Manouchehrinia A, Edwards LJ, Roshanisefat H, Tench CR, Constantinescu CS.Multiple sclerosis course and clinical outcomes in patients with comorbid asthma: a survey study.
BMJ Open. 2015 May 20;5(5):e007806. doi: 10.1136/bmjopen-2015-007806.
OBJECTIVE:To determine if comorbid asthma is associated with accumulation of multiple sclerosis (MS)-related impairment and disability.
METHOD:We sent a comprehensive questionnaire to a cohort of patients with MS and examined the association between comorbid asthma and reaching Expanded Disability Status Scale (EDSS) scores 4.0 and 6.0. Multiple Sclerosis Impact Scale (MSIS-29) scores were compared between patients with MS with and without comorbid asthma.
RESULTS:680 patients participated in our study of whom 88 (12.9%) had comorbid asthma. There was no difference in the prevalence of asthma between our MS cohort and the England general population (OR: 0.89, 95% CI 0.68 to 1.17). We did not observe a significant association between having asthma and the risk of reaching EDSS scores 4.0 and 6.0 (HR: 1.29, 95% CI 0.93 to 1.77, and HR: 1.33, 95% CI 0.93 to 1.89, respectively) after controlling for confounders. Patients with MS with asthma reported higher level of psychological impairments (coefficient: 2.29, 95% CI 0.1 to 4.49).
CONCLUSIONS:Asthma is a prevalent condition among patients with MS and it may contribute to the psychological impairment in MS. Although we did not observe significant association between comorbid asthma and physical disability in MS, it seems that the two conditions influence one another.
The aim of many immunologists is the drive a Th1/Th17 response towards a Th2 response. It is thought that Asthma is associated with a Th2 biased response. So what is the influence of having asthma and MS. Will a Th2-Asthma response slow MS.
Well the answer is no, not that much. Most EAE experiments are not done for long enough for proper B cell responses to develop, so it is considered that a Th2 response should be desirable in two legged EAE (If you ask people to describe MS they tell you about EAE). However, it probable that both Th1 and Th2/B responses are undesirable and so far studies aimed at driving Th2 (B cell promoting) responses in MS have yet to show the promise of that hoped.
This is the basis of the many studies, trying to give MSers parasitic worms, in the hope that it drives a TH2 responses such as in the TRIOMS (Germany) trial. The HINT (USA) and WIRMS (UK) trials should have been finished by now. Do we know that has happened?