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More microbiome ceasarian sections and milk affect MS onset

Caesarean section and infant formula feeding are associated with an earlier age of onset of multiple sclerosis. Dalla Costa G, Romeo M, Esposito F, Sangalli F, Colombo B, Radaelli M, Moiola L, Comi G, Martinelli V. Mult Scler Relat Disord. 2019;33:75-77 Mode of delivery and lactation are among the earliest factors influencing gut microbiota composition and potentially MS risk, but their...

Oligoclonal bands…here to stay

J Neuroimmunol. 2019 May 16;333:576966. doi: 10.1016/j.jneuroim.2019.576966. [Epub ahead of print] Persistence of intrathecal oligoclonal B cells and IgG in multiple sclerosis. Tomescu-Baciu A, Johansen JN, Holmøy T, Greiff V, Stensland M, de Souza GA, Vartdal F, Lossius A. Abstract In multiple sclerosis (MS), B cells are trafficking across the blood-brain barrier, but it is not known...

Filgrastim for natalizumab-induced PML

PML, JCV infection Natalizumab (aka Tysabri), is one of the hard hitters in the DMT world and owing to its mechanism of blocking the ingress of immune cells into the brain, works quickly – achieving control in as little as 4 weeks. In the AFFIRM study, natalizumab reduced the rate of clinical relapse by 68% in the first year! But, one of the drawbacks of stopping the immune surveillance of...

Does your neurologist walk the talk?

Thanks to Daniel Kahneman and Amos Tversky behavioural psychology and behavioural economics have become very sexy. Kahneman & Tversky have spawned an industry of nudge theorists; people who devise ways of getting populations of people to do things that are good for them. People with MS are no different from the general population when it comes to doing what they are told to do. We have major...

Reproductictive choices

Reproductive history of the Danish multiple sclerosis population: A register-based study. Moberg JY, Laursen B, Thygesen LC, Magyari M. Mult Scler. 2019 May 30:1352458519851245.  BACKGROUND: A diagnosis of multiple sclerosis (MS) may impact the choice of parenthood. OBJECTIVE: To investigate the number of live births, abortions and ectopic pregnancies among persons with MS. METHODS: From the...

Getting rid of MRI as an outcome measure in trials may be feasible

Blood neurofilament light as a potential endpoint in Phase 2 studies in MS Maria Pia Sormani, Dieter A. Haering, Harald Kropshofer, David Leppert, Uma Kundu, Christian Barro, Ludwig Kappos, Davorka Tomic, Jens Kuhle Objectives To assess whether neurofilament light chain (NfL) could serve as an informative endpoint in Phase 2 studies in patients with relapsing–remitting multiple sclerosis (RRMS)...

Going round the guts to get to the brain.

MAdCAM-1-Mediated Intestinal Lymphocyte Homing Is Critical for the Development of Active Experimental Autoimmune Encephalomyelitis. Kuhbandner K, Hammer A, Haase S, Terbrack E, Hoffmann A, Schippers A, Wagner N, Hussain RZ, Miller-Little WA, Koh AY, Stoolman JS, Segal BM, Linker RA, Stüve O. Front Immunol. 2019;10:903 Lymphocyte homing into the intestine is mediated by binding of leukocytes to...

Autoimmunity and Alemtuzumab (CAM-Thy)

Secondary Autoimmunity after alemtuzumab, is one of the problems associated with this drug. It was suggested that autoimmunity occurred in people who repopulated their T cells from memory cells compared to getting new ones from the thymus. So the suggestion was that if you make more cells from the thymus you get a more diverse T cell repertoire you get less autoimmunity. The Cambridge group...

HSV-2 encephalitis with Ocrelizumab

The effect of DMTs on lymphocytes causing lymphopenia (from E Fox et al. Neuol Clin Pract Feb 2019) Why does this not come as a surprise to all and sundry, the report of a potentially harmful infection following immunosuppressive treatment, but this time from the new kid on the block, ocrelizumab (Ocrevus). Not to sound cliched, but if you hadn’t seen this one coming, well then the rest is...

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