ArchiveOctober 2021

#MSCOVID19 Choosing Boosters

As you may know I am a big fan of Dr Seheult and Medcram. They are respiratory docs and did a fantastic job in educating me about SARS-COV-2. They also wrote a nice letter to me when I acknowledged them in one of our COVID-19 reviews. This is education and here they ask which vaccine would you have if you can choose a COVID booster. In US the Vaccine choice is Moderna, Pfizer or JnJ sometime...

B cell Science

If you are interested in B cells…why wouldn’t you be, here is a reference for the hard core science buff. Some reading for the weekend. Next Generation Sequencing of Cerebrospinal Fluid B Cell Repertoires in Multiple Sclerosis and Other Neuro-Inflammatory Diseases-A Comprehensive Review.Ruschil C, Kemmerer CL, Beller L, Gabernet G, Kowarik MC.Diagnostics (Basel). 2021;11(10):1871...

Predicting autoimmunity after alemtuzumab

In this study plasmacells/plasma blasts were described as CD19+, CD27+, CD38 high and if you had high numbers of them you were 5 times more likely to get secondary autoimmunity However you can have high levels of these cells and not develop secondary autoimmunity. Analysis of the phase III trial will determine if this is correct So if there are the original facs plot data it could be done by the...

Repopulating B cells after B cell depleting therapy. Ofatumumab seems quicker than Ocrelizumab

This post is for your interest, but it is all useful for doctors nurses and pharma At the moment we have been talking about the possibilitiy of delaying anti-CD20 to allow your B cells to repopulate to increase your COVID-19 vaccine response. Obviously you need to consider the risks or lack of risks from such a delay and it is not my job to advise but I can help and supply relevent information...

Stem cells for relapsing MS? They are safe, but they don’t work…Back to the drawing board

You have been clamouring for stem cell therapy and the academics have done much to do such studies. There are still a number in the pipeline. Sad to say this multi-national one is a bust and it did not meet its efficacy end-point targets, so simply put they did not work. The study was a safety study and I guess oen can make the point that it is a safe approach. However, giving people with MS...

The hidden story

I would like to share with you an experience from one of our final year medical students, Molly Bond. Molly has been with our group for over an year now and has been shadowing the clinical team for this time. At the end of her attachment she wrote for the medical school a reflective piece about her experience. I’d like to share a portion of this with you. Her observations are insightful and...

Repairing with alemtuzumab

If you are taking alemtuzumab you may be familiar with the idea that alemtuzumab promotes remyelination. Here we have a new paper saying that by measuring electrical activity of nerves from the eye to the brain they can see remyelination after alemtuzumab treatment. Masuda H, Mori M, Kuwabara S. Remyelination and neuroprotective effects of alemtuzumab therapy in patients with multiple sclerosis...

#MSCOVID19 what use is this research to my MS? Anti-drug antibody testing

Below is work from DrRuth at BartsMS and our friends in Wales and elsewhere. This study shows that people taking fingolimod and anti-CD20 depleting antibodies dont’ make a good COVID-19 vaccine responses. You know this already as we reported this some time ago when the paper was first submitted to MedRXiv. This result has been replicated over and over again, but the work is a collaboration...

Antigenic key to MS?…….Again

Recently at ECTRIMS we heard of a plan for antigen-specific tolerance against 12 peptides against MBP. MOG, PLP, RASPGPR2 and GDP-L-fucose synthase to treat MS, starting in Spring 2022 (R Martin ECTRIMS2021). Where did the latter two targets come from? The answer in what we call a “fishing trip” to find targets these two were pulled out Eurpoean patent EP3586866A1 As you know I have...

#MSCOVID19 and anti CD20 and covid-19 vaccination responses. More of the same. T cell responses not affected, so what does this say about how anti-CD20 works in MS?

More of the same….anti-CD20 inhibits seroconversion, but there is a T cell response. Even if there is an antibody response it is of lower quality. Get vaccinated before anti-CD20 and the vaccine response is like controls. Time matters and the longer the interval between dose and vaccine more response. So I think it is safe to say we know this already….but prepared this has not...

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