Mom's Story

A discussion about Mom's Story and MS…

Archive for the tag “therapy”

New Lab Studies Add Evidence That High Salt Diets Increase Inflammation and May Have Implications for MS

Summary
• The results from two recently published laboratory studies suggest that high levels of salt shift the balance of the immune system toward inflammation, and that salt alters the function of several types of immune cells pertinent to MS.
• These two studies, which were both published in the Journal of Clinical Investigation, were led by Dr. David Hafler (Yale University) and Dr. Dominik Müller (Max-Delbruck Center, Berlin, Germany).
• Dr. Hafler is funded by the National MS Society to study the impact of high salt on the immune system, and the Yale team is also conducting a pilot clinical trial to explore the impact of high- and low-salt diets on MS disease activity.

Background: Eating high levels of salt, which is part of the typical Western diet, has been linked to heart disease, chronic inflammation, and cancer. Recent lab reports have also suggested that dietary salt can speed the development of the immune attack in an MS-like disease in mice, and that the mouse disease responds differently to salt depending on the gender and genetic makeup of the mice. One small study in people found a possible link between dietary salt levels and relapses in people with MS, but this study suggested a link, which is not the same as establishing an actual cause. So far, laboratory findings related to the effects of salt have been stronger than the few studies that have been reported in people. Understanding whether high dietary salt is a risk factor for developing MS or for worsening disease activity is an active area of research.

The Studies: Two studies recently published in the Journal of Clinical Investigation suggest that high dietary salt affects two types of immune cells in a way that increases inflammation, a state that is generally considered harmful in MS. A study by National MS Society-supported researchers at Yale University and Harvard Medical School led by David Hafler, MD, investigated the effects of high salt on regulatory immune cells called “Tregs.” Tregs normally suppress immune responses by other immune cells, but in people with MS Tregs have been shown to be less able to perform this helpful function to turn off attacks. The team showed in mice and in cells in lab dishes that high salt blocks the ability of Tregs to suppress potentially harmful immune cells, and shifts Tregs toward activity that increases inflammation.

The other study, by an international team led by Dominik N. Müller at the Max-Delbruck Center in Berlin, Germany, investigated immune cells called “macrophages.” This study showed that high salt blocks the activation of a subset of macrophages, reducing their ability to suppress inflammatory cells and creating an imbalance in the immune system. In mouse models, high salt diets also delayed wound healing.

Comment: Taken together, these laboratory studies add new evidence that high levels of dietary salt may increase inflammation and autoimmunity, and decrease the ability of regulatory cells and processes to limit harmful immune cell activity. More studies are needed to determine the possible role of a high-salt diet in the risk of developing MS and whether reducing salt intake may be helpful for reducing disease activity in people with MS. Dr. Hafler is funded by the National MS Society to study the impact of high salt on the immune system, and the Yale team is also conducting a pilot clinical trial to explore the impact of high- and low-salt diets on MS disease activity.

Read more about dietary factors that may play a role in MS
Read more about research on the immune system in MS

Study Uncovers Gene Variation Linked to Response to MS Therapy; May Open Up New Treatment Approaches

Collaborating researchers in the U.S. and Italy have uncovered a gene variant that appears to influence whether a person responds well to interferon beta, a commonly used therapy for relapsing forms of MS. More broadly, the gene may regulate immune activity in unexpected ways, and its discovery may lead to new approaches to stopping inflammation and immune attacks in MS. Drs. Federica Esposito and Filippo Martinelli Boneschi (San Raffaele Scientific Institute, Milan), Philip L. De Jager (Brigham and Women’s Hospital, Boston) and colleagues have published their results in the Annals of Neurology (Early online May 14, 2015). The study was supported by the National MS Society and several other agencies.

