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Saturday, January 26, 2019

Looking at MS Differently - Consider B and T cell crosstalk in the complex dynamics of immune response


It’s time to look at

MS differently


The science of multiple sclerosis (MS) is still under construction—there’s much more to know. Join us at GetCloserToMS.com to learn more about what may hold the next big advancement.
The science of MS is under construction
The science of MS is under construction
Explore the key players in MS that drive and perpetuate neuroinflammation1-4
TAKE A CLOSER LOOK
B and T cell crosstalk in MS
B and T cell crosstalk in MS
Consider B and T cell crosstalk in the complex dynamics of immune response3
DIG DEEPER

References: 1. Salou M, Nicol B, Garcia A, Laplaud DA. Involvement of CD8+ T cells in multiple sclerosis. Front Immunol. 2015;6:604. 2. Bittner S, Ruck T, Wiendl H, Grauer OM, Meuth SG. Targeting B cells in relapsing–remitting multiple sclerosis: from pathophysiology to optimal clinical management. Ther Adv Neurol Disord. 2017;10(1):51-66. 3. Baker D, Marta M, Pryce G, Giovannoni G, Schmierer K. Memory B cells are major targets for effective immunotherapy in relapsing multiple sclerosis. EBioMedicine. 2017;16:41-50. 4. Li R, Rezk A, Healy LM, et al. Cytokine-defined B cell responses as therapeutic targets in multiple sclerosis. Front Immunol. 2015;6:626.



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Thursday, January 24, 2019

Greater Benefits for Relapsing-Remitting MS Found with HSCT Therapy

January 24, 2019
Erica Slaughter, MS

Nonmyeloablative hematopoietic stem cell transplantation (HSCT) was associated with prolonged time to disease progression when compared to disease-modifying therapies (DMT) for patients with relapsing-remitting multiple sclerosis (RRMS), according to results published in Journal of the American Medical Association (JAMA).


In a randomized controlled trial, participants who met inclusion criteria for the trial (N=110) were randomized into the HSCT group (n=55) and continuation of DMT group (n=55). There were no significant differences between the HSCT and DMT groups in terms of sex, age, baseline expanded disability status scale (EDSS) scores, number of gadolinium-enhancing lesions, T2-weighted lesion volume on MRI before randomization, number of prior DMTs, or type of prior DMT or immune treatments.

Participants in the DMT group received a DMT of higher efficacy or a different class than the therapy taken at the time of randomization (based on decision of their treating neurologist). For patients in the HSCT group, DMT use was discontinued, followed by variable washout periods before admission for HSCT.

Peripheral blood stem cells were collected 10 days after intravenous cyclophosphamide (2 g/m2) and 5 to 10 μg/kg per day of subcutaneous filgrastim beginning 5 days after cyclophosphamide. The immune ablative regimen was intravenous cyclophosphamide, 50 mg/kg per day on days −5 to day −2 before stem cell infusion (day 0) and rabbit antithymocyte globulin, .5 mg/kg on day −5, 1 mg/kg on day −4, and 1.5 mg/kg on days −3, −2, and −1. Blood products were irradiated, cytomegalovirus safe, and leukocyte depleted. Filgrastim (5-10 μg/kg per day) was started on day +4 and continued until engraftment.

The primary endpoint, defined as an increase in disease progression (EDSS score increase of ≥1) of at least 1 point on 2 evaluations 6 months apart after at least 1 year of treatment, occurred in 3 patients in the HSCT group and 34 patients in the DMT group, with a median follow-up of 2 years. The proportion of patients in the HSCT group with disease progression was 1.92% (95% confidence interval [CI], .27%-12.9%) at 1 year and 2 years, 5.19% (95% CI, 1.26%- 20.1%) at 3 years, and 9.71% (95% CI, 3%-28.8%) at 4 and 5 years.

The proportion of patients in the DMT group with disease progression was 24.5% (95% CI, 14.7%-39.1%) at 1 year, 54.5% (95% CI, 40.7%-69.4%) at 2 years, 62.5% (95% CI,48.3%- 76.7%) at 3 years, 71.2% (95% CI, 56.8%-84.2%) at 4 years, and 75.3% (95% CI, 60.4%-87.8%) at 5 years.

Mean EDSS score decreased (improved) in the HSCT group, from a pre-HSCT score of 3.38 to 2.36 at 1 year (mean change, −1.02 points), while the mean EDSS score increased (worsened) in the DMT group, from 3.31 to 3.98 at 1 year (mean change, +.67 points). The difference between the HSCT group and DMT group in the change in EDSS scores from baseline to 1 year was −1.7 (95% CI, −2.03 to −1.29; P <.001).

Notably, there was significant improvement in EDSS scores, NRS scores, and T2-weighted lesion volume percentages in the 31 patients who crossed over from the DMT group to receive HCST, suggesting that current definitions of progression for RRMS may not accurately assess irreversible disease progression for all patients.

