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Charcot Today. It’s not all Unknown! Can we stop memory B cells entering the CNS?

The Charot meeting has now kicked off and after the first key talks. I guess I am currently left confused, it’s the T cells, it’s the B cells, its CD8 T cells, it’s, it’s, it’s, it’s…. as Prof Hauser said today…It’s all unknown how B cell therapies work”. It’s all of them. So lots to do. The cells are all involved, but I am not...

Protecting nerves with the -imods. Is there something missing

Fingolimod is a sphingosine-1-phophaste receptor (S1PR) modulator. There are five S1PR. The immune modulating effect is mediated by S1P1R. Siponimod is an S1P1R and S1P5R selective modulator. Fingo also binds to S1P3R (this causes some of the heart related issues) and S1P4R in addition to S1P1R and S1P5R. S1P5R is found on glial cells and it has been suggested that repair and protection can occur...

B cells and MS…”It’s behind you”…Are we looking in the wrong place?

As the countdown to B cell week at Charcot Meeting (a meeting aiming at training young neurologists) occurs, I had a gripe that I had been given a miss as far as this meeting is concerned. I will be sat at home licking my wounds, as young new minds are manipulated and learn all things MS. However, what you learn depends on what you get taught. There are a series of company sponsored symposia at...

The effect of epilepsy on lifespan

Approximately 30% of the general population are expected to experience a fit at some stage of their life. The occurrence of repeated fits (or epilepsy) is less common, and is more likely if you have underlying brain injury or abnormalities in you brain waves (as demonstrated by the electroencephalogram or EEG). The risk of epilepsy, however, trebles when you have MS – affecting 3% of...

To B or not to memory B…That is the question

What’ has this post got to do with MS? Well perhaps not a lot…except to say that it is B cell week at the Charcot MS Meeting in Italy. So it is apt that in the past week we have had a review of B cell function by some opinion leaders and we get a lot of pretty pictures..very pretty…and a set of facts, as usual…sadly with next to no interpretation..as usual:-(. I was...

Innovation Costs, Pharmaceutical Repurposing Gouges?

Dimethyl fumarate (Tecfidera) a slow releases repurposed variant of dimethyl fumarate (fumiderm) that was first used in psoriasis. Rather than get a once a day variant as the patent ran out, another new variant has been approved in the USA and this has been called vumerity and the active compound is diroximel fumarate, which is taken twice a day Diroximel fumarate is less likely to cause...

Infection risks of highly active depleting antibodies

Infections problems is a sore that profG openned. CD52 depletes T, B cells and monocytes and is associated with higher infection rate. However, once depleted cells can return if an infection occurs. In contrast ocrelizumab depletes B cells for ever and this was associated with bacterial infections. It tells us something about the immune response and protection from infection. So if you...

Hopebird

The debate about what is active and inactive secondary progressive MS will not be settled by the EMA adopting a positive opinion, recommending the granting of a marketing authorisation for siponimod, which is now ‘licensed’ for the treatment of adult patients with secondary progressive multiple sclerosis (SPMS) with active disease. Siponimod reduces disability progression in people with active...

Sunlight and microbes

This study looks at exposure to a vitamin D promoting ultraviolet light and they change rapidly. They make the case that there is a skin-gut pathway to promote health ,but sadly it rather says to me if it can change in a week, what are the studies attempting to link gut microbiome and MS susceptibility really going to find. Get abit of sunlight and you have a different gut microbiome profile. We...

Menopause in MS

Regardless of from whence you hail, if you’re a woman you are twice as likely to be diagnosed with MS than a man. It is probably one of the most constant and persistent risk factor in MS. Hidden beneath this risk is the effect of hormones on the immune system. For instance, until the age of puberty, the frequency of MS is similar in both boys and girls. The cases start to become female...

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