News

August 28, 2017 News by Alice Melão, MSc

RRMS Patients Needed for Phase 3 Trial to Assess Adverse GI Effects of ALKS 8700 Therapy vs. Tecfidera

Alkermes is funding a Phase 3 clinical trial evaluating the effects of its ALKS 8700 therapy on the gastrointestinal tracts of relapsing-remitting multiple sclerosis (RRMS) patients, compared to Tecfidera (dimethyl fumarate), according to a news release by the National Multiple Sclerosis Society. ALKS 8700, an orally administrated form of monomethyl fumarate, is still…

August 25, 2017 News by Alice Melão, MSc

Topas and Lily Are Partnering to Develop Therapies for Autoimmune Disorders

Topas Therapeutics and Eli Lilly and Company are teaming up to develop compounds that could be used to treat inflammatory and autoimmune diseases, such as multiple sclerosis and diabetes. The compounds, based on a Topas technology platform, will be aimed at restoring immune tolerance. Immune tolerance refers to the immune system being unresponsive to certain antigens — for instance, the body’s own proteins. Without immune tolerance, the body can generate an excessive immune response that prompts the immune system to attack healthy organs or tissue — a process called autoimmunity Under the multiyear agreement, Topas will receive research and development funding. It will also receive financial rewards from the success of any drug developed under the collaboration. The agreement will give Lilly the option to license all therapies created under the collaboration, and to develop them further. "We are excited to be working with Lilly to generate drug candidates using our proprietary technology," Timm Jessen, the CEO of Topas Therapeutics, said in a press release. "We expect this work to support the value of our approach" of triggering immune tolerance against antigens, he said. The fact that an important pharmaceutical company like Lilly is interested "in our technology, we believe, supports the strong commercial potential of our work." Topas develops compounds against autoimmune reactions — that is, situations in which the immune system attacks healthy parts of the body. It is already developing treatments for multiple sclerosis, type 1 diabetes, celiac disease, and other autoimmune disorders. While the majority of such therapies try to shut down the immune system, Topas’ approach is to trigger antigen-specific immune tolerance. This allows the body to regain control over an excessive immune response, while sparing the body's normal immunity. Topas links its compounds to tiny nanoparticles that liver sinusoidal endothelial cells can absorb. The liver cells are the first place where immune T-cells can learn what the body should not fight against. In studies of mice with multiple sclerosis, a single injection of nanoparticles containing peptides found in neurons triggered a potent protective effect, improving the disease's symptoms and blocking its progression. Peptides are components of proteins. "Lilly is committed to be an innovation leader in immunology," said Dr. Thomas F. Bumol, senior vice president of biotechnology and immunology research at Lilly. "Topas has a very novel approach to immune tolerance induction, which we would like to see successfully applied to certain disease-relevant antigens. We look forward to working together with Topas on their unique platform."

August 24, 2017 News by Alice Melão, MSc

Horseback Riding Plus Standard Care Can Help MS Patients Improve Balance, Other Symptoms

Therapeutic horseback riding, also known as hippotherapy, when combined with standard care regimens significantly reduces fatigue and spasticity in multiple sclerosis. It also improves balance and quality of life, according to a German study. Hippotherapy takes advantage of a horse's natural movements to develop a patient's muscle tone and improve breathing, while strengthening the torso muscles. Horseback riding also improves balance control, coordination and gait, while boosting a patient's social communication skills, which can benefit self-esteem. “Hippotherapy as a complementary treatment can be defined as one-patient-one-horse physiotherapy treatment with and on the horse,” researchers wrote. Team leaders Vanessa Vermöhlen and Petra Schiller of the University of Cologne evaluated the benefits of half-hour weekly sessions of hippotherapy in combination with standard care. They randomly assigned 70 MS patients with lower limb spasticity to either an intervention group that did 12 weeks of hippotherapy, or a control group that received only standard therapy. The team evaluated the impact therapeutic horseback riding had on balance, measured by the Berg Balance Scale (BBS). They also measured its effect on other multiple sclerosis symptoms and signs, including fatigue, quality of life, pain, and spasticity. Overall, the team found that those who received hippotherapy plus standard care improved their BBS scores by 4.8 points after six weeks of therapy, and 6.4 by the trial's end. These increases were significantly higher than those achieved by the control group (2.9 points at six weeks and 3.1 points at 12 weeks). Although this represents a difference of only 3.3 points after 12 weeks, it still reflects a relevant change in patients' balance control capabilities, the authors said. In addition, the researchers also recognized significant improvements in fatigue, spasticity and quality of life of those undergoing hippotherapy plus standard care compared to those on the control group. The observed beneficial effects of hippotherapy validate previous reports that showing that activities with horses could help adults and children improve their balance, gait and psychomotor abilities.

