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Friday, September 11, 2015

MS Progress Seems to Skyrocket Among Smokers




Patients with multiple sclerosis (MS) who continued to smoke saw a faster time to conversion to secondary progressive MS (SPMS), according to a cross-sectional study.

Each additional year of smoking accelerated the time to conversion to SPMS and disability by 4.7% (acceleration factor 1.047, 95% CI 1.023-1.072, P<0.001), according to Jan Hillert, MD, PhD, of the Karolinska Institutet at Karolinska University Hospital Solna in Stockholm, and colleagues.

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Wednesday, September 9, 2015

MS Connect- A Better Future for Multiple Sclerosis

Help create a centralized mobile app platform to improve quality of care for patients with MS!



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Tuesday, September 8, 2015

Stem cell treatments may offer hope for MS patients

By Dr. Ben Thrower

The management of MS has advanced rapidly during the past few decades. In 1992, there were no FDA-approved therapies for MS. In 2015, we have 13 approved treatments for altering the course of MS. Unfortunately, gaps in our knowledge remain. We have no approved options for progressive forms of MS and for many, the current treatment options are not enough to completely stop the course of their MS. Could stem cells be the magic bullet we are looking for? What types of stem cell treatments are there? Do stem cells have the potential to reverse disability? In this article we will look at hematopoietic stem cell transplants, mesenchymal stem cells and for-profit stem cell clinics in the U.S. and abroad.

MS is an autoimmune disease resulting from complex interactions between genetic and environmental factors, resulting in an immune attack that destroys myelin and the underlying axons themselves. Like other autoimmune diseases, including rheumatoid arthritis and systemic lupus, MS represents an immune system gone awry. As noted, there are 13 FDA-approved disease modifying therapies. For some people with MS, these therapies may be quite effective in slowing the progression of disability, decreasing relapse frequency and helping prevent new MRI lesions. Our current treatments are not always effective enough for some people, however.

Host vs donor

What if we could “reboot” the immune system of the person with MS and give them an immune system that does not attack myelin? Sometimes this happens during the course of treatment of another health problem like certain cancers. During the treatment of some cancers, bone marrow transplants are used. These are typically allogeneic transplants, meaning that the stem cells used for the transplant come from someone other than the patient. This is typically a brother, sister or an unrelated donor who is matched as closely as possible. Cells from umbilical cord blood can also be used. Once the cells from the donor are harvested, the recipient is treated with high doses of chemotherapy to kill any cancer. This chemotherapy also wipes out the recipients existing immune system The donor cells are then given to the recipient by vein and a new immune system is generated in the bone marrow. This new immune system is essentially that of the donor and not the recipient. The person with MS who gets an allogeneic bone marrow transplant to treat their cancer may have added benefit of treating their MS as well. They have been given a new immune system, one that does not attack myelin. Obviously, this is not the way we want to resort to treating MS. Allogeneic stem cell transplants require the long-term use of drugs to help prevent a war between the new immune system and the recipient. When the new immune system attacks the recipient, we call that graft versus host disease. When the recipient’s remaining immune system attacks the new immune system, we call that host versus graft disease. In addition to these complications, there is the risk of serious infections due to immune suppression from the initial high-dose chemotherapy, or the long-term lower dose immune suppressant drugs.

This brings us to a procedure called autologous hematopoietic stem cell transplantation or HSCT for MS. In contrast to the allogeneic stem cells from another individual, autologous stem cells come from the patient’s own bone marrow. There are several advantages. No donor needs to be identified and there is no risk of graft versus host or host versus graft disease. This eliminates the need for long-term immune suppressant drugs. There are still, however, the risks associated with the high-dose chemotherapeutic agents used in the initial shut down (immune ablation) of the immune system.

