CategoryLab Lessons

Is your mind ready for a derisky business?

Over the past years, anti-CD20 treatments such as Ocrevus have quickly superseded other DMTs on the first and second line treatment shelf. This is good news, because Ocrevus has a high efficacy in controlling MS-related inflammation. The MRI results are very impressive, and pwMS treated early with this drug will definitely do better in the long run. However, the most logical outcome of solving...

BK channels a target to save oligodendrocytes?

Maddalena Rupnik, David Baker, David L Selwood Oligodendrocytes, BK channels and the preservation of myelin Oligodendrocytes wrap multiple lamellae of their membrane, myelin, around axons of the central nervous system (CNS), to improve impulse conduction. Myelin synthesis is specialised and dynamic, responsive to local neuronal excitation...

Advanced pwMS skills: Reading between the lesions!

For many pwMS, the annual MRI scanning has become an anxiety-provoking routine. The goal is to compare the most recent MRI with the previous one. Similar to a sepia or black-and-white filter on your camera, we use different MRI filters to improve visualisation of certain brain structures. A T2-sequence is the MRI filter we use to visualise (new) MS lesions. If new lesions appear between scanning...

Dimethyl fumarate for Primary Progressive MS? Is it all just MS

Figure of DMF action from Frontiers in Neurology A fair number of you probably take Dimethyl Fumarate (DMF) for your relapsing remitting MS, but did you realise that it may also work in Primary Progressive MS? This is what this latest piece of research suggests. There is one basic principle to MS treatments as a whole; which is that the treatment efficacy is very much in line with the extent of...

The plot thickens with Optic Neuritis

Optic neuritis (i.e. inflammation of the optic nerve at the back of the eye) is one of the most frequent presentations in MS. It can result in either semi-permanent or permanent visual loss. Attempts to aid visual recovery have been partially successful with the use of sodium channel blockers, but not with remyelination therapies, such as anti-LINGO. This paper on retinal oxygen supply may be the...

B cell Science

If you are interested in B cells…why wouldn’t you be, here is a reference for the hard core science buff. Some reading for the weekend. Next Generation Sequencing of Cerebrospinal Fluid B Cell Repertoires in Multiple Sclerosis and Other Neuro-Inflammatory Diseases-A Comprehensive Review.Ruschil C, Kemmerer CL, Beller L, Gabernet G, Kowarik MC.Diagnostics (Basel). 2021;11(10):1871...

Repopulating B cells after B cell depleting therapy. Ofatumumab seems quicker than Ocrelizumab

This post is for your interest, but it is all useful for doctors nurses and pharma At the moment we have been talking about the possibilitiy of delaying anti-CD20 to allow your B cells to repopulate to increase your COVID-19 vaccine response. Obviously you need to consider the risks or lack of risks from such a delay and it is not my job to advise but I can help and supply relevent information...

T time …..Another way that influences of T cells inhibit MS?..or is it T blinker time?

CD40 is a costimulatory protein (needed for activation of cells in addition to signalling via the antigen receptor) found on antigen-presenting cells including B cells, macrophages and dendritic cells. EBV induces B cell activation as it produces molecules that mimics the activation of B cell receptor (meaning that the B cell doesnt need to see its target for activation) and mimics the...

Understanding why heat affects your symptoms

Today we have a post by Mark Baker and Lavinia Austerschmidt (Blizard Institute Queen Mary University of London) As you may know transport of sodium ions into nerves is a key mechanisms that allows nerves to transmit nerve impulses or action potentials. The action potential is the result of ions moving in and out of the cell. Specifically, it involves potassium (K+) and sodium (Na+) ions. The...

B cell depletion with ofatumumab and a new-kid-on the (CD20) block with the appearence of “Ubli” at ECTRIMS2021

Ofatumumab antibody depletes B cells. Sure it is going to deplete them T cells too . It depletes B cells, so no surprise there (see below). It is given every month to wipe away the B cells in the blood. What does it do to memory B cells? I have no idea but would say that it is likely. What does it do to CD20 T cells…I probably would answer “I don’t care” but if the Guru of...

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