August 24, 2017 News by Patricia Inacio, PhD

MS Patients Can Use Smartphone to Take Part in Novartis Study of Movement Performance and Symptoms

A multiple sclerosis study will collect information about patients' movement performance and symptoms from their smartphones, Novartis has reported. The study is aimed at evaluating in real time the daily challenges of people living with MS. The results may help researchers develop new ways to measure treatments' effectiveness, the company said. Novartis is partnering on what it has dubbed the elevateMS study with Sage Bionetworks. The non-profit research organization is developing new predictors of disease to accelerate health research. A cellphone application will allow MS patients to send information about their situation from anywhere. The app will use sensors to gather information on patients' movements. It will also assess functional performance tasks that participants engage in. Patients can also fill out questionnaires with the app. A division of Apple called the Apple ResearchKit platform developed the app. Those interested in participating in the study can download it here. The elevateMS app allows a smartphone user to register important features of their disease. It includes a symptom tracker tool that allows users to record their overall wellness. They can also get an overview of what's been happening to them on an activity dashboard. Patients, neurologists and disease advocates gave Apple's app team input that helped with the design. "As physicians, we always want to know how our patients with MS are doing on the treatments we prescribe," Dr. Stanley Cohan, medical director of the Providence Multiple Sclerosis Center in Portland, Oregon, said in a press release. "With the elevateMS app, study participants can frequently document their symptoms in a personal health story," said Cohan, one of the scientific advisors to the study. "In turn, this data may provide researchers with new ways to look at disease progression and treatment effectiveness." The elevateMS study is open to MS patients 18 years old or older in the United States who own a smartphone. Additional information about it is available at www.elevatems.org.

August 23, 2017 News by Rachita Narsaria, MD

Nortis Awarded $688K Grant from NIH to Develop ‘Living’ Model of Blood-Brain Barrier for Research

Nortis, a Seattle-based biotech company, has received a $688,000 grant by the National Institutes of Health to create a living, 3-D model of the human blood-brain barrier that will be used for laboratory testing to accelerate drug development and lessen the likelihood of failure in clinical trials. This grant provides funding for a third year of a Small Business Innovation Research (SBIR) award given to Nortis by the National Institute of Neurological Disorders and Stroke (NINDS), a branch of the NIH. SBIR provides grants to U.S.-based small businesses to do federal research and enable the commercialization of technology. The blood-brain barrier is a tissue barrier that only allows certain molecules to pass from blood vessels into the brain. It is a protective mechanism to prevent the entry of foreign bodies and infection-causing organisms in the brain. Researchers are trying to find ways of delivering medications across this barrier, to reach brain tissues to treat diseases that include multiple sclerosis. "Understanding how drugs are transported across the blood-brain barrier and interact with the brain presents a significant scientific challenge," Thomas Neumann, CEO of Nortis and principal investigator on the project, said in a press release. "More predictive preclinical models based on human tissue are urgently needed to reduce costs and minimize clinical trial failures," he added. "This grant will help us develop new in-vitro alternatives to traditional pharmaceutical drug development testing on laboratory animals."

August 23, 2017 News by Alice Melão, MSc

Researchers Identify Nerve Pathway Linking Brain Inflammation, Gut Dysfunction in MS

Chronic stress and inflammation in the brain can cause multi-organ dysfunction including severe gut failure, mediated by a newly identified nerve pathway in animal models of multiple sclerosis, a Japanese study shows. MS is an autoimmune disease caused by CD4+ T-cells that cross the blood-brain barrier protecting the central nervous system. This inflames and stresses the brain and spinal cord. In previous studies, a team led by professor Masaaki Murakami of Japan's Hokkaido University showed that these cells could cross the blood-brain barrier in specific sites. These entrance sites depend on brain regional activation, which was found to be triggered by specific nerve interactions — a mechanism the team called gateway reflexes. In collaboration with other Japanese researchers and a team from Germany, the project aimed to address the potential correlation among chronic stress, brain inflammation and organ failures in MS. Using mice with MS-like disease — the experimental autoimmune encephalomyelitis model — researchers found that animals that had autoreactive CD4+ T-cells and which were exposed to stressful conditions developed severe symptoms such as gastrointestinal failure, or even death. Detailed analysis of the animals' brains showed that in stressed mice, CD4+ T-cells accumulated in two specific sites in the center of the brain around blood vessels. This event would cause inflammation around those vessels, and activation of a nerve pathway that is commonly turned off. This switch led to gut dysfunction, bleeding and failure. "These results demonstrate a direct link between brain micro-inflammation and fatal gastrointestinal diseases via the establishment of a new neural pathway under stress," Murakami, the study's senior author, said in a news release. Researchers were able to prevent gut symptoms by inhibiting inflammation in the brain or blocking the nerve pathway responsible for driving the signals from the brain to the gastrointestinal tract. "Micro-inflammation in the brain is also seen in Alzheimer's disease and Parkinson's disease," Murakamai concluded. "So it's of particular interest to investigate possible connections between brain micro-inflammations and organ dysfunctions, including those within the brain itself, in those patients."

