Multiple Sclerosis Jessica Kelly-Hannon It’s causes, effects and treatments

What is Multiple Sclerosis? Multiple Sclerosis is an inflammatory autoimmune disorder of the brain and spinal chord. It causes severe demyelination of axons. This demyelination causes chronic neurodegeneration and leads to loss of movement and eventually severe disability. There is no cure for Multiple Sclerosis, only treatments to extend and improve life quality.

What is Multiple Sclerosis? Multiple Sclerosis can be difficult to diagnose as initial symptoms usually resolve themselves over a short period of time. This is a hallmark of MS, as symptoms will appear and disappear, lasting for short periods of time and then disappearing entirely. This is known as relapsing, remitting, multiple sclerosis (RRMS). As the disease progresses the time spent in remission decreases, and the patient’s disability increasing. Contrasting to this a patient could have slow and progressive onset of MS where symptoms continue to get worse over time. This is called Primary Progressive Multiple Sclerosis.

What causes Multiple Sclerosis? We don’t know the primary cause of MS but we do have an idea about some possible causes: Environmental factors: Migration, Diet, Poison, Infection, and Viruses have all been considered as causation factors of MS Genetic Factors:MS is not thought to be an inherited disease but it has been noted that MS occurrence is somewhat increased in someone who has a close relative with the disease.

How do we Diagnose Multiple Sclerosis? MS can be difficult to diagnose initially as symptoms of the disease can easily be attributed to other problems and as all symptoms generally subside after a short time, these symptoms don’t cause a lot of alarm. Common symptoms include: Tingling, pins and needles or numbness Muscle weakness (generally in one or both legs) Chronic pain Muscle spasm

Combining these early symptoms with: supporting medical imagery, such as MRI And laboratory testing, such as testing the cerebrospinal fluid (CSF) acquired through a lumbar puncture, Enable us to more accurately diagnose MS. How do we Diagnose Multiple Sclerosis?

Types Of Multiple Sclerosis There are 4 types of MS: Relapsing-Remitting Secondary Progressive Primary Progressive Progressive Relapsing There is also benign MS where the initial symptoms are present but full remission occurs and partial or permeant disability does not occur

Available Treatments. Current treatments for MS include: Drug treatment: High-dose methyl prednisolone β-interferons such as Rebif, Avonex, and Betaferon Copaxone (glatiramer acetate) Natilizumab (humanised monoclonal antibody) Regular exercise Lifestyle changes

Natalizumab Treatment Natalizumab is a humanised monoclonal antibody, administered intravenously. It’s action is against the cell adhesion molecule α4-integrin receptor molecules. It’s action is believed to reduce the ability of imflammatory immune cells to attach and cross the blood-brain barrier (BBB). In MS this effect is believed to occur on cells expressing VCAM-1 and in parenchymal cells expressing the osteopontin gene. Repeated treatment reduces the amount of leukocytes migrating into the brain.

Future Treatments Although a cure for MS seems far in the future, there are new drugs that show some promise. One such drug is Alemtazumab which is a humanised monoclonal antibody originally made for leukemia but showing promise is the treatment of MS.

Alemtuzumab Treatment Originally made in Cambridge it was called Campath. Is a humanised monoclonal antibody. It’s action sees it bind to CD52, a protein on the surface of mature lymphocytes causing them to be them to be targeted for destruction. The drug is in trial phases for MS at the moment but it is thought that is will be combined with Copaxone as it is expected to work synergistically. During trials it has shown promise when compared against interferon beta 1α.

Conclusion MS is a progressive debilitating disease. It’s onset symptoms lead to poor diagnosis although this is improving. Treatments focus on reducing relapses and improving quality of life of patients. No cure has yet been found. Future drug treatments and drug combinations are showing promising results