Investigators noted this study was limited by its small sample size and the limited ability to collect follow-up data for patients receiving DMT and to assess longer-term secondary outcomes due to a study design that allowed patients in the DMT group in whom that treatment failed to cross over to receive HSCT.

HSCT is designed to eliminate autoreactive lymphocytes and “reboot” the immune system in a non-inflammatory environment. In an observational study of long-term disability outcomes of patients with relapsing and progressive forms of MS, researchers found that nearly half of these patients were free of neurological progression 5 years after receiving autologous HSCT1. Better outcomes were associated with younger age, relapsing form of MS, fewer prior immunotherapies, and lower EDSS score at baseline.

“We think what happens in HSCT is that the immune response is exposed to myelin in the absence of the danger signal,” Richard K. Burt, MD, principle investigator and chief, division of immunotherapy at Northwestern University's Feinberg School of Medicine in Chicago, Illinois, said in an interview with the National MS Society. “What we’re doing is stopping inflammation you need to treat when the disease in its inflammatory stage.”

CONTINUE READING


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Monday, January 21, 2019

A remarkable new study shows stem cells can reverse MS in some patients

A majority of patients in a small trial who got stem cell transplants after chemo saw their quality of life and disability improve.

By the time Amanda Loy turned 28, her multiple sclerosis had progressed to the point that she could no longer work full time. Her hands and legs felt numb all the time, her bladder always felt full, and she had to rely on a cane to walk for more than 10 minutes. After she gave birth to a son a year later, in 2008, the symptoms worsened. It was around then that she decided to travel from her home in Anchorage, Alaska, to Chicago to inquire about a new treatment she’d heard about at a Seattle hospital.
Nearly a dozen years on, Loy is now back to working full time as a teacher in the radiology program at the University of Alaska. She runs half-marathons and plays soccer with her son, who is 10. She no longer takes MS medications. Her only lingering symptom is some mild nerve pain from time to time.
“It sounds so dramatic, but [the treatment] gave me my life back,” she said.
The treatment is an experimental chemotherapy and hematopoietic stem cell transplant offered in the first randomized trial comparing the outcomes of patients receiving the treatment to patients who took standard MS medications.
The results of the trial appeared Tuesday in the journal JAMAand they are impressive: Among the 55 patients in the control group who took medication, 34 saw their disease worsen. But for the 55 (including Loy) who received the chemo and stem cell transplant, only three got worse. The rest saw their quality of life and disability improve.
It’s the best evidence to date that the treatment works for patients with what’s called “relapsing remitting” MS. “I do think it’s going to change the natural history of MS,” said Northwestern University stem cell researcher Richard Burt, the study’s lead author and Loy’s doctor. “When you use it in the right group of patients with MS, you get these really gratifying results.”
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Small molecule could delay onset


Treatment with a small molecule could delay the damage that multiple sclerosis inflicts in the brain and other parts of the central nervous system, say scientists.
woman in wheelchair getting out of a car with carer
A new treatment for MS may soon be in sight.
Multiple sclerosis (MS) is a disabling disease that destroys the myelin sheath that protects nerve fibers, causing loss of signaling and nerve cell damage in the central nervous system (CNS).
Now, a recent study from the University of Chicago in Illinois has revealed how a small molecule that bears the name Sephin1 can delay myelin damage in a mouse model of MS.
The journal Brain has recently published an account of the findings.
The study reveals that Sephin1 works by prolonging an inbuilt, integrated stress response (ISR) that reduces the harm that inflammation causes to myelin-producing cells, or oligodendrocytes.
First study author Yanan Chen, a postdoctoral scholar in the Department of Neurology, says that Sephin1 appears to offer "therapeutic potential with no measurable adverse effects."


               
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Sunday, January 20, 2019

2018 - Archived MS Educational Videos - something for everybody affected by MS

WOW - the entire year of 2018 - All of our videos.
Find what you would like to learn and click the link(s) from the listings showing below



JANUARY:

1)       Making MS Connections

2)       A Compassionate Talk Addressing Challenges of Living with MS

3)       STAYING ACTIVE, Using Simple Exercise and Lifestyle to Feel Better, Living with MS

4)       Learn of a Comprehensive Healthcare team, Cognition, Depression & more, in MS

5)       Axons, Movement in MS, Putting the Pieces together & The MS Healthcare Team

6)       MS NEURO TV WEBINAR: Multiple Sclerosis and The Leaky Pool Theory

7)       The 2017 MS Symposium of South Florida- The Neurological Aspects of MS and Beyond TAI CHI

8)       The 2017 MS Symposium of South Florida- The Neurological Aspects of MS and Beyond

9)       The 2017 MS Symposium of South Florida- Psychological Aspects & Sexuality



FEBRUARY:

1)       MS NEURO TV WEBINAR: Shared Decisions & Effective Communication in Multiple Sclerosis

2)       Effectively Communicating with your MS Healthcare Team

3)       Learn of a comprehensive healthcare team in relation to MS and about Bladder issues with MS