August 22, 2017 News by Patricia Silva, PhD

Mavenclad Improves Relapsing MS Patients’ Quality of Life, Independent U.K. Study Finds

Merck’s Mavenclad tablets significantly improve quality of life among relapsing multiple sclerosis patients while reducing the number of relapses, according to new analyses of previously unpublished data from clinical trials assessing the drug. This new data, published in the Multiple Sclerosis Journal, come just as the European Commission ponders whether to approve the once- rejected therapy to treat relapsing forms of MS. Its decision is expected later this month, seven years after a perceived increased of cancer risk led the European Medicines Agency (EMA) to block Mavenclad. In 2011, the U.S. Food and Drug Administration (FDA) rejected the medication, forcing its eventual withdrawal from the Australian and Russian markets, where it had already been licensed. For the study, researchers at Queen Mary University of London used data obtained from the EMA through a Freedom of Information request. They analyzed data from the Phase 3 CLARITY trial, which compared Mavenclad to placebo. The trial's 1,326 participants completed a quality-of-life questionnaire that focused on disease aspects such as mobility, self-care, usual activities, pain or discomfort, and anxiety. After two years, those on Mavenclad had significantly improved their quality of life compared to the control group, particularly in terms of self-care. Mavenclad also helped mobility, which might be related to its ability to prevent relapses and delay progression, researchers said. While researchers assessed quality of life using two different questionnaires, patients had only completed one in sufficient numbers to allow for a solid analysis. The other quality-of-life tool provided researchers with numerically positive results, but the low number of responses made the result difficult to interpret. This wasn't the first time QMUL researchers have contributed in this way to knowledge of Mavenclad in MS. In 2015, they used a Freedom of Information request to obtain data showing that Mavenclad was not related to increased cancer risk. “Cladribine seemed to have such excellent potential as a treatment for MS that we thought it was tragic the development program was shelved, and significant parts of the clinical trial data remained unpublished,” study leader Klaus Schmierer, a neurologist at both QMUL and Barts Health NHS Trust, said in a press release. “In addition to the drug being highly effective, well tolerated and safe as far as short-term studies can show, we now know it also improves patients’ quality of life. The new results seemed so clear, we felt it was extremely important to publish and share these data." Mavenclad has now been studied in some 2,700 patients with relapsing MS in the Phase 3 trials CLARITY, CLARITY EXTENSION, and ORACLE-MS, as well as the Phase 2 ONWARD trial, and the ongoing long-term study PREMIERE. The treatment differs from most other oral MS therapies in that a short treatment course — a maximum 20 days — triggered effects that were upheld for two years. Studies of Mavenclad’s mechanisms suggest the drug gets such results by resetting the immune system. In June 2017, the EMA's Committee for Medicinal Products for Human Use urged the European Commission to approve Mavenclad. Merck also plans to seek U.S. approval for its therapy and is now in talks with the FDA about Mavenclad's future.