Background: For reasons that are unclear, some people with relapsing forms of MS do not respond well to therapy and continue to experience disease activity despite being on a disease-modifying therapy. Previous genetic studies in MS have uncovered over 159 genetic variations that contribute to making people susceptible to developing MS, but these studies haven’t identified genetic variations that influence how a person responds to treatment. Finding a way to identify early in the disease course the best therapy for an individual – a “personalized medicine” approach – is likely to improve outcomes of treatment and quality of life for people living with MS. One of the lead authors of this study, Dr. De Jager, recently won the Barancik Prize for Innovation in MS Research for tackling critical questions like this with the goal of developing personalized treatments and prevention of MS.

This Study: Trying a different approach to search for genetic influences on treatment responses, the investigators first studied a group of individuals with MS who were taking interferon beta or glatiramer acetate. The individuals were classified as being responders, partial responders, or non-responders to their medication based on specific criteria. Then the researchers analyzed their full complement of genes (genome-wide association study) and found one genetic variant that was consistently associated with lack of response to interferon beta. When the researchers repeated this in three other groups of people with MS from Italy, France and the U.S., this finding held up.

The genetic variant (rs9828519) is near a gene (SLC9A9) that controls pH levels (acidity) within cells. The team explored functions of this gene, and found that its activity was diminished in people more likely to have MS relapses. They also conducted laboratory work, finding suggestions that the gene appears to play a role in regulating immune cell activity, and that its loss leads to damaging immune reactions. This suggests the gene may play a broader role in regulating immune activity.

Comment: Although the results of this study are not yet ready for applying to the management of MS, this discovery may lead to new approaches for stopping inflammation and immune attacks in MS. In addition, this study is an important step toward the goal of personalized medicine. The researchers point out that additional research is warranted to confirm their findings and to determine whether the genetic variant is relevant to how well people respond to other MS medications.

Researchers implicate chemical in MS

A new study confirms that the cytokine granulocyte macrophage colony-stimulating factor (GM-CSF) likely plays an important role in multiple sclerosis. Researchers also offer a new explanation for why the MS treatment interferon-Beta (INF-β) is often effective at reducing attacks.

Researchers, led by Abdolmohamad Rostami, M.D., Ph.D., Chair of the Department of Neurology at Thomas Jefferson University and director of its neuroimmunology laboratory, tested blood samples of patients with MS who had not yet received therapy, and those currently being treated with INF-β, a commonly used therapy. On average, untreated patients had two to three times as many immune cells producing GM-CSF as did patients being treated with INF-β, or normal subjects. Researchers looked at brain samples of deceased patients with MS and found increased numbers of GM-CSF-producing cells in comparison to normal brain samples.

“Abundant GM-CSF production at the sites of CNS inflammation suggests that GM-CSF contributes to MS pathogenesis. Our findings also reveal a potential mechanism of IFN-β therapy, namely suppression of GM-CSF production,” the authors said.

The findings were published online in the Journal of Immunology.

Single-Payer Healthcare

Lets take this seriously:

How Common Is It To Have MS With Other Medical Conditions? First Results from the MS “Comorbidities” Project

