ArchiveJune 2021

How does fingolimod work?

We have been told that fingolimod inhibits the migration of T cells out of lymph nodes as a working mechanism, but I would also argue that it inhibits B cells migration but that is not all. it also inhibits macrophage function. So if we believe that there are bad macrophages it should be beneficial. Sferruzza G, Clarelli F, Mascia E, Ferrè L, Ottoboni L, Sorosina M, Santoro S, Moiola L...

Hey doc what’s my NFL level?

Barts-MS rose-tinted-odometer: ★★★★★ (it’s a Red & White Wednesday, as in the flag of St George, #cf2e2e) The reason why rheumatologists are so way ahead of us in treating rheumatoid arthritis (RA) and protecting joints (the RA end-organ) is that they have an inflammatory biomarker that is closely linked to outcome, it is called the C-reactive protein (CRP), which they include as part of...

Infection risk secondary neutropenia with ocrelizumab

All drugs have a range of predictable side effects. In the case of immunosuppressants/immune depleting agents this is a low white cell count, which increases the risk of infection in the short- or long-term. Ocrelizumab is a monoclonal anti-B-cell (anti-CD20) treatment that specifically targets B-cells, but it may also have what we in the business call off target effects on other immune cells...

Laura’s story

Barts-MS rose-tinted-odometer: ★ (a very Black & Red Monday) I received an email from Laura, a young woman with very active MS, who had been on natalizumab (Tysabri) for 7 years and had recently seroconverted to being high-index JCV seropositive. She was put onto natalizumab extended interval dosing (EID), i.e an infusion every 8 weeks, to derisk PML and to reduced the number of infusions she...

Dysbiosis

Barts-MS rose-tinted-odometer: ★★★ (a lilac rose-tinted Sunday; and why not! #C8A2C8) Dysbiosis refers to abnormalities in the human microbiome that affect disease and life outcomes. In the context of MS, it is claimed that changes in the gut microbiome may not only increase your risk of getting MS but act as a proinflammatory signal to drive MS disease activity and reduce remyelination and...

Drip, Drip Drip, COVID-19 vaccination results….France begins to support Israeli Conclusions

 Share Impact of disease-modifying treatments on humoral response after COVID-19 vaccination: A mirror of the response after SARS-CoV-2 infection.Bigaut K, Kremer L, Fleury M, Lanotte L, Collongues N, de Seze J.Rev Neurol (Paris). 2021 Jun 16:S0035-3787(21)00569-5.  Objective: To analyze the humoral response after COVID-19 vaccination in patients with multiple sclerosis (MS) according to disease...

Memory B cells for MS….It’s nowt to do with me

This is a review that is open access for you to read.. I feel abit airbrushed but hey DiSano KD, Gilli F, Pachner AR. Memory B Cells in Multiple Sclerosis: Emerging Players in Disease Pathogenesis. Front Immunol. 2021 Jun 8;12:676686. doi: 10.3389/fimmu.2021.676686. Multiple Sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Once thought to be primarily driven...

Do central nervous system anti-CD20 effects matter?

Barts-MS rose-tinted-odometer: ★★★ (gray Friday; overcast and miserable #3a3b3c) It was not easy writing this blog post; I hope it makes sense. I was asked the other day ‘what defines a low versus a high-dose B-cell depleting anti-CD20 therapy?’. Unlike with small molecules the dose of monoclonal antibodies is not necessarily about drug/antibody levels, but how much of the target gets...

Watch Out Ted…Can you get Doggy MS?

In case you don’t know Ted is the name of a cute pootch from one of the readers. Like many people they got a Dog during lock down. But could Ted become the solution to MS? This week I did a post about the name Mouse Doctor and if you remember, we made a comment that people working on cats/dogs and monkeys get special attention when it comes to generating the ire of the anti-vivs...

MD Merch

After my post you have asked about the Merch. Although they are all drawn by me, to avoid any copyright claims, e.g. the original felt model was made by the House of Mouse, the merch is used as a gift, so they are limited edition and often bespoke. Believe it or not the T shirt shop that houses all my designs have updated their software due to the down fall of “Flash” and has...

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