CategoryLab Lessons

The biggest danger to science is the airbrush

You write a paper and maybe get 5minutes of fame, but sadly with time this may get forgotten and this may get airbrushed out of history. Recently, I have been feeling the paint spray as our work on B cells in MS is being forgotten as the big-swingers wake up and tell us all that memory B cells are important, but that gripe is for another day. Today hopefully you are arriving here by following the...

The Natalizumab #AttackMS Trial

We propose the very early use of natalizumab to maximise outcomes in people with very early relapsing MS. In the European Union, natalizumab is licensed to treat adults with highly active relapsing-remitting multiple sclerosis for the following patient groups: Patients with highly active disease despite a full and adequate course of treatment with at least one disease-modifying therapy (DMT) or...

AAN 2019 posters #2

Well, here is part deux of the 2019 AAN posters; a veritable smorgasbord of hidden gems on Market St in Philadelphia. 1. Effect of Ibudilast on Neurofilament light chain in Progressive MS Analysis from a Phase II Trial. Fox et al. Cleveland Clinic.Previous results from the SPRINT-MS study that used 80-100mg/day of Ibudilast, showed slowing of the progression in brain atrophy (i.e. volume loss) by...

Prof Franklinstein suggests age is a problem

Why do we do this? Well a few years ago the collaborators of Prof Franklin sewed a young and an old mouse together and gave the old mouse a young mouse’s blood supply. This gruesome experiment is called parabiosis and is frowned upon in the UK as unacceptable science…The stress of the procedure must be horrendous. Imagine being sewn to a bully who is going to torment you…or...

Mice are back in the frame as MOG T cell reactivity in MS is higher than first thought

Myelin oligodendrocytes glycoprotein is a CNS specific protein on the surface of myelin. Therefore it can be attacked by antibodies and this can cause demyelination in beasties. Disease induction in EAE was first shown by Dr Love in 1994. A little later it was shown that a Myelin oligodendrocyte protein peptide could induce disease in C57BL/6 mice on which transgenics and gene knockout mice were...

Warts and all

I have previously made the case that warts, both cutaneous and genital, are a relative contraindication to alemtuzumab therapy. I had one patient who has a torrid time with cutaneous warts after receiving alemtuzumab treatment. Fortunately, her immune system rejected them when it reconstituted and she is now fine. At least with alemtuzumab and other IRTs (immune reconstitution therapies) you can...

Fatigue in MS – what we don’t know?

Fatigue in MS is a strange duck, on many levels obvious and frequently described by PwMS (80-90%), but one that lacks sound medical explanation and science doesn’t even know how to test it yet. I was sure that the fatigue in MS, particularly exercise induced fatigue, was somehow related to the conduction block caused by the demyelination in the long tracts (corticospinal tract). It would...

More evidence that myelin basic protein is unlikely to be a major target in MS.

Brain Citrullination Patterns and T Cell Reactivity of Cerebrospinal Fluid-Derived CD4+ T Cells in Multiple Sclerosis.Faigle W, Cruciani C, Wolski W, Roschitzki B, Puthenparampil M, Tomas-Ojer P, Sellés-Moreno C, Zeis T, Jelcic I, Schaeren-Wiemers N, Sospedra M, Martin R.Front Immunol. 2019 Apr 10;10:540 “Immune responses to citrullinated (or deimination is the conversion of the...

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...

Oligodendrocytes do everything? They disrupt the blood brain Barrier

Aberrant oligodendroglial-vascular interactions disrupt the blood-brain barrier, triggering CNS inflammation.Niu J, Tsai HH, Hoi KK, Huang N, Yu G, Kim K, Baranzini SE, Xiao L, Chan JR, Fancy SPJ. Nat Neurosci. 2019 Apr 15. doi: 10.1038/s41593-019-0369-4. [Epub ahead of print]. Disruption of the blood-brain barrier (BBB) is critical to initiation and perpetuation of disease in multiple...

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