AuthorDrBenJ

EBV and MS

This is not about coronavirus. Epstein-Barr Virus is an(other) extremely common virus which has infected the vast majority of people (~95%) by their late 20s. Unlike coronavirus, EBV has co-evolved with humans and the observation that it is so ubiquitous suggests that it actually may confer some kind of evolutionary benefit, e.g. by enhancing the host’s ability to respond to novel...

Childhood obesity, vitamin D, and MS risk

The cause of MS is still not known. Genetic studies have shown that over 200 sites in the genome determine susceptibility to MS, but altogether this only explains a fraction of MS risk. It’s also clear that ‘environmental factors’ – by which I mean anything not directly to do with genes – have an important role in determining who gets MS. Environmental factors that seem to increase...

EBV in the brain

Epstein Barr Virus (EBV) is a herpes virus which is spread by saliva and infects around 95% of us during our lifetimes. In the majority of people EBV infection does not cause prominent symptoms – it may cause a ‘flu-like’ illness which gets better on its own, or it may go completely unnoticed. Some people who are infected with EBV experience a more severe illness – termed glandular...

#Thinkhand – Natalizumab preserves upper limb function in advanced disease

Most people with MS will have discrete episodes of disability – relapses – from which they get better. Unfortunately over time, many people gradually accumulate disability and stop having clear relapses. This shift is often labelled as a shift from ‘relapsing’ to ‘progressive’ disease, and once in the second phase people are often given the label...

Can interleukin-4 save nerve cells?

Untreated inflammation is bad for the brain. Over time, repeated bouts of inflammation predispose to the gradual loss of nerve cells from the brain and spinal cord. This gradual degenerative process is what we can quantify with brain atrophy and measurements of neurofilament. Loss of nerve projections (axons) begins very early in the inflammatory process, occurs both within and distant from...

Personalising Plex: individualised treatment for refractory MS relapses

We know antibodies can cause problems in MS because PLEX works. What’s PLEX? Most people who suffer an MS relapse will get better with steroids. Giving steroids in the short term shortens the duration of the relapse, although it doesn’t have an effect on longer-term outcomes. A minority of people (about 5%) will not respond to steroids, and continue to get worse despite high-dose steroid...

Putting the CART before the horse: could CAR-T cells be a last-resort therapy in MS to rival HSCT?

First off, apologies my long winter hibernation from the blog. As you may have gathered (if anyone is paying close attention to my blogging habits) I’m no longer full-time at BartsMS, and have been working in mental health down the road at Mile End. There are loads of interesting things to say about the overlap between MS and mental health, lots of which have been discussed before on the...

Danger! Danger! How does the brain sense damage?

The mechanisms which drive inflammation and neuron death in MS are very complicated. These processes involve interactions between multiple cell types in and outside the brain. The crosstalk between nerve cells (neurons), immune cells from the blood, and brain-resident supporting cells (glia) is important to study because it could open up new avenues for disease-modifying therapy.  Glial...

The good, the bands, and the ugly: do oligoclonal bands mean more brain shrinkage?

Oligoclonal bands (OCBs) are now back in the diagnostic criteria for MS – they can be used to support a diagnosis. If someone has a clinically-isolated syndrome – an episode of symptoms or signs due to demyelination without any evidence of previous events – the presence of OCBs makes it much more likely that they will go on to develop clinically-definite MS. ...

Why does smoking increase your risk of MS?

We don’t understand yet why people get MS. The accepted view is that there is an interaction between risk genes and environmental factors like EBV, smoking, and vitamin D status. Epidemiological studies have helped to identify these risk factors for developing MS, but it is unclear how these factors actually contribute to disease evolution and progression. There is strong evidence that...

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