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Thursday, October 25, 2018

The Connection Between MS and Life Expectancy

When it comes to the prognosis for multiple sclerosis (MS), there’s both good news and bad news. Although no known cure exists for MS, there is some good news about life expectancy. Because MS isn’t a fatal disease, people who have MS essentially have the same life expectancy as the general population.

According to the National Multiple Sclerosis Society (NMSS), the majority of people who have MS will experience a relatively normal life span. On average, most people with MS live about seven years less than the general population. Those with MS tend to die from many of the same conditions, such as cancer and heart disease, as people who don’t have the condition. Apart from cases of severe MS, which are rare, the prognosis for longevity is generally good.
However, people who have MS also have to contend with other issues that can decrease their quality of life. Even though most will never become severely disabled, many experience symptoms that cause pain, discomfort, and inconvenience.
Another way of evaluating the prognosis for MS is to examine how disabilities resulting from the condition’s symptoms may affect people. According to the NMSS, around two-thirds of people with MS are able to walk without a wheelchair two decades after their diagnosis. Some people will need crutches or a cane to remain ambulatory. Others use an electric scooter or wheelchair to help them cope with fatigue or balance difficulties.

It’s hard to predict how MS will progress in every person. The severity of the disease varies widely from person to person.
  • Around 45 percent of those with MS aren’t severely affected by the disease.
  • Most people living with MS will undergo a certain amount of disease progression.
To help determine your personal prognosis, it helps to understand the risk factors that may indicate a greater chance of developing a severe form of the condition. According to the Mayo Clinic, women are twice as likely as men to develop MS. Additionally, certain factors indicate a higher risk for more severe symptoms, including the following:
  • You’re over 40 at the initial onset of symptoms.
  • Your initial symptoms affect many parts of your body.
  • Your initial symptoms affect mental functioning, urinary control, or motor control.

Prognosis is affected by the type of MS. Primary progressive MS (PPMS) is characterized by a steady decline in function without relapses or remissions. There may be some periods of inactive decline as every case is different. However, the steady progression continues.
For the relapsing forms of MS, there are several guidelines that may help predict prognosis. People with MS tend to do better if they experience:
  • few symptom attacks in the initial few years post-diagnosis
  • a longer amount of time passing between attacks
  • a complete recovery from their attacks
  • symptoms related to sensory problems, such as tingling, vision loss, or numbness
  • neurological exams that appear almost normal five years after diagnosis
While most people with MS have a close-to-normal life expectancy, it can be difficult for doctors to predict whether their condition will worsen or improve, since the disease varies so much from person to person. In most cases, however, MS isn’t a fatal condition.

MS generally affects quality of life more than longevity. While certain rare types of MS can potentially affect lifespan, they are the exception rather than the rule. People with MS must contend with many difficult symptoms that will affect their lifestyle, but they can rest assured that their life expectancy essentially mirrors that of people who don’t have the condition.
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Monday, October 22, 2018

Study: Immunotherapy may provide neuroprotection in MS

October 17, 2018

Emerging evidence points to a leaky blood-brain barrier as an early event that may lead to the death of nerve cells in multiple sclerosis. Until now, treatments to inhibit the blood from harming the brain were not available. Scientists from the Gladstone Institutes may have developed an antibody that blocks the inflammatory and oxidative activity of fibrin, which contributes to neurodegeneration in the brain. Using this approach, researchers could be in a position to achieve neuroprotection without shutting down protective immune responses or blood clotting.

Normally, the blood protein fibrin does not enter the brain. But in several neurological disorders, the blood-brain barrier — which keeps large molecules in the blood from entering the brain — becomes abnormally permeable, allowing fibrin to leak into the brain and trigger inflammation. Researchers have shied away from targeting fibrin to treat neurological diseases because of concerns that targeting the protein would impair its beneficial role in blood clotting.

To come up with a very precise and highly effective antibody, researchers focused on targeting only a small region of the fibrin protein involved in activating the immune system in the brain. This way, they avoided interfering with the part of the protein responsible for clotting. The therapeutic fibrin antibody entered the brain, accumulated at fibrin-rich areas, and protected against neuroinflammation and neurodegeneration. The study’s authors found treatment with the antibody reduced activation of inflammatory cells and their accumulation at sites of inflammation in the mouse model of MS. In addition, it reduced the loss of nerve axons.

Results of mouse model studies sometimes do not translate to humans and may be years away from being a marketable treatment. However, the researchers said the next step will be to make a version of the antibody that can be used in human patients. Given that the treatment targets an immune response and a blood clotting factor, the authors caution that tests monitoring the immune system and blood clotting will be important during clinical evaluation.

The findings were published in the journal Nature Immunology.