4)       Julie Roberts, “The Ups and Down of Living with MS” - An inspiring talk from a country singer and MS patient advocate 

5)       Multiple Sclerosis: Creating BALANCE with proper Exercise and Knowledge

6)       Proactive management of Multiple Sclerosis (MS)

7)       The 2017 MS Symposium of South Florida- Immunology of MS

8)       The 2017 MS Symposium of South Florida- Multiple Sclerosis, Relapse & Symptom Management, and Lifestyle Issues

9)       Multiple Sclerosis - Proper Fitness, Exercise and Knowledge

 

 

MARCH

1)      MS NEURO TV WEBINAR: Access to MS Care & Resources

2)     Caregiver Rights & Financial Responsibilities

3)      Multiple Sclerosis: Understanding the disease and symptoms 

4)      Multiple Sclerosis: Understanding the Need for a Comprehensive MS Healthcare Team 

5)      Multiple Sclerosis: Exercise and movement at any level to improve strength and flexibility 

6)      MS Exercise Tutorial: Improve Balance & Mobility 

7)      Multiple Sclerosis: Understanding of the importance for early treatment 

8)      Dr. Michael Hemphill’s Overview of Multiple Sclerosis (MS) 

 

APRIL:

1)       How A Person with Multiple Sclerosis (MS) Can Exercise 

2)       MS NEURO TV WEBINAR: All About MS Disease Progression

3)       MS Exercise Tutorial: Improving Your Balance and Mobility 

4)       Multiple Sclerosis from a Different Perspective 

 

 

MAY

MS NEURO TV WEBINAR: Injection Therapy Options for Multiple Sclerosis

 

JUNE

1)       MS NEURO TV WEBINAR: Pain Management in Multiple Sclerosis

2)       SSDI (Social Security Disabilty) information for those with Multiple Sclerosis 

 

JULY

1)       Listen with Drs. Williams & Thrower Discussing A Compass to MS Care 

2)       Adaptive Yoga for MS - Compass to Care MS Forum 

3)       Highlights from the 2017 MS Views and News Champions Tackling MS Benefit

4)       MS NEURO TV WEBINAR: Infusion Therapy Options for Multiple Sclerosis

5)       Country Singer, Julie Roberts: An inspirational talk on “Moving Forward in Life with MS"

6)       Compass to Care - MS Roundtable Q&A with Neurologists: Boster, Hunter & Kantor 

 

AUGUST

1)       Wellness, Exercise, Health & Movement: Benefiting MS patients and most others 

2)       Living with MS and Cognitive Challenges

3)       A Current Overview of Multiple Sclerosis, Plus Shared Decision Making

4)       MS NEURO TV WEBINAR: Multiple Sclerosis Relapses

5)       Communicating with Your MS Healthcare Team Concerning Various Aspects of Multiple Sclerosis

6)       Cognitive Issues with Multiple Sclerosis

7)       Neuro-ophthalmic Manifestations of MS

 

 

SEPTEMBER

1)       MS NEURO TV WEBINAR: Knowing When to Switch Your MS Treatment

2)       MS= MOVE SOMETHING!!! Staying active - Exercises specifically for people living with MS

3)       BALANCE - MS Symptoms Management, Relapses and A Complete Overview of MS

4)       Staying Strong with MS Through Exercise: Doing What You Can Today

5)       MS Learning in Rural America - Importance of Early MS Treatment, Shared Decision Making & More

6)       "One Million Miles for MS" with Paul Pelland (LongHaulPaul), an inspirational MS advocate

7)       Psychological Factors of living with MS, plus Learning More About MS Symptoms 

 

OCTOBER

1)       Emotional aspects of living with MS; Shared Decisions, Talking with your Neuro Team & an Awesome Q&A 

2)       MS NEURO TV WEBINAR: Staying Active with Multiple Sclerosis

 

NOVEMBER

1)       Beneficial to an MS patient - Partnering With and Understanding a Comprehensive Healthcare Team

2)       Multiple Sclerosis: Movin' and Groovin' – An Interactive Intro to Movement and Physical Fitness 

3)       MS NEURO TV WEBINAR: The Immunology of Multiple Sclerosis, MRI and More

4)       Living Better with MS - Reconditioning the Deconditioning Associated with Chronic Illness

5)       Facing Cognitive Issues with MS + Knowing the Benefit of a Comprehensive Healthcare Team

 

DECEMBER

MS NEURO TV: Oral Therapy Options for Multiple Sclerosis

Champions Tackling MS Join Together at 2018 Benefit

 

The 2018 MS Symposium of South Florida- Benefit of Yoga Therapy for Multiple Sclerosis

Fight or Flight: The science of exercise to build core strength for better movement

Exercise: Finding what Works for You (Stretch Bands, Sand Weights & more)

Integrative Medicine - Improving One’s Quality of Life using Complementary Therapies

Multiple MS Topics: Q&A with MS Expert Panel at 2018 MS Symposium