Monday, 7 February 2011

MS research roundup

I was thinking it might be interesting if I did a regular roundup - say monthly - of MS-related research. There's a lot of really good stuff going on just now. I only have a few items here, as these are just the recent ones I can remember. From now on I'll do a draft post as I go along. If it looks like it's going to be too long, I can cut out a few!

I've deliberately excluded everything to do with CCSVI, as I'm going to do a separate post about that.

Researchers at the University of Oxford have established that vitamin D directly influences over 200 of our genes.There is a growing body of evidence that vitamin D deficiency can make an individual more susceptible to MS, as well as other auto-immune conditions such as rheumatoid arthitis, type 1 diabetes, Crohn's disease and even certain cancers. The main source of vitamin D in the body is from exposing the sun to sunlight, although we can also gain some from oily fish.

 It was already known that people with one auto-immune disease were more likely to get another. Researchers from Canada and the USA looked at whether smoking could influence this, and found that smokers with MS were more likely than non-smokers to report another auto-immune conditions. Smoking is a risk factor for both MS and other auto-immune conditions.

Along the length of axons (the long part of the nerve cell, stretching into the body), the myelin is separated into short stretches by nodes of Ranvier. In a normal cell, electrical signals can leap from one node of Ranvier to the next, protected by the insulating myelin.

In MS, the myelin sheath gets broken down and the electrical signal can no longer be conducted properly. Now researchers at the University of North Carolina are suggesting that when myelin begins to break down, the myelin segments begin to slide together and overlap, interfering with the operation of the nodes of Ranvier. For people in the early stages of MS, they say, regrowing the nodes (once we know how to do that!) could prevent the segments from overlapping, possibly halting the disease.

We more often think of histamine as being related to allergies, and anti-histamines as what we take for hay fever. But histamine is involved in other processes in the body. Researchers in Italy used animals with a laboratory-generated form of MS then assessed the effect of histamine on their cells. They found a wide range of results, including an increase in the ability of some immune system cells to stick to inflamed blood vessels in the brain, a crucial step in the development of MS. This connection between the pathways involved in allergy and auto-immune conditions had not previously been established. Histamine looks like a possible target for the development of new drugs.

Finally, a report about a treatment that is already available, but seems to be sadly underused. When people have severe stiffness and/or spasticity that is not relieved by the traditional medications, in some cases an intrathecal baclofen pump will be used. Intrathecal means into the spine. The pump is a small device inserted under the skin of the abdomen, with a reservoir of liquid baclofen. It delivers a constant low dose of baclofen directly into the spinal column, and significantly reduces stiffness and spasticity.

While it must be borne in mind that this report is issued by the manufacturer of the device, the study methods seem robust. It finds that of the 13% of people with MS who may be candidates for the device, only 1% actually have one. The expert panel who carried out the research noted that the main barrier to use of the device is that many physicians do not present it as safe, well tolerated and effective. This may occur due to lack of physician understanding of the quality of life issues related to spasticity, the potential benefits of the device and appropriate patient selection, as well as focusing on disease modifiers rather than symptom control.

I've seen at first hand how effective these devices are. It's appalling if people who really need them are being deprived of them.

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