Wednesday, 11 July 2018

Ask a Question July

If you have a question unrelated to other posts.

This is the place for you
 Pic by MD2 Derwent Water

29 comments:

  1. I'm a layperson so what I'm asking might not make biological sense. It's probably not a simple question either. Wish I'd paid more attention in school!

    I sort of understand that T-Cells manage to traverse the blood brain barrier and they attack myelin. Do all T-Cells do this or do only a few go rogue?

    I've wondered if, when the BBR repairs itself, are the the T-Cells moving around in a place they shouldn't be causing havoc, leading to inflammation and degeneration of myelin. They die off and then you're OK for a while until the BBR lets more in, then the process starts over but given the pre-existing degeneration, the effects are incrementally worse.

    Or is it once they are in, they are in and they will just cause havoc for as long as they can?

    I guess my question is, for RRMS probably, is it an opening/closing of the BBR "gate" that gives rise to relapses and remission, or is it more random than that?

    Thanks! P.S. Loved the photo.

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    Replies
    1. Glad you liked the photo! The scenery in the Lake District is stunning.
      We had a post from Dr Love on what cells are in lesions a while back that's worth a read and hopefully answers some of your questions.
      https://multiple-sclerosis-research.blogspot.com/2011/12/education-espresso-pathology-lesion.html

      Delete
    2. Thank you, that was very interesting. (Not sure why I kept writing BBR, I meant BBB!)

      Delete
  2. Did MD1 and ProfG desert this blog for good?

    They have probably posted no more than a handful of good posts between then since the beginning of the year.

    Is this the beginning of the end of this blog as we knew it? Would we need to see the emergence of another Zamboni to brig it back to life?

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    Replies
    1. I am still here, but my phone have been locked out of the comments for a couple of months and is not allowing me to comment.

      The blog bosses have been aiming for one post a day and there are more people posting. Likewise we can only post on the same thing so many times.

      I have also had a lot less spare time for the past few months, for a number of reasons and so simply not had time to post.

      Delete
    2. MD you are missed from the blog! We are looking forward to get your phone fixed :P

      Wish MD2 was more active too :/

      Delete
    3. I’m more confused than ever. Is the consensus, that with non active MRi scans , age in the 50’s, and progressive MS , there is no effective treatment to preserve upper limb function? I Know Ocrevus only nominally slows progression, less than 30%. I’ve
      been reading about saving hand function, but it seems the above mentioned subset of MS may be left out in the cold.

      Delete
    4. Try this :)

      "Graham Walker"
      I can concur from my own experience : I was a road cyclist, competitive , in my younger days and now , ppMS, 5 years into diagnosis, I ride on the road 25 miles (40 km ) 5 times per week , weather permitting. My Neurologist and other professionals say they are amazed at how I'm holding progression.
      I am able to do this because I'm mentally adapted because of my past experience, I utalize clip on pedals and shoes, and I have a very supportive wife and family.
      Exercise is undoubtedly very important !

      Delete
  3. MS Society asks for our opinion to test existing drugs for MS:


    What existing medicine do you think could help in MS?

    Please join our initiative! Our consortium want to hear from everybody, especially people living with MS. If you can suggest a drug that that may have the potential to slow progression please email research@mssociety.org.uk by 30 July 2018.

    It needs to be a treatment that’s already licensed for another condition, and we’d like as much information about it as you can give. The consortium will analyse available information on each drug to identify the most promising. We expect these to be the first drugs tested when the platform is ready.

    https://www.mssociety.org.uk/research/latest-research/latest-research-news-and-blogs/which-existing-drugs-could-help-in-progressive-ms?utm_source=Facebook&utm_medium=organic_post&utm_content=Which_existing_drugs_could_help_in_progressive_MS&utm_campaign=2018M7202_0484

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  4. If it is thought that B and or T cells are part of the problem in MS why can't we analyze some of these in pWMS and see what kind of receptors they have to pinpoint the kind of antigen that is leading to the inflammation and better understand the pathology ? Or at least develop a biomarker based test ?

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    Replies
    1. The "antigen" for T cells has been looked for for decades but nothing convincing has ever been found. Same goes for the antibodies produced by B cells in the CNS ie this isn't autoimmunity as such in the classical sense more an aberrant immune response in the CNS the triggers for which are still frustratingly to be understood.

      Delete
  5. What is the (updated) data on the likelihood of progressing to Secondary progressive MS factoring in being on a DMT? (The data I've seen so far is that generally 80% of people with RRMS 15 to 20 years after being diagnosed with RRMS will progress to SPMS.

    ReplyDelete
    Replies
    1. I think the doctors on here (and knowledgable MS doctors generally) believe that MS is one disease, not three. Whichever kind a person has, there will be 'progression', in the sense that they will have lasting scarring on their brains (with the possible exception of people who have Lemtrada or HSCT early on in their disease). Whether the scarring manifests as permanent disability depends where it is and how bad it is. This in turn will depend, in part, on the treatment they have had on the way. So there are no general stats on this - if someone has been put on an effective DMT and changed to another if the previous one becomes ineffective, they are much less likely to end up with permanent loss of function (is that your definition of SPMS?).

