Assay: a laboratory test for to determine the level of a particular substance in a sample. For, example neurofilament assay to measure the levels of neurofilaments in a blood or spinal fluid specimens.

Biomarker: something that can be used to measure a biological process indirectly. For example, raised blood neurofilament levels indicates damaged axons or neurons. Another example is brain atrophy on MRI, which indicates loss of brain tissue.

Flipping the pyramid: this is the therapeutic strategy of using high-efficacy DMTs, that are typically used second, third or fourth-line as first-line treatments.

Platform therapy: this refers to treatments at the base of the MS DMT pyramid and refers to those used first-line, e.g. interferon-beta, glatiramer acetate, teriflunomide or dimethyl fumarate.

The following is the old glossary copied from our old blog. Please don’t hesitate to ask us to add and explain words that you don’t understand.

Ablation = in the context of immunoablation or bone marrow transplantation this refers to destroying or ablating the current bone marrow or immune system so that it can regenerate from surviving or transplanted stem cells, respectively. Pre-ablation refers to the state of the cells or immune system prior to the ablative treatment and post-ablation to the state of the cells after the treatment.

Aggregate(s) = this is an adjective that is used to describe a collection of cells in the brains of MSers. It usually refers to B cells. B-cell aggregates are similar to B-cell follicles that are seen in lymph nodes. The follicles and aggregates are where the B-cells are educated and mature to make antibodies.

Acronym = an acronym is an abbreviation formed from the initial components in a phrase or a word, for example CIS is used for clinically isolated syndrome

Antibody = Immunoglobulin

  1. Fab (Fragment antibody binding) region
  2. Fc(Fragement crystallisable) region
  3. Heavy chain (blue) with one variable (VH) domain followed by a constant domain (CH1), a hinge region, and two more constant (CH2 and CH3) domains.
  4. Light chain (green) with one variable (VL) and one constant (CL) domain
  5. Antigen binding site (paratope)
  6. Hinge regions.
  7. Heavy chain. There are five types of mammalian Ig heavy chain denoted by the Greek Alpha, delta, epsilon gamma and mu. The type of heavy chain present defines the class of antibody; these chains are found in IgA, IgD, IgE, IgG, and IgM antibodies, respectively.
  8. Light chain. There are type types of Ig Light chains
  9. Lamda = A type of “light chain” that binds to a “heavy chain” to form the antibody molecule. The other type is Lamba 
  10. Kappa = A type of “light chain” that binds to a “heavy chain” to form the antibody molecule. The other type is kappa
Anti-JCV = this refers to antibodies in the blood or serum that rcognise the JC virus. The level of the antibodies to a virus is called the titre.

Axon: An axon is also known as a nerve fibre; is a long, slender projection of a nerve cell, or neuron, that typically conducts electrical impulses away from the neuron’s cell body. The function of the axon is to transmit information to different neurons, muscles and glands. Axon dysfunction causes many symptoms in MSers.

Axonal damage: is a term that refers to damage to the axon; it can involve transection of demylination of the axon. The latter can result in block of conduction, i.e. loss of function. In some situations the damaged axon can fire spontaneously and cause positive symptoms, for example pins and needles or muscle spasms.

Balloon dilatation: a procedure of blowing up a balloon in a closed space (artery, vein or organ) to expand its size.

Illustration of balloon dilatation of an artery.
BG-12 = Biogen-12, BG-12 is the name given by Biogen-Idec to dimethyl fumarate (DMF) a drug they have developed to treat MS.

BPA = Big Pharma Alternative; the BPA is a movement to look for an alternative to big Pharma to develop drugs.

Brain atrophy: the shrinking of the brain that can occur as part of normal ageing or at an accelerated rate in MSers.

Progressive brain atrophy; please note the enlargement of the ventricles (black spaces in the centre of the brain).

CIS = clinically-isolated syndrome; this refers to the initial clinical event in MS, for example optic neuritis. The MS diagnostic criteria often do not allow a diagnosis of MS to be made at this stage of the disease. Not all people with a CIS go onto develop MS; about 80% will develop MS after 20 years of follow-up.

Clonus = clonus is the rapid contractions of muscles due to spasticity. The following video is an example of clonus at the ankle; it is brought on by rapidly bending or flexing the ankle upwards. It is common in MSers.

Cognition = Cognition refers to  mental processes that include attention, memory, producing and understanding language, learning, reasoning, problem solving, and decision making.
Cortical region: this refers to a specialised area of the cerebral cortex or surface of the brain. Depending which area is affected it can have different manifestations. We often refer to the area as being either from the dominant or non-dominant hemisphere (in most people the left hemisphere is dominant). Cortical regions are typically referred to by the name of the lobe they affect, e.g. frontal, temporal, parietal or occipital lobes.

Cortical lesion = this refers to an MS lesion or plaque that occurs in the gray matter on the surface of the brain.

Crowd-funding = Crowd funding or crowdfunding (alternately crowd financing, equity crowdfunding, or hyper funding) describes the collective effort of individuals who network and pool their money, usually via the Internet, to support efforts initiated by other people or organizations. Crowdfunding is used in support of a wide variety of activities, including disaster relief, citizen journalism, support of artists by fans, political campaigns, startup company funding, motion picture promotion, free software development, inventions development, scientific research, and civic projects.

