exchange. My question is why is she getting sicker? “ The simple answer is I don’t know because I am not familiar with her particular case...

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