CategoryLab Lessons

Biohacking comes of age

Barts-MS rose-tinted-odometer  ★★ You know something is happening when it gets its own review article in the New England Journal of Medicine. The review article in last weeks issue covers the science and medicine around intermittent fasting (IF) and its effects on health, ageing and disease. The article even includes a few lines on IF and its potential impact on MS.  In my ‘2020 Vision’ post...

Zero stars

Barts-MS rose-tinted-odometer – zero stars Some of our readers are not satisfied with the Swedish Gothenburg 50-year follow-up data on MS outcomes, I presented yesterday; they make the comment that the data is out of date. However, there are very few databases that have 50+ year follow-up data; one of them is the Swedish National MS Register. The following is the latest Swedish registry...

As the New Year dawns, a look back @ Barts neurofilament service

Back in 2015 there was a great need to prognosticate in MS, predict high risk subjects from low risk, and select appropriate treatments based on disease activity in MS. We envisaged back then that the neurofilament test (a neuronal protein that is released during damage) would be a robust marker for risk-stratification in MS, and introduced into our clinical practice at Barts, instead of it being...

Glass-half-full

Barts-MS rose-tinted-odometer  ★★★★★ I was attacked yesterday for painting a too bleak picture of MS outcomes and for not focusing on the fact that some pwMS actually age well and do well in the long-term. I apologise for being so negative, hence this post to address the data gap.  The best data we have on the longterm follow-up of pwMS in a ‘community-setting’ is the Gothenburg study. In...

What is advanced MS?

Barts-MS rose-tinted-odometer – zero stars Someone recently asked what is advanced MS? I suspect they have been getting frustrated with our use of this adjective without a clearer understanding of what it really means. To find out if you have advanced MS you need to put yourself through a battery of stress tests to find-out much reserve you have left to deal with MS and life in the future...

Flu, it’s not too late to be vaccinated

Barts-MS rose-tinted-odometer  ★★★ Not walking my talk. Having not taken up the NHS offer of the seasonal flu vaccine and having just spent the last 3 days bed-bound with severe flu I found the following research paper very timely.  Using the Norwegian registries these investigators show that pwMS are much more susceptible to the complications of influenza, i.e. pwMS are much more likely to...

Antibodies are important for some people with MS

Yesterday I was whinging about studies looking for anti-CNS antibodies and suggesting that they may be effect rather than cause, but are antibodies important. I would say almost certainly for some individuals and this post shows you why. Some people have circulating antibodies that are damaging and these can be removed from the blood. In this study people who did not respond well to a dose of...

Astrocytic disease control. Have we found the magic treatment for progressive MS

We have been spending all our time looking at T and B cells but there has been insufficient attention paid to the glial response, which is important given the the glial cells are probably very important in progressive MS. This study looks at astrocytes This paper looks at how astrocytes may be involved and the signalling molecules involved. I am sorry but I don’t have the time or the will...

HSCT Units can you please show me the data?

Barts-MS rose-tinted-odometer  0/★ I am often asked why given the extraordinary efficacy of HSCT in early RRMS, but not advanced MS, why I don’t refer more of my patients for HSCT early on in the course of their disease. There are several reasons these are the main ones.  Firstly, to be eligible for HSCT under our London guidelines patients have to fail at least two DMTs one of which has to be a...

Beating the dead horse abit more

This week we asked “LOOKING FOR AUTOIMMUNITY, IS IT FLOGGING A DEAD HORSE?” No sooner has our trusty Nag given its last breathe, it gets another whipping. Same story. The antibody occurs in a few people and they are against an internal proteins within a cell, suggesting an effect rather than a cause. Do I think these things cause problems? Absolutelty I do BACKGROUND: Nuclear antigen...

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