Unfair as it seems, MS doesn’t keep other disorders away. It’s possible to have MS and “something else” at the same time. A new international initiative is being launched to understand how common it is for people with MS to have other conditions and how these other conditions may impact the course and treatment of an individual’s MS. The first stage of this project is now published, in preparation for an international scientific workshop jointly supported by the National MS Society and the European Committee for Treatment and Research in MS (ECTRIMS) to focus attention on comorbidities and determining next steps to finding solutions for people with MS.
Background: In scientific terms, having two chronic medical conditions at once is called “comorbidity.” There is growing recognition that comorbidities may complicate the diagnosis of MS and also influence disease progression, as well as an individual’s wellness and quality of life. In addition MS some other disorders may have risk factors in common. For these reasons, the MS Comorbidities Project is seeking to characterize the types and frequencies of comorbidities in MS in advance of a scientific meeting to map out next steps for research strategies to address this gap area. This project is being undertaken by the International Advisory Committee on Clinical Trials in MS, a committee comprised of international leaders in MS research and clinical care that is jointly supported by the National MS Society and ECTRIMS.
The first phase of this project was a systematic review of existing published studies related to specific medical conditions in people who have MS. Ruth Ann Marrie, MD, PhD (University of Manitoba) and colleagues* in Denmark, Italy and the U.S., now report their findings in seven papers published in the MS Journal. (Read overview and companion papers; no subscription is needed.) The review was supported in part by the National MS Society (U.S.A.) and a Don Paty Career Development Award from the MS Society of Canada.
Review Results: The authors identified more than 7,000 studies on a variety of comorbidities and MS, and narrowed these down, completing a full-text review of 249 studies that were conducted between 1905 and 2012. Most were conducted in North America or Europe, leading the authors to comment that little is known about comorbidities that occur with MS in Central or South America, Asia, or Africa. In addition, the quality and design of the studies were so variable that it was difficult to compare results. Nevertheless, their extensive research yielded these highlights, among many others:
• The five most prevalent disorders occurring alongside MS were depression, anxiety, high blood pressure, high cholesterol, and chronic lung disease.
• The most prevalent autoimmune diseases occurring with MS were thyroid disease and psoriasis.
• The types of cancer that occurred most often in people with MS were cervical, breast, and digestive system cancers. There appeared to be a higher than expected risk of meningiomas and urinary system cancers, and a lower than expected risk of pancreatic, ovarian, prostate and testicular cancer, compared to the general population.
• Some disorders were found more often than expected by the investigators based on previous research, such as heart disease, congestive heart failure, stroke, arthritis, inflammatory bowel disease, irritable bowel syndrome, seizure disorders, bipolar disorder, sleep disorders, and alcohol abuse.
Comment: The authors suggest that further work is necessary to develop data sources that examine MS comorbidities worldwide, and that are specific to individuals of different ages, genders, and ethnicities. They also conclude that efforts should be coordinated so that methodologies are similar and results can be compared.
To this end, the Society and ECTRIMS are convening a workshop that will move this research forward. The International Advisory Committee on Clinical Trials in MS and other experts in MS research will meet in spring 2015 to discuss next research steps, such as available data that may facilitate further research and which comorbidities demand more immediate focus.

Writing Mom’s Story

I began writing the story in late 2007. Actually, I began the story in February 1978. Immediately after getting out of bed that February morning, I couldn’t stand. The room was whirling, my stomach was churning. I sat on the edge of t he bed until my head cleared a little and I could stand. I tried to dress, but wasn’t able to bend down without the room spinning again and the nausea returning. I made a doctor’s appointment. He couldn’t find anything and treated me with Dramamine for a mild middle ear inflammation. It cleared after about a week and I put the occurrence in the back of my mind. In August of the same year, I awoke one morning with a gray spot in the vision of my left eye. It enlarged over the morning. By afternoon, my vision in my left eye was limited to the extreme outer edges. Being Saturday, I went to the Emergency Room, convinced I was going blind. An Ophthalmologist happened to be on duty. He diagnosed the problem immediately as optic neuritis and prescribed prednisone. That cleared in about eight weeks.
Fast forward to 1989. I had been a “normal volunteer” at the National Institutes of Health for several years. I was asked if I would volunteer for an MRI. They said it’s easy if you’re not claustrophobic, no needles, only some noise. I said I would be glad to do it. They were right, lots of noise but no other discomforts. About a week later, a physician called to tell me that they found something strange on my brain. I went back to the physician and came away with a definite diagnosis of multiple sclerosis (MS). I launched a search for information, this being pre-internet, I went to libraries and contacted the National Multiple Sclerosis Society (www.nmss.org ).
By June of 2006 I had retired on disability from my position as a Science Librarian and worked from home as an editor and writer. I attended a meeting of the Outdoor Writers Association of America (www.owaa.org ). I was interested in writing for children by this time and I attended a session given by the renowned children’s author, Kathleen Kudlinski (www.kathleenkudlinski.com ). Her one piece of advice (among others) that I took away from her presentation was: “Write what you know.”
In October 2007, after spending over a year researching and learning about writing for children, I asked myself, “What do I know?” It came to me quickly, I know about MS. I have been interested in health issues and have read quite extensively, especially about plagues and infectious diseases. But also about MS, I have an extensive library about the disease and I have reviewed books on the subject for Library Journal.

