CategoryLab Lessons

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...

My position on anti-CD20 therapies has been criticised, why?

Barts-MS rose-tinted-odometer: ★★★★★ I have recently been criticised by a colleague for supporting the DODO (double-dose ocrelizumab study) and the ADIOS (adaptive dosing ocrelizumab study) studies. How you can I on the one hand support more ocrelizumab and on the other hand suggest reducing the dose in the longterm. I responded that it is all about timing and how you use anti–CD20...

Grey matter, matters

How big is your grey matter iceberg?  As you are aware, MS is an iceberg, with most of the MS disease activity and resultant damage being hidden. The study below expands the concept of the MS iceberg to the cerebral cortex or grey matter. Most lesions (~80%) found at post-mortem in the grey matter are not detected using specialised MR imaging. Please note that post-mortem MRI imaging in more...

#MSCOVID19 Whilst two swallows may make a summer…but it seems two COVID-19 papers make a bummer….for anti-CD20 therapy

Banksy and the Swallow bummer = a disappointing or unpleasant situation or experience. When it all started the Great and the Good (Neuro) experts looked at the different DMT and thought about the risks Disease-Modifying Therapies During the COVID-19 Outbreak: A Narrative Review of International and National Recommendations Smathorn et al.  International Journal of MS Care (2020) 22...

MS Virtual 2020: Biomarkers

It’s that time of the year again, ECTRIMS in conjunction with its American counterpart, ACTRIMS will now be featured as a virtual conference in the coronavirus era. The program is more streamlined than before, running between Fri, Sep 11 – Sun, Sep 13, 2020. This year, my focus will be again be on the biomarkers session (Fri, Sep 11) eager to see what’s new and what’s not...

#MSCOVID19. GloSlow… Antibody tests

Testing for COVID-19 in the UK has been woefull. It is too little too late and sadly now many of us will never know if we have been infected or not. I admit I am embarrassed by the speed that we have have been able to act…Wow getting you hands on human samples is even more tedious that working with animals. I will stop there in case I get myself into trouble I am being tested for virus...

Reducing issues with CD20 depletion

What is the optimum dose and dosing schedule for ocrelizumab? We don’t know because the manufacturers haven’t done the studies, but rituximab it seems that we can reduce the dose. A common dose was 1000mg and it was reduced to 500mg. Efficacy was maintained and impotant it reduced the loss of circulating antibodies. This is important as the loss of such antibodies was associated with...

Gut microbes and antibiotics

As you know microbiome is my favourite subject,so when this paper came out in a Top Science Comic I thought I better let you have a look as it is your new hope. Gut microorganisms act together to exacerbate inflammation in spinal cords, Nature (2020). DOI: 10.1038/s41586-020-2634-9, www.nature.com/articles/s41586-020-2634-9 Mice were given an antibiotic cocktail that contained ampicillin...

Journal Club: Early vs. Late or Low vs. High efficacy

You are welcome to watch our online journal club discussing the following paper. Anna He et al. Timing of high-efficacy therapy for multiple sclerosis: a retrospective observational cohort study. Lancet Neurol 2020 Apr;19(4):307-316.Background: High-efficacy therapies in multiple sclerosis are traditionally used after unsuccessful treatment with first-line disease modifying therapies. We...

Autoimmunity in MS…It occurs

As you know I am a useless speller and often don’t check the posts until after they go live…Why? It is too much of pain if I am doing it by phone and with predictive texting who knows what it sometimes does. Also being slightly dyslexic there are some words, which I spell wrong over an over again like “soory” and “comming” and some times it is names like...

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