August 21, 2017 News by Iqra Mumal, MSc

MS-related Death Rate in British Military Is Much Higher Than in Other Professions, Study Finds

British military personnel are at significantly higher risk of dying from multiple sclerosis than people in other occupations, a study reports. University of Southampton researchers had done a previous study of mortality rates by occupation by checking records of residents of England and Wales. They noticed that the death rate among MS patients in the armed forces was much higher than that of people in other professions over three successive decades. MS has a genetic component but is also influenced by environmental factors, including vitamin D deficiency, smoking and certain viruses. Researchers wanted to learn why so many military people die of MS, and the causes. The team looked at the death records of men aged 20-74 between 1979 and 2010. They compared military people's MS-related mortality rates and death rates from all motor neuron diseases with those of other occupations. They also compared rates across social classes, which in the military presumably means lower-ranking enlisted people, higher-ranking enlisted people, and officers. They discovered that the MS-related mortality rate among military people was significantly higher than in other professions. The death rate from MS was also significantly higher than the rate from all motor neuron diseases in the armed forces. Interestingly, military people did not have a higher MS-related death rate when the team divided those in the study into three social classes or when they compared the armed forces mortality rate to those of similar occupations, such as police and fire services. The consistency of the findings, together with the high statistical significance observed, indicated that the results were not due to simple chance or a problem with the study method, the team said. They speculated that the higher military death rate could stem from the close proximity in which military personnel live and work, which could facilitate the transmission of infections that have the potential to cause MS. The results conflicted with those of a study that analyzed hospital admissions due to MS in a population of former military personnel. It reported no increased incidence of MS-related admissions in former military people, compared with non-military controls. Since such cohort studies are less prone to bias, the Southampton team called for more research on the topic.

August 18, 2017 News by Charles Moore

Twin Cities MuckFest MS, Mud- and Obstacle-filled Run for MS Society, Set for Saturday

The Twin Cities MuckFest MS is set for Saturday at the Scott County Fair in Jordan, Minnesota. All money raised in the event will go to the National Multiple Sclerosis Society to support its work in helping people living with multiple sclerosis and in advancing research toward better treatments and a cure. The MuckFest MS is a fun mud run that has raised millions for the Society, and requires no special training or equipment — the only things needed, organizers says, are sneakers, a sense of humor and a willingness to get a little mucky. Participants run on a designed 5K course that features super-sized obstacles and lots of mud. A first wave of runners in the Aug. 19 event will take to the course at 9 a.m., followed by successive groups every 20 minutes throughout the day. "We muck it because … We want to end MS," MuckFest MS proclaims on its webpage. "Even though the event is built for laughs from start to finish, we’re on a serious mission to advance cutting-edge research and support the life-changing work of the National MS Society." Runners are advised to wear closed-toe sneakers, and cleats of any kind are not permitted. An older of soiled choice of clothing is welcome, but should be clothes that won't restrict movement and will provide protection as runners move through the obstacles. Pants or shorts are acceptable. Many muckers, organizers say, choose to wear thin work or athletic gloves to better grip obstacles and ropes. All MuckFest MS events are held in wet muddy fields, so there is little flat terrain. They are not ADA-standard accessible, wheelchair runners will have to move through grass and dirt. The organizers, however, promise to do their best to make portions of the event accessible to people with disabilities. Participation is $105 on the day of event, plus processing fee, and those planning to register Saturday are asked to arrive by 10 a.m. Online registration is now closed. Spectators are welcome without charge. According to the MS Society, "the MuckFest MS runners and volunteers have raised over $27 million to support the life-changing work of the National MS Society" to date. "That means more cutting-edge research and continued support for people living with MS in your community." Multiple Sclerosis News Today plans to interview an event participant — Beth Kantor, a retired nurse from Plymouth, Minnesota, who has relapsing MS — after the event. Kantor is also volunteering at this year's MuckFest MS, helping others as they too take to the course. The first wave/start time is at 9:00 a.m Saturday, August 19, and then every 20 minutes throughout the day. More information, including a look at the obstacles, is available here. A blog by past Muckfesters, offering ideas and suggestions, is also available. MuckFest MS runs take place in a dozen U.S. cities each year. AbbVie is the national sponsor, and local sponsors for MuckFest MS 2017 include Acorda and Genentech. A national event sponsor is The Traveler Beer Co.