Cytopathic = this words describes pathology in cells; cyto = cell and pathic = pathology. This refers to abnormal cells under the microscope. Cytopathic is a descriptive word only; you require additional information to define the cause of the pathology. 

DMT = disease-modifying therapy

Double-blind = this refers to when both the subjects and assessors of a clinical trial are not aware of what they are receiving, i.e. active or placebo treatment. This is to prevent any biases that may affect the results of the trial. Single-blind is the term used to describe a trial in which only the assessors are blinded; this happens in trials when it is impossible to blind the subjects to what they are receiving, for example drug A may cause an infusion reaction so that when the subjects get a reaction they know what they are receiving.

EAE = experimental allergic encephalomyelitis; this is an animal model of MS. 

EBV = Epstein Barr virus; this is the virus that cause infectious mononucleosus or glandular fever. It is also called the kissing disease as the virus is transmitted in saliva.

EDSS = Expanded Disability Status Scale or Kurtzke’s EDSS is the scale we use to measure the impact of MS on a person. It is a scale from zero (no disability) to 10 (death)

Epiphenomenon = is a secondary phenomenon that occurs alongside or in parallel to a primary phenomenon; for example fractures are an epiphenomenon of MS. MS itself does not cause fractures, the fractures are a result of falls that occur due to poor balance. Poor balance is the phenomenon and falls and fractures are the epiphenomena.Epub = Electronic publication

Gait = a person’s manner of walking.

HRQOL = Health-related Quality of Life

Ig = Immunoglobulin (see description of an antibody above)

IgA = Immunoglobulin A (see description of an antibody above)

IgD = Immunoglobulin D (see description of an antibody above)

IgE = Immunoglobulin E (see description of an antibody above)

IgG = Immunoglobulin G (see description of an antibody above)

IgG-VH = Immunoglobulin G variable region of the heavy chain (see description of an antibody above)

IgG-VL = Immunoglobulin G variable region of the light chain (see description of an antibody above)

IgM = Immunoglobulin M (see description of an antibody above)

Induction Therapy is a therapeutic strategy employing rapid, short term-modulation of the immune system using a therapeutic agent to induce immune non-responsiveness, also known as operational tolerance. If it doesn’t cure the disease or cause severe side effects, other treatment may be added or used instead.

In vivo = biological experiment within the whole body of a human or animal.

In vitro = biological experiments outside the body; for example experiments on human cells in a test tube in the laboratory

JCV = The JC virus or John Cunningham virus is a type of human polyomavirus (formerly known as papovavirus). It was discovered in 1971 and named using the two initials of a patient with progressive multifocal leukoencephalopathy (PML).

Kappa light chain = this is one type of light chain that goes into forming immunoglobulins or antibodies (see description of an antibody above).

Kurtzke’s EDSS = Kurtzle’s Expanded Disability Status Scale is the scale we use to measure the impact of MS on a person. It is a scale from zero (no disability) to 10 (death)

Lambda light chain = this is one type of light chain that goes into forming immunoglobulins or antibodies (see description of an antibody above).

Lesions = lesions refer to well circumscribed areas of pathology in MS; depending on their age they may show different types of pathology. In the early stages lesions may have lots of inflammation and demyelination (loss of myelin) the so called acute lesion. As the lesions age the demyelination becomes less prominent and there may be loss of axons and gliosis (a type of fibrosis in the brain). Some lesions remyelinate and are called shadow plaques or shadow lesions. Plaques are another term for lesions.

MS = multiple sclerosis

MSer = someone with MS

Myelin = myelin is the fatty insulation around nerve processes. In the central nervous system it is made by a cell called the oligodendrocyte and in the peripheral nervous system by a cell called the Schwann cell. Myelin helps nerve cells transmit electrical impulses quickly and efficiently with little energy requirements. Loss of myelin makes the nerve process or axon vulnerable to degeneration and slows down the speed of conduction of electrical impulses or blocks the conduction all together. Demyelination refers to the process of loss of myelin and is typical of MS. Dysmyelination refers to the production of abnormal myelin and happens in a large number of genetic disorders.

NEDA = no evidence of disease activity; i.e. no clinical relapses, no disease progression and no new or enlarging lesions on MRI and no Gd-enhancing lesions on MRI.

NMO = neuromyelitis optica; this is an autoimmune disease that may mimic MS. It target the spinal cord and optic nerves.

Non-redundant pathways = redundant means that if a particular nerve pathway is damaged it causes symptoms and signs; in other words another neuronal pathway can take-over its function. A non-redundant pathway implies that if it is lost you can get along without it; other pathways or nerve pathways cannot adapt and compensate for the damage.

North-South Gradient = The north-south gradient refers to the change of MS incidence (new cases per year) and prevalence (total number of case in the population)  as you move further away from the equator. MS is commoner the further you are away from the equator.

