We often discuss MS in isolation to other autoimmune disorders, but how does it stack up against them? Given the choice if you were a woman of childbearing age and knowing the relative risks of childbirth which is the ‘safest’ autoimmune disorder to have? In the Table below (Table 1) you can see the figures from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD)...
Why are we still discussing Teriflunomide?
Teriflunomide is what I call a dark horse in the DMT family, doesn’t get much air time but every clinical trial of a new agent trumpets its success without meaning to. For example, it’s brain atrophy data makes the anti-CD20s look inadequate, it’s safety profile (despite the overzealous monitoring required by the regulatory authorities) is good, plus you can get rid of the...
Death cell receptors on astrocytes may attenuate inflammation
It is well know that reactive astrocytes in autoimmunity drive inflammatory activity in the central nervous system. There is very little focus on their neuronal protective function under similar conditions. Astrocytes regularly interact with resident immune cells (microglia) and other infiltrating cells such as T and B cells. One way in which they do this is via the programmed cell death 1 ligand...
The latest on vaccinations
Vaccinations are probably one of the most controversial topics in MS, namely the induction of rebound activity following vaccines. In MS it doesn’t get more controversial than COVID19 vaccines. In an analysis of the World Health Organization (WHO) pharmacovigilance database it was found that there wasn’t an association between central nervous system demyelinating diseases and COVID19...
Are you a gamer?
I’m not really a gamer but my brother is. When he was younger his excuse for spending hours at a time gaming was that it improved manual dexterity and reaction time. Whether this is true is anyone’s guess but the lack of sleep and staring at a computer screen for too long in my opinion was a recipe for mood disorders and short-sightedness. But what about gaming in health? In more...
ECTRIMS 2023 is just around the corner!
Another year, another ECTRIMS! My first impressions of the ECTRIMS 2023 programme are a sobering one and reflect the primary issues facing MS in the post-COVID era, including infections, new treatment strategies, the prominence of body fluid biomarkers, silent progression, MS in the elderly and defining treatment failure or response. Whereas in previous years sessions tended to be somewhat...
SIZOMUS Update
SIZOMUS is the first anti-plasma cell drug clinical trial in the world for MS treatment. We were fortunate as an MS group to be given the opportunity to conduct this study and happy that MS patients in the UK have been given the opportunity to participate in this ground breaking opportunity. Plasma cells in addition to B cells are responsible for bulk of the antibodies produced in the CNS in MS...
OCB negative cases may not be MS
Having antibodies in the spinal fluid in the form of oligoclonal bands (OCBs) is a hallmark of MS. It’s discovery dates back to 1959 when scientists used agar electrophoresis to sub divide gamma globulins from a patient with subacute sclerosing panencephalitis (caused by the measles virus). So it’s not specific for MS. However, it is present in 90-95% of cases of MS. What then of the...
C-section and MS risk
If you thought MS risk association was simply EBV and Vitamin D deficiency, and a host of other minor risk factors then you are about to be proven wrong. It would seem we’re now adding c-sections to the list. In a very large study conducted using the Norwegian birth registry reviewing mode of delivery from 1967-2003 (n=2,133,795), investigators found a statistically modest increase (roughly...
Can fatigue be defined in MS?
Fatigue – is defined as difficulty initiating or sustaining voluntary activities and is accompanied by a feeling of disproportionate effort. Fatigue in MS has been linked to white matter lesion volume (MS lesions that occur in the main part of the brain), global as well as regional (i.e. specific brain regions) brain abnormalities. Although, this may be too simple a concept as brain...