      Delete
  6. Is there an update to the PML Risk updated http://multiple-sclerosis-research.blogspot.com/2017/03/clinicspeak-neurospeak-natalizumab-pml.html ?

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  7. Good morning and congratulations for the blog.

    If as the MS is believed to be caused by a virus and has more incidence in high latitudes, is it possible that the hours of sun influence the number of viruses and not the MS? Like malaria.

    Thank you.

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  8. Concerning the search for what went wrong with Daclizumab, I understood that the Neuropathology Department in Göttingen (where some of the Zinbryta patients had died) issued a statement indicating that the suppression of the Il-2 receptors had apparently led for some to an increase in eosinophils which in turn resulted in cases of eosinophilic meningitis.

    Any comments?

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  9. Finally

    Missouri Trial to Examine if Fasting Alters Gut Microbiome and Immune System of RRMS Patients in Helpful Ways

    •IF ameliorates the clinical course and pathology of the MS mouse model (EAE)
    •IF increases gut microbial diversity, alters their composition and metabolic pathways
    •Gut microbiota transfer from mice on IF led to protection from EAE in recipient mice
    •Findings with IER in MS patients partially recapitulates what is observed with IF in EAE

    https://www.cell.com/cell-metabolism/fulltext/S1550-4131(18)30313-9

    Taking place at the Missouri university, the trial (NCT03539094) is expected to enroll 60 RRMS patients. Half will be randomly assigned to eat a standard Western-style diet seven days a week, and the other half to Western-style diet five days a week, with two days set aside for fasting (consuming a maximum of 500 calories each day).

    Funny today is my 500 calories (gonna eat now) Have not eat anything today

    :)

    https://multiplesclerosisnewstoday.com/2018/07/12/trial-will-investigate-if-fasting-benefits-immune-response-and-gut-microbiome-of-rrms-patients/?utm_source=Multiple+Sclerosis&utm_campaign=323cdbb020-RSS_NON-US_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_b5fb7a3dae-323cdbb020-71699829

    Obrigado

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  10. Citotoxic Tcells can became Tregs

    "It was thought that Tregs always started out as Tregs, but new research shows that overactive T cells can become Tregs and help suppress the overreaction"

    http://www.imperial.ac.uk/news/187131/immune-cells-switch-from-gang-members/

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  11. What happenened to England in the cup? They seemed to have lost steam in the second half. Anyway good showing to get to the semis.

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    Replies
    1. Inexperience, pressure of the occasion plus they were playing a very savvy side of experienced players with 2 of the best midfielders around in Modric and Rakitic. Plus England didn't take their chances (should have been at least 2 up at half time), Croatia did.
      No disgrace though for a change ;-)

      Delete
  12. mousedoctor
    i noticed you mentioned that the phone was causing you an issue with posting. it seems to be a browser issue on the phone as i get the same thing. try using chrome, as that solved the issue for me.

    ReplyDelete
  13. MGUS and MS - do you have any knowledge/opinion about monoclonal gammooathy and MS? Is it recognised and if it occurs is there an opinion on using DMTs which are usually immunosuppressive in the face of MGUS? Thanks

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  14. MD2 I know that you were as frustrated as me at the bill to legalise cannabis for medicinal use not getting a reading in parliament. It had been so painful to read Andy's guest post on the issue, back in Feb, and pertinent to wife Vicky.
    Am so pleased to receive today an email from the home office in reply to signing an online petition. So good to know some progress, if limited is being made, and I hope that someone like Vicky benefit from the panel that is providing a route for specialist clinicians to prescribe cannabis based products in exceptional circumstances.
    Start of better things to come, I hope!

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  15. Just read an interesting story about Invermectin.

    https://multiplesclerosisnewstoday.com/2018/07/13/anti-parasitic-agent-eases-ms-motor-symtoms-aid-remyelination-in-ms-mice/

    Any comments?

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  16. Virus and dementia :)

    Herpes Viruses and Senile Dementia: First Population Evidence for a Causal Link

    Abstract: Three articles have very recently appeared that are of especial relevance to the causes of dementia and its potential treatment. The first two (Tsai et al., published in PLoS One in November 2017; Chen et al., published in the January/February 2018 issue of Journal of Clinical Psychiatry) demonstrate an increased risk of subsequent senile dementia (SD) development in patients with acute varicella zoster (herpes zoster) infection. These articles present data highly relevant to the third, and most important, paper—by Tzeng et al., published online in the journal Neurotherapeutics at the end of February 2018. These authors report that infection with a different herpes virus, herpes simplex virus type 1 (HSV1), leads to a similarly increased risk of later developing SD. Further, when the authors looked at patients treated aggressively with antiherpetic medications at the time, the relative risk of SD was reduced by a factor of 10. It should be stressed that no investigations were made on subjects already suffering from SD, and that those treated were the few rare cases severely affected by HSV. Nonetheless, antiherpetic medication prevented later SD development in 90% of their study group. These articles provide the first population evidence for a causal link between herpes virus infection and senile dementia.

    Are you on the right track? :)

    https://content.iospress.com/articles/journal-of-alzheimers-disease/jad180266

    Obrigado

    ReplyDelete

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