When other routes fail
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Monday, September 7, 2015

New Study Unravels How Myelin is Repaired, May Suggest New MS Treatments

New Study Unravels How Myelin is Repaired, May Suggest New MS Treatments 
Sept 3, 2015 - Japanese scientists have discovered new information about how the myelin sheath is repaired following damage. Myelin is a fatty substance that wraps around nerve cells and helps them to conduct impulses. The research could have major implications for how multiple sclerosis is understood and even treated. The study, titled Inactivation of Protein Tyrosine Phosphatase Receptor Type Z by Pleiotrophin Promotes Remyelination through Activation of Differentiation of Oligodendrocyte Precursor Cells,” appeared in the Journal of Neuroscience on September 2, 2015.

The symptoms of multiple sclerosis are due to an immune attack on the body’s own myelin. When myelin is lost around nerve cells, this can cause unpredictable loss of movement, sensation, vision problems and feelings of pain. Myelin is made by special nervous system cells called oligodendrocytes. Although it is well-known that myelin can be repaired by oligodendrocytes if it is damaged scientists do not understand the exact repair mechanisms used by these cells. In MS, myelin unfortunately does not appear to be easily repaired, also for unknown reasons.
The researchers, led by Professor Masaharu Noda and colleagues of the National Institute for Basic Biology, wanted to study how myelin is repaired in mice with an experimental form of MS, induced by the myelin-damaging drug cuprizone. They studied both normal mice and genetically-altered mice that lacked protein tyrosine phosphatase receptor type Z (PTPRZ), which is a protein that may cause oligodendrocytes to turn into mature cells, rather than stay in a more immature stage.
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Overview of Multiple Sclerosis


multiple sclerosis overview Multiple sclerosis (MS) is a progressive, debilitating, immune mediated, and eventually fatal neurodegenerative disorder where the myelin sheath – the insulating cover of all neurons — in the central nervous system (CNS) becomes damaged due to inflammation. It so happens that the body’s immune system attacks these myelin sheaths (mostly the white matter of the brain and spinal cord) when the T cells cross the blood-brain barrier to attack the epitopes presented by the myelin sheath cells. As a result, MS is more appropriately termed an “immune mediated” disease, and not an “auto-immune” disease, as the exact target of these T cells and the cause of their behavior remains unknown.
This attack disturbs and progressively destroys the conduction of nerve impulses, leading to scarring and permanent damage to the myelin sheath and consequently the nerve fibres, and resulting in severe neurodegenerative complications, such as impaired vision, loss of senses, loss of balance, loss of control over voluntary muscles, and all other bodily functions connected to the CNS. A classic hallmark of MS is the exacerbation or ‘flare-up’ of symptoms which occur repeatedly within spans of months to years in the relapsing-remitting form of the disease.
Until now, there has been no such approved ‘cure’ for MS, only short term medications which can treat patients with symptomatic attacks and flare-ups. They merely keep the patient under control for that particular bout of exacerbation, and do not have any guaranteed long-term effect.
Proper diagnosis and a thorough check up in accordance with the patient’s history of symptomatic attacks can help a physician zero in on the possibility of an MS diagnosis, with MRI and CSF testing showing typical lesions (scars / plaques) in the brain considered to be the most definitive way to confirm multiple sclerosis. MS has the potential of causing severe damage in its initial phases of attacks, and hence the earlier the treatment starts, the more effective it is for the patient.
Since the condition is a very serious one, with the patient progressively experiencing the disease’s symptoms, there is an issue of emotional stress as well. Clinicians have noted that it is very important that friends and family of those who suffer with MS provide as much support as possible. This is vital in maintaining a healthy lifestyle for the patient, to prevent further flare-ups and reduction in lifespan.

Epidemiology of Multiple Sclerosis1:

MS affects around 2 to 2.5 million people globally, with women being affected twice or three times as many as men. It affects people between the ages 20 and 50. The average age of diagnosis of MS is 29 years for women and 31 years for men. According to data provided by the National Multiple Sclerosis Society, in the United states, an estimated 400,000 people are affected by MS. However, this is just an estimate, as the CDC does not require physicians in the U.S. to report new cases of MS, and the symptoms are also not pronounced during the initial stages. The prevalence estimate varies between 58 to 95 per 100,000 population.
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