This was not the oral pill used in MS, but the variant injected into the skin. Although cladribine does not typically cause very marked loss of lymphocytes, it happens in a very small number of individuals • We report a case of lethal influenza A infection with severe lymphopenia in an MS patient receiving s.c. cladribine. •Cladribine-related lymphopenia is usually mild to moderate, however...
The war on descriptions, should we rage the same war on the the Animal experimentalists
ProfG has been talking about the nomenclature surrounding MS, because it matters in what can be done for people with MS. You may view him like “Atlas” with the Weight of the MS World on his shoulders. However, with all the running he has been doing, he has turned into “Stick-boy” and the weight of MS is crushing him as he gains a few bruises from dealing with the...
Pharma are Blocking Microglia
You have been saying that pharma have been doing nothing to target progressive MS, but you are wrong and here is another example. In this study they have made an inhibitor of migroglial cell/macrophage activation and they say it inhibits progression in animals and so imply it may be useful for progressive MS. However targeting microglia will infuence the processes occuring during relapsing EAE...
Barts-MS Journal Club 28-Sept-2020
The following is our journal club from 28th September and was presented by Dr Ben Jacobs. Briggs et al. Nicotinic acetylcholine receptors α7 and α9 modifies tobacco smoke risk for multiple sclerosis. MSJ First Published September 14, 2020 Research Article Introduction: Tobacco smoke exposure is an established risk factor for multiple sclerosis (MS), yet how it confers risk is not known. Evidence...
Is this the end for animal work on myelinating cells…it should be.
Recently there has been a debate on whether humans myelinate like animals and the suggestion was that in MS they may not. Yet we are ploughing huge resource into animal experiments to find repair agents for humans To work on animals, you typically have to have ethical approval and in Europe you need to consider reduction, refinement and replacement of animals in research. Each year we have to...
A Cart to destroy B cells in the brain.
Antibodies againts the CD19 marker on B cells can clear out B cells from the blood and to some extent the lymph glands, but antibody doesn’t get into the brain very well and so will not clear out the brain very well. Even if it did get in the brain, as the antibodies often need natural killer cells/neutrohils to mediate the destuction and these cells are not attracted into the brain. T...
Phenytoin in acute optic neuritis
The original phenytoin study, published by the team at University College London, demonstrated that the use of phenytoin (- sodium channel blocker) for three months after the onset of acute optic neuritis was neuroprotective. Slide from Medscape education We have now analysed the blood samples taken for neurofilament analysis and found that neurofilament heavy chain levels (as opposed to light...
T time…Is it time for Otilimab/ mavrilimumab?
Otilimab and mavrilimumab are human antibodies that block Granulocyte-macrophage colony stimulating factor (GM-CSF) of the GM-CSF receptor respectively. The may block macrophage function but could also block a new T cell type implicated in MS, which secretes GM-CSF J. Rasouli et al. A distinct GM-CSF+ T helper cell subset requires T-bet to adopt a TH1 phenotype and promote neuroinflammation...
Proof of the Pudding. Treatment free pregnancies may be possible
Yesterday there was a debate on whether we should use anti-CD20 antibodies as immune reconsititution therapies. Of course the answer needs a trial, but what do peole think was the outcome. Sadly, it seems that a substantial number of the clinical fraternity don’t get or buy it. My head is so bruised and the wall has a dint it in. The only way to covince them is data, but in the absence of a...
Gut time
Why don’t I bother reporting microbiome studies as the next great cure and why not report all the supportive (scientifically interesting) animal studies which give us “Cure of the week”. Simple…the data seems to be something that is produced via the intestine and the effects are simply not good or consistent enough….for it to be ready for prime time. This week...