Oxidative stress = As part of the inflammatory reaction cells make different forms of oxygen that can react with the tissues to damage them. The more oxidative stress the more the damage. The cumulative effects of oxidative stress plays a role in ageing and the degeneration of the nerves and axons in the brain and spinal cord of MSers.

Parabiosis: is the surgical act of artificially creating conjoined twins of two organisms.

Pharma = Pharma is derived from Pharmaceutical and refers to the Pharmaceutical Industry.

Phase 1 Clinical Trials = phase 1 refers to first in man studies. These are typically done in healthy volunteers to ascertain the safety and ADMET of a drug. ADMET is a acronym for the Absorption, Distribution, Metabolism, Excretion and Toxicity of a drug in man.

Phase 2 Clinical Trials = phase 2 refers to early exploratory trials in MSers. Phase 2 trials are shorter studies to give you an idea that the drug works, to find out the dose and to see if there are any major side effects.

Phase 3 Clinical Trials = phase 3 refers to larger registration studies. These are done on a large number of subjects using clinically meaningful outcomes. Regulatory authorities usually require at least two phase 3 studies to get a drug licensed. The exception is drugs for orphan or rare diseases.

Phase 4 Clinical Trials = phase 4 refers to clinical studies done after the drug is licensed and marketed. These studies are usually done to see how safe the drug is and to monitor for rare side effects.

Preablation = = in the context of immunoablation or bone marrow transplantation refers to the state of the cells or immune system before treatment to destroy the immune system.

Plasma = the yellow-colored liquid component of blood, in which blood cells are suspended. It is collected in blood that has not been able to clot. If the blood clots first then the liquid is called serum.

PML = progressive multifocal leukoencephalopathy, this is a rare viral infection of the brain that occurs in people that have an immune system that does not function properly. It is important to MSers because it is relatively common in people receiving the natalizumab (Tysabri).

Post-ablation = in the context of immunoablation or bone marrow transplantation refers to the state of the cells or immune system after treatment to destroy the immune system.

PP = primary progressive

PPMS = primary progressive MS

Redundant pathways = redundant means that if a particular nerve pathway is damaged it causes symptoms and signs; in other words another neuronal pathway can take-over its function. A non-redundant pathway implies that if it is lost you can get along without it; other pathways or nerve pathways cannot adapt and compensate for the damage.

Repurposing = repurposing of drugs refers taking old drugs that are already on the market for another indication and using them for another disease. For example, simvastatin is a drug that is licensed to lower cholesterol. It may be useful to slow brain atrophy or shrinkage in MSers. If it was licensed for MS this would be called repurposing of an old drug.

Self-tolerance = tolerance refers to a property of the immune system; the immune system is tolerant when it does not recognise a organ, cell or component of the body as being foreign and therefore does not attack it. Self-tolerance refers to the ability of the immune system to recognise ourselves as self and not attack it. When self-tolerance fails we get autoimmune disease; in the case of MS the immune system attacks the myelin sheath that insulates nerves.

Sequestration = in the context of MS is refers to disease processes that may occur behind a closed blood-brain-barrier, i.e. within the brain. Another reference is to the sequestration of lymphocytes in the lymph nodes as a result of treatments that modulates sphingosine-1-phosphate a chemical that results in lymphocytes migrating from lymph nodes. Fingolimod is a drug that results in sequestration of lymphocytes in lymph nodes.

Serum = plasma from which the clotting proteins have been removed

Social media = the contemporary definition refers to them being a group of web-based applications that build on the ideological and technological foundations of the internet and allow the creation and exchange of user-generated content. This blog is an example of one form of social media.

Social media tsunami = refers to riding the wave of a social media campaign. This typically refers to when an idea or concept spreads virally, i.e. very rapidly and quickly, via social media networks and gets adopted very quickly by many people. Social media tsunamis often defy current wisdom or logic.

SP = secondary progressive

SPMS = secondary progressive MS

T2 lesions = T2 lesions refers to the white blobs that can be seen on MRI in a person with MS.

T2 lesion volume = simply refers to the size of the T2 lesions in 3D; it is typically measured in millilitres.

T2 lesions are the white blobs on this MRI

Titre = The level of the antibodies to a particular target or virus is called the titre. The higher the titre the higher the level of the antibody. Titres are classically reported as dilution; for example a titre of 1 in 64 means you can detect antibodies when the serum has been diluted 64 times, but not when it has been diluted 128 times. Dilutions are typically doubling dilutions (1:2, 1:4, 1:8, 1:16, 1:32. 1:64, 1:128, 1:256, ……).

Tremor = a tremor is an involuntary rhythmic muscle contraction and relaxation involving to and fro movements of one or more body parts. It is the most common of all involuntary movements and can affect the hands, arms, eyes, face, head, vocal folds, trunk, and legs. Most tremors occur in the hands. There are many different types of tremor. The commonest in MSers is so called intention tremor, or cerebellar tremor, that results from damage to the cerebellum.

Tsunami = is Japanese for a large wave

VZV Varicella Zoster Virus, this is a member of the herpes family of viruses that causes chicken pox and when it reactivates shingles. 



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