CategoryCauses

Treating MS in an ageing population

Image from MSARDs As the entire world learns to embrace ageing, it brings with challenges for healthcare service delivery and economy. Although, MS is a disease of the young (median age of onset is 32) ageing looms in the horizon and cannot be blithely ignored. In some instances, the MS isn’t picked up until much later (the oldest patient I’ve diagnosed is 84 years old!), which raises...

On being EBV-negative and having MS

Barts-MS rose-tinted-odometer: ★★★★★ I have been diagnosed with MS and I am Epstein Barr Virus (EBV) negative. Therefore, EBV is not the cause of MS. Correct? I wish it was that simple.  Firstly, no laboratory test is 100% sensitive and specific. In other words, some people who have negative standard EBV serology may still have the virus, i.e. a false negative result, and some people who have a...

Life is short, may your telomeres not get shorter

As cells divide, chromosomes replicate so that each cell contains the full complement of genetic material required for it to work. Telomeres are stretches of genetic material that are found at the ends of chromosomes protecting it from damage. There are a few interesting facts related to telomere length: 1) telomere length shortening is believed to be a major contributor to ageing; 2) telomere...

Epidemic

Barts-MS rose-tinted-odometer: ★ Do you live in Scotland? Thes latest MS incidence (new cases) and prevalence (all cases) figures from the Scottish Highlands should make Scottish public health officials shiver.  In the Scottish Highlands, there are now over 18 people diagnosed with MS every year per 100,000 population with a total of 376 people with MS per 100,000 population. These figures...

#BlackSwan: anecdotal evidence we can’t ignore

Barts-MS rose-tinted-odometer: ★★★★★ What is a black swan event?  “The black swan theory or theory of black swan events is a metaphor that describes an event that comes as a surprise, has a major effect, and is often inappropriately rationalised after the fact with the benefit of hindsight”. (Source Wikipedia) The case study below is another example of a mounting number of case studies of...

Plot thickens: MS versus other antibody disorders

The MSVirtual2020 late breaking news was announced this weekend. Despite a diagnostic biomarker for neuromyelitis optica (the Aquaporin 4 antibody), it remains difficult differentiate NMO from MS clinically. Dr David Leppert from Basel, Switzerland presented their findings on biomarkers of the innate immune system, focusing on neutrophil activity markers (a type of immune cell) in the...

T cells bite the dust

An interesting presentation from this years MSVirtual2020 was presentation by Dr Beatrice Wasser on ‘GlcNac signalling to reduce T cell pathogenicity in MS’. Abstract Background: Both adaptive and innate immune cells infiltrate the CNS during multiple sclerosis (MS) and in its animal model experimental autoimmune encephalomyelitis (EAE). Pathogenic T cells are known as key drivers of...

A false sense of security?

Just catching up with my reading. Whilst I was away on holiday the ASCLEPIOS I and II trials was published in the New England Journal of Medicine.  There is little doubt that ofatumumab is superior to teriflunomide when it comes to suppressing focal inflammation, i.e. relapses, MRI activity and peripheral blood neurofilament levels. However, ofatumumab’s effectiveness against teriflunomide on the...

EBV or not

The umpteenth study on causality means very little if it is not scientifically plausible. This is core science, and it’s what real scientists work on. EBV infection has long been strong contender for the development of MS. But, how strong is this link? What does having had EBV as a teenager do to your biological makeup (i.e. endophenotype)? In a first study of its kind the Swedish group...

Not COVID-19: obesity and MS

Are you sick and tired of hearing about COVID-19 and MS? How about something completely different; the destigmatization of obesity?  Finally, the medical community or at least a part of it are making amends for the half-century or more of treating obesity as a disorder of self-control. The joint internal consensus statement for ending the stigma of obesity is long overdue (see article and...

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