The science underlying our understanding of multiple sclerosis — through to new technologies that might expand that understanding in ways “never imagined” — was the focus of a recent educational webinar titled “The Evolving Science of Multiple Sclerosis (MS).”
Kottil Rammohan, MD, a professor of clinical neurology and director of the MS Center of Excellence at the University of Miami Miller School of Medicine, gave the talk.
The April 19 webinar was sponsored by EMD Serono and hosted by John Walsh, MD, the company’s vice president of U.S. Medical Affairs, Neurology and Immunology.
Rammohan began by mentioning the first characterization of MS by Jean-Martin Charcot in the 1800s, and surveyed the variety of failed treatments used on MS patients at different times, including exposure to cold and infection with malaria.
It was not until 1959 that the presence of oligoclonal bands — which indicate local central nervous system production of antibodies — in patients’ cerebrospinal fluid, which bathes the brain and spinal cord, was set as a diagnostic criterion for MS.
Soon afterward, a type of white blood cell known as B-cells or B-lymphocytes (blood cells that produce antibodies) was identified as playing a role in disease progression.
Today, Rammohan said, the picture is much more complex due to the amount of research conducted since 1959, and the known complexity of the disease itself.
He thinks of MS, he said, as having four phases. The first is the immune system reaction against myelin — the protective layer wrapped around neurons that plays a role in transmitting nerve impulses in the brain. Normally, the immune system has a mechanism called tolerance that prevents it from attacking the body’s own cells and tissues. Tolerance to self is lost in this first MS phase, Rammohan said.
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