CategoryCauses

Japan epicentre of an Asian MS epidemic

I am about to return from a short MS meeting in Tokyo. This was my first exposure to Japan and Japanese culture. It is everything and more than I expected. I am beginning to get a sense of what ikigai means. Ikigai translates ‘to a reason for being, encompassing joy, a sense of purpose and meaning and a feeling of well-being’. Ikigai derives from iki, meaning life and kai, meaning the realisation...

MS, it’s in the Genes

A systems biology approach uncovers cell-specific gene regulatory effects of genetic associations in multiple sclerosis. International Multiple Sclerosis Genetics Consortium. Nat Commun. 2019:10(1):2236. Madireddy L, Patsopoulos NA, Cotsapas C, Bos SD, Beecham A, McCauley J, Kim K, Jia X, Santaniello A, Caillier SJ, Andlauer TFM, Barcellos LF, Berge T, Bernardinelli L, Martinelli-Boneschi...

It’s not all in the Genes! Elements of MS are preventable by changing the environment

Multiple sclerosis among first- and second-generation immigrants in Denmark: a population-based cohort study. Munk Nielsen N, Corn G, Frisch M, Stenager E, Koch-Henriksen N, Wohlfahrt J, Magyari M, Melbye M. Brain. 2019 May 13. pii: awz088. doi: 10.1093/brain/awz088. [Epub ahead of print] Multiple sclerosis is a disease with a highly variable incidence worldwide. While knowledge...

The new black death is ageing

I say to many of patients one of the most powerful predictors of progressive, or more correctly worsening, MS is ageing. Age also predicts recovery of function; the younger you are the better you do. This study shows that ageing restricts the ability of stem cells to make oligodendrocytes to promote remyelination. As you are aware age also predicts response, or lack or response, to DMTs. The...

Old age; how is it going to affect me?

Is ageing a disease? It is if you have MS. We have been making the argument for moving our treatment target in MS to focus on old age; i.e. how do we your HCPs get you to old age with enough brain to deal with the ravages of age-related cognitive impairment? Mechanisms of neuronal loss in MS It is clear that your brain and cognitive reserves are what protects you from the ‘normal age-related...

Re-vitalise your gut

Gut microbiome The lions share of the risk (~70%) for developing MS is attributable to environmental risk, while genetics explains bulk of the remaining risk. The environmental risk factors studied in MS have been manifold, ranging from the latitude effect, to viruses, and may well explain some of the heterogeneity that we observe. For some time now, researchers have been looking at an imbalance...

Is it B and/or T cells and which ones?

Can studying the pathology of MS and animal models of MS teach us about the cell types driving MS? Professor Lassmann is the doyen of multiple sclerosis pathology. He makes two very important points in this review. EAE the experimental model of MS is not MS. Interestingly, most EAE models are driven by CD4+ T-cells, which is very relevant to the second point he makes. Does this mean we should not...

Blood starved MS

There is mounting evidence that the brain blood supply is affected in MS. Perfusion MRI studies have found that blood flow is globally impaired in the normal appearing brain of both relapsing and progressive forms of MS. Interestingly, there appears to be an association between this and cognitive (memory and intelligence) dysfunction in MS. In animal models, chronic hypoperfusion of the brain...

Why is everyone drinking anti-CD20 kool-aid?

Prof G will ocrelizumab and rituximab prevent SPMS? Just back from the COMBAT-MS stakeholders meeting in Pasadena with the Kaiser (Kaiser Foundation Research Institute) and Swedish (Karolinska Institute) trial teams, PCORI (Patient-Centered Outcomes Research Institute) and many brave an wonderful people with MS and their families. The COMBAT-MS study (NCT03193866) is recruiting well and is on...

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