Now in it’s second edition.

National MS Society Invests Nearly $19 Million in New Research to Stop Multiple Sclerosis, Restore Function and End MS Forever

What do exercise, skin cells and gut bacteria have in common? They are among the new leads being explored to move us closer to a world free of MS.

The National Multiple Sclerosis Society has committed nearly $19 million to support an expected 54 new MS research projects. These are part of a comprehensive research strategy aimed at stopping MS, restoring function that has been lost, and ending the disease forever – for every single person with MS.

This financial commitment is the latest in the Society’s relentless research efforts to move us closer to a world free of MS, investing more than $50 million in 2014 alone to support 380 new and ongoing studies around the world. So that no opportunity is wasted, the Society pursues all promising paths, while focusing on three priority areas: progressive MS, nervous system repair, and wellness and lifestyle.

Just a few of the new cutting-edge research projects include a study at Stanford University using skin cells to produce repair cells for possible future use to restore nerve-insulating myelin in MS; pre-clinical studies by a commercial firm (Glialogix) to test the nervous system-protective qualities of an oral therapy repurposed to address progressive MS; a Mayo Clinic study of beneficial gut bacteria for clues to a novel therapeutic strategy for MS; and a wellness study at the University of Illinois at Urbana-Champaign testing whether an exercise program done at home can increase strength and balance and reduce falls in people with MS.

“The comprehensive nature of these new research investments is very exciting,” noted National MS Society Executive Vice President, Research Bruce Bebo, PhD.  “While we’re driving research to stop MS, restore function and end the disease forever, at the same time we’re identifying key interventions and solutions that can help people with MS live their best lives now.”  Download details about the new research awards.

Multiple sclerosis interrupts the flow of information within the brain and between the brain and the body.  Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease.  Worldwide, over 2.3 million people live with the unpredictable challenges of multiple sclerosis.

“MS research is a top National MS Society priority, with increasing annual investments to drive solutions for every person with MS,” Cynthia Zagieboylo, President and CEO of the Society. “We fund the entire research spectrum, propelling novel ideas into the lab, translating breakthroughs into clinical trials, and moving success in clinical trials into new treatments for people living with MS.”

To find the best research with the most promise, the National MS Society relies on more than 130 world-class scientists who volunteer their time to carefully evaluate hundreds of proposals every year.  This rigorous evaluation process assures that Society funds fuel research that delivers results in the shortest time possible.

There are FDA-approved therapies that can impact the underlying disease course in people with the more common forms of MS.  However, none of these can stop progression or reverse the damage to restore function.  National MS Society-funded research paved the way for existing therapies – none of which existed 20 years ago – and continues to be a driving force of MS research.

Live Webcast: Research Advances from the World’s Largest MS Meeting

September 13, 2014

On Saturday, September 13, 2014, join a panel of experts for a live nationwide Webcast on “Research Advances from the World’s Largest MS Meeting

Saturday, September 13, 2014
2 – 3 pm ET (1 – 2 pm CT, Noon – 1 pm MT, 11am – Noon PT)

To register for the live webcast please click here.

Topics include:

  • Progressive MS
  • Genetics
  • Wellness and rehabilitation
  • Repair and protection

Moderator: Kate Milliken, founder, Milligrace Productions. Kate has been living with MS since 2006.

Panelists include:

Dr. Philip DeJager, Brigham and Women’s Hospital, Boston, MA

Dr. Don Mahad, University of Edinburgh, UK

Dr. Ellen Mowry, Johns Hopkins University, Baltimore, MD

Dr. Timothy Coetzee, Chief Advocacy, Services and Research Officer for the National MS Society

Register

We want to thank Genzyme, a Sanofi Company; Novartis Pharmaceuticals; Questcor Pharmaceuticals; and Walgreens Specialty Pharmacy for providing generous educational grants to make this program possible.

