CategoryCauses

Thyroid disease with Alemtuzumab – risk mitigation

There is a popular old saying in English – “forewarned is forearmed”. Prior knowledge that something is going to happen offers tactical advantage, whether you’re at war or simply everyday life. The difficulty, however, is that more often than not we are transfixed by the detail of the matter, resulting in numerous avenues of investigation in the process, some of which are...

Is cholesterol truly bad for you?

Low-density lipoprotein particle, apolipoprotein B (blue) is surrounded by various forms of cholesterol (orange and yellow) and other lipids. JUAN GAERTNER/SCIENCE PHOTO LIBRARY Scientists have known for a long time that cholesterol like other basic food components forms an essential component in a healthy human body. It forms the cell membrane architecture (or the cell wall), helps produce the...

Black Swan?

Is this the black swan I have been looking for? We need to be able to explain smouldering MS and why pwMS get worse despite having no evident disease activity (NEDA) on DMTs. One of the hypotheses is that something is occurring within the brains and spinal cords of pwMS. I have referred to this in the past as the field hypothesis and have suggested that it could be due to an active virus within...

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...

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