ArchiveJuly 2020

#T4TD colour vision

When your neurologist looks in your eyes with an ophthalmoscope he/she is looking for the telltale signs of previous damage to the optic nerve. The sign we look for is optic disc pallor. The optic disc is made up of nerve fibres from the retina, which then pass out of the back of the eye to form the optic nerve. If you have had optic neuritis in the past and have lost nerve fibres this can be...

Progresssive trials its all sorted or is it?

Serum neurofilament light as a biomarker in progressive multiple sclerosis.Kapoor R, Smith KE, Allegretta M, Arnold DL, Carroll W, Comabella M, Furlan R, Harp C, Kuhle J, Leppert D, Plavina T, Sellebjerg F, Sincock C, Teunissen CE, Topalli I, von Raison F, Walker E, Fox RJ.Neurology. 2020 Jul 16:10.1212/WNL.0000000000010346 There is an unmet need in multiple sclerosis (MS) therapy for treatments...

#ThinkSpeak: Rachel Horne

An interview with Rachel Horne who wrote the extraordinary blog post “The Kingdom of the Sick” (14th July 2020), which in my opinion is almost certainly the most well written and insightful piece on this blog.

CoI: nothing relevant in relation to this blog post

COVID Breakfast

Get rid of your cornflakes this morning and if you want to survice COVID-19 eat cabbage and cucumber. COVID-Cure What should we research next? Association between consumption of vegetables and COVID-19 mortality at a country level in Europe. Fonseca SC et al. MedRXiv doi:  Background Many foods have an antioxidant activity, and nutrition may mitigate COVID-19. To test the potential role of...

CNS lymphoma in autoimmunity

Non-Hodgkin’s Lymphoma (a cancer involving predominantly of B cells) involving the brain, also known as primary CNS lymphoma (PCNSL) is something I see every year like clock work for the haem-oncology service at St Bartholomew’s Hospital, London. And despite the regularity of my visits, there is something extraordinary about the whole experience. You start to either vegetate or have...

#MSCOVID19: the storm

I have been asked many times about how COVID-19 is affecting our MS research programme. The short answer is massively and its true impact is yet to be realised because we are a far way off from anything that feels and looks like normal. We are still paralysed by the threat of a second wave of COVID-19; the social distancing requirements within the NHS means everything is going to be at half-mast...

Are you lucky to have autoimmunity with alemtuzumab

Development of autoimmune thyroid disease in multiple sclerosis patients post-alemtuzumab improves treatment response.Sovetkina A, Nadir R, Scalfari A, Tona F, Murphy K, Rigoni E, Dorsey R, Malik O, Nandoskar A, Singh-Curry V, Nicholas R, Martin N.J Clin Endocrinol Metab. 2020 Jul 15:dgaa453 Context: Alemtuzumab is an anti-CD52 monoclonal antibody used in the treatment of relapsing...

#MSCOVID19 It’s not T-time is M-time. Alemtuzumab shows more evidence to support a major role for the macrophage

You do not need peripheral B cells in the blood to fight COVID-19 so does that mean it is T-time for the T cells to get rid of COVID-19. Woo, M.S., Steins, D., Häußler, V. et al. Control of SARS-CoV-2 infection in rituximab-treated neuroimmunological patients. J Neurol (2020). . There are no B cells and no anti-SARS-Cov2 antibodies If they had read our paper…… The...

#T4TD Anticholinergics

Are you taking anticholinergics?  It is clear that centrally acting anticholinergic drugs, which block so-called muscarinic receptors, are being used by many people with multiple sclerosis as DIY agents to promote remyelination. The scientific rationale for this practice is based on preclinical work in cell culture systems and animal models and one proof-of-concept study of clemastine in pwMS...

#MSCOVID19. CD20-antibodies will take time to be optimally vaccine ready.

COVID‐19 vaccine‐readiness for anti‐CD20‐depleting therapy in autoimmune diseases David Baker, Charles AK Roberts, Gareth Pryce, Angray S KangMonica Marta, Saul Reyes,Klaus Schmierer, Gavin GiovannoniSandra Amor. Clin Exp Immunol Although most autoimmune diseases are considered to be CD4 T‐cell or antibody‐mediated, many respond to CD20‐depleting antibodies that have limited influence on CD4 and...

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