*For people who cannot participate in real-time, we will post the recorded version with transcript for viewing shortly after the event.

Results Published from First Human Clinical Trials of “Anti-LINGO” Myelin Repair Strategy

August 27, 2014

Results from two phase I human safety trials of an exploratory treatment aimed at repairing myelin damaged by multiple sclerosis have now been published. One to two treatments with Biogen Idec’s BIIB033 (anti-LINGO monoclonal antibody) were given by injection under the skin or into the vein of healthy volunteers and people with relapsing-remitting or secondary-progressive MS. No serious adverse safety events were reported, and although these studies were not designed to evaluate effectiveness, the results were considered positive and have led to a phase II trial, now underway in relapsing MS. The results were published on August 27, 2014 in the online journal Neurology® Neuroimmunology & Neuroinflammation.

“It’s encouraging to see an entirely new treatment strategy aimed at repairing MS myelin damage moving forward in clinical trials,” noted Dr. Timothy Coetzee, Chief Advocacy, Services and Research Officer at the National MS Society. “Repairing myelin may be the best way to protect the nervous system from MS damage, and it holds potential for restoring function that has been lost in people living with this disease,” he added.

Background: In MS, immune attacks lead to the loss of myelin that coats and protects nerve fibers in the brain and spinal cord. Repairing the nervous system was just a dream a few years ago. Today it holds significant promise as a strategy to restore the function that MS has taken from people; and reducing or stopping MS progression. This remarkable progress is due in large part to the National MS Society’s comprehensive efforts and multi-million dollar research investments. Today the Society is supporting 87 research projects in nervous system repair, with multi-year commitments totaling over $35 million.

The first human trials of anti-LINGO leverage research aimed at stimulating the body’s natural healing abilities. LINGO is a protein seen in neurons and myelin-producing cells (oligodendrocytes), and blockading this protein with a monoclonal antibody called anti-LINGO has been shown to promote remyelination in animal models.

Details: In these first tests of anti-LINGO in humans, 72 healthy people and 47 people with relapsing-remitting MS or secondary-progressive MS were given anti-LINGO or inactive placebo by injection under the skin or into the vein. The participants with MS were given two treatments, two weeks apart.

All participants were monitored extensively for any signs of adverse reactions. There were no serious adverse safety events noted. The most common side effects included headache, upper respiratory tract infection, stuffy nose, GI symptoms and urinary tract infection, and these were experienced by participants who were on placebo as well as those who received doses of anti-LINGO.

Generally phase I studies are not designed to detect benefit, but largely to evaluate the safety and tolerability of exploratory therapies, to refine appropriate dosing, and to determine whether they reach their targets – in this case, the central nervous system. That is true of these trials, and there was no evidence from MRI or other tests that showed clear evidence that existing brain lesions healed from this short exposure to anti-LINGO. However, the safety, dosing and pharmacology results were considered positive and have led to the design and launch of a phase II trial by Biogen Idec, now underway in relapsing MS.

Online Radio Station for MS is First of its Kind

 

MSFocusRadio.org offers 24/7/365 education, empowerment for MS community.
The Multiple Sclerosis Foundation (MSF) is proud to announce the launch of a new online radio station, MSFocus Radio. Found on the web at www.MSFocusRadio.org, or on mobile devices via a free app, this service of the MSF is a first of its kind for the MS community.
Featuring original content produced by the MSF in conjunction with our panel of healthcare experts, MSFocus Radio provides motivation, education, and empowerment to people affected by multiple sclerosis, 24 hours a day, seven days a week. MSFocus Radio is the MS resource that travels anywhere, thanks to free apps for both iOS and Android devices (available through iTunes and Google Play) provided by the MSF.
Noting the station’s worldwide availability and round-the-clock scheduling, MSF Co-Executive Director Jules Kuperberg commented, “MSFocus Radio has dramatically broadened the scope of MSF’s outreach both nationally and worldwide.”
To listen to MSFocusRadio or download the apps, visit www.msfocusradio.org now.

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