CategoryLab Lessons

Does alemtuzumab treatment increase your chances of having a miscarriage or premature birth? A large systematic review of numerous studies involving women with ‘normal thyroid function’ showed a strong association between the presence of anti-thyroid peroxidase antibodies and having a miscarriage and/or premature birth, i.e. the chances were increased by approximately 3.9x and 2.1x, respectively...

Trying to understand whether a sneaky fag is bad for you?

The Genetic Background of Mice Influences the Effects of Cigarette Smoke on Onset and Severity of Experimental Autoimmune Encephalomyelitis.Enzmann G, Adelfio R, Godel A, Haghayegh Jahromi N, Tietz S, Burgener SS, Deutsch U, Wekerle H, Benarafa C, Engelhardt B. Int J Mol Sci. 2019 Mar 21;20(6). pii: E1433. doi: 10.3390/ijms20061433. Multiple sclerosis (MS) is the most common inflammatory disorder...

Calling all male MSers

Do men with MS deserve to be offered higher efficacy DMTs earlier than women? When you do a baseline prognostic profile of someone with MS, being female is a good prognostic factor compared to being a male. Men have a worse outcome. This study below shows men do worse when it comes to poor cognition compared to women (#ThinkCognition). The question of why women do better cognitively may relate to...

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...

Listeriosis

Can we prevent alemtuzumab-associated listeriosis? The following is a published case report of someone with MS developing listeriosis congruent with their second course of alemtuzumab treatment. It is clear this patient was not taking her diatary advice very seriously. We have a potential solution for this problem. Holmøy et al. Listeria monocytogenes infection associated with alemtuzumab – a...

1st-line HSCT

If push came to shove would you really choose HSCT as a first-line treatment to treat your MS? When asked on the blog yesterday which DMT would I choose if I had MS, I chose HSCT. One of my patients, who I have been looking after for over a decade, sent me an email stating how upset she was that I had never offered her HSCT. I clearly need to explain my position so as not to upset anyone else...

MS DMTs that hit the regenerative note

Santiago Ramon y Cajal Who said that the brain doesn’t regenerate? Well, it was the neuroscience Dogma as far back as philosophy. But, not in certain quarters; Santiago Ramon y Cajal (1852-1934), widely believed to be the father of modern neuroscience in his treatise ‘Degeneration and Regeneration of the Nervous System’, alludes to the potential of the brain to regenerate in the...

Katerina Akassoglou

Did you enjoy ACTRIMS? On Thursday evening I had the privilege of being at the Barancik Prize award ceremony and lecture. Katerina Akassoglou received the award for her work on the blood-brain barrier and fibrin as a pro-inflammatory agent of the innate immune system. Her lecture was a tour de force on what a single individual with dedication and focus can achieve. Well done. I was particularly...

Answer to the Grey Matter Question

So last week I set you the task of answering some questions related to the belief that the cause of progressive MS was found. β-Synuclein-reactive T cells induce autoimmune CNS grey matter degeneration.Lodygin D, Hermann M, Schweingruber N, Flügel-Koch C, Watanabe T, Schlosser C, Merlini A, Körner H, Chang HF, Fischer HJ, Reichardt HM, Zagrebelsky M, Mollenhauer B, Kügler S, Fitzner D, Frahm J...

Can you have it both ways?

As you know there has beeen a suggestion that if you have more salt it drives pathogenic T cells in MS. MD2 suggested that the animal data on which this idea is based (OK there is a corrleation of more MS and more Burger bars….Maybethe link is greenhouse gas-or is that hot air?) was a croc based on the dose equivalents that you would have to eat half a kilo a day. Not deterred scientitsts...

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