August 17, 2017 News by Patricia Inacio, PhD

Ocrevus Approved in Canada to Treat Relapsing-Remitting MS

Health Canada has approved Ocrevus for the treatment of adults with relapsing-remitting multiple sclerosis (RRMS) with active disease, Roche Canada announced. The approval followed the positive results from the Phase 3 OPERA studies, which evaluated the safety and efficacy of Ocrevus in 825 patients with RRMS. The OPERA 1 and OPERA 2 trials showed that Ocrevus significantly reduced disease activity and disability progression of RRMS patients, with annual relapse rates falling by almost half. Moreover, Ocrevus outperformed Rebif, the standard of care in MS, in slowing worsening of disability and significantly reducing lesions seen on MRI scans over a two-year treatment period. "Ocrevus is a major addition to the treatment options available for MS. The RRMS Ocrevus clinical trial data show a significant reduction in relapses and disease progression, as well as a good safety profile," Daniel Selchen, a neurologist and head of the Division of Neurology at St. Michael's Hospital in Toronto, said in a press release. "For appropriate patients, Ocrevus will be of great value in reducing the burden of MS." The treatment's approval, however, did not extend to — or mention — people with primary progressive MS, in contrast to the U.S. Food and Drug Administration's action in March, which approved Ocrevus for both MS forms. Health Canada did not give address PPMS in its announcement. Estimates are that 100,000 Canadians are currently living with MS, and most have the relapsing form. A number welcomed Ocrevus' arrival for what it offers in their fight against this disease.

August 16, 2017 News by Iqra Mumal, MSc

Enzyme Regulates Development of Specific T-cells That Contribute to Autoimmune Disease, Study Suggests

A new study highlights a crucial role for the enzyme protein tyrosine phosphatase N2 in the development of early immune T-cells, and suggests that decreased levels of this enzyme can lead to the production of subsets of T-cells that contribute to the development of autoimmune diseases such as multiple sclerosis. T-cells, which are a type of immune cells that fight infection, are composed of multiple subsets that have different roles in immunity. Researchers at Monash University set out to characterize the role of PTPN2 in early T-cell development and in the development of T-cell subsets αβ TCR and γδ TCR. To do this, researchers deleted the gene coding for PTPN2 and looked at the resulting T-cell population. Results demonstrated that the deletion of PTPN2 led to the production of γδ T-cells with pro-inflammatory properties that have been associated with many autoimmune diseases by inhibiting certain pathways that regulate proper T-cell development. “This is an important advance in our understanding of critical checkpoints in T-cell development,” Tony Tiganis, principal research fellow in the Department of Biochemistry and Molecular Biology at Monash University in Australia, said in a press release. “It helps decide whether the progenitors go on to become T-cells or something else; if they become one type of T-cell or another type.” Interestingly, there are already drugs that target some of the pathways that PTPN2 regulates, which could lead to the use of existing drugs to treat some of these autoimmune diseases, including MS. “Understanding the mechanisms that govern early T-cell development and how these are altered in human disease may ultimately afford opportunities for novel treatments. This is very exciting,” said Florian Wiede, a post-doctoral candidate at Monash and first author of the study.

August 16, 2017 News by Patricia Silva, PhD

Ulcer Bacterium Might Play Role in MS, but More Studies Needed, Greek Researchers Say

Secondary progressive multiple sclerosis (SPMS) patients have larger quantities of certain antibodies to the stomach ulcer bacterium Helicobacter pylori than those with relapsing-remitting multiple sclerosis (RMSS), finds a Greek study which also showed that MS patients in general differ from healthy people in this aspect. Although researchers at the University of Thessaly think…

August 15, 2017 News by Kara Elam

ACTRIMS 2018 Forum in San Diego to Showcase Latest Multiple Sclerosis Research

The Americas Committee for the Treatment and Research in Multiple Sclerosis, otherwise known as ACTRIMS, says its third annual ACTRIMS Forum will take place Feb. 1-3, 2018, at the Hilton San Diego Bayfront in San Diego, California. These forums bolster the ACTRIMS mission, which is to foster the careers of young researchers interested in MS by promoting mentor relationships with senior scientists, and giving promising investigators a chance to present their early research findings. ACTRIMS 2017 was a record-breaking year with over 800 people attending. Organizers say 1,000 people will attend this year's conference. The 2018 forum's theme is “Therapeutic Targets in MS: The Frontier and the Future of Disease Modifying Therapy.” ACTRIMS 2018 also features continuing medical education credits for attendees, as well as participation grants for applicable young investigators.

August 14, 2017 News by Patricia Inacio, PhD

Human Gut Microbes May Help Suppress MS, New Research Suggests

A bacteria present in the gut, called Prevotella histicola, prevented multiple sclerosis from developing in a preclinical mouse model, found researchers at the Mayo Clinic in Rochester, Minnesota, along with colleagues at the University of Iowa. Current research suggests that alterations to the gut microbiome residing in human intestines may potentially trigger inflammatory diseases such as MS. In an attempt to identify which gut resident bacteria are capable of modulating immune responses, researchers studied cultured small pieces of intestine tissue extracted from biopsies of patients with celiac disease. The team then isolated three bacteria strains and found that one of species — P. histicola — had the capacity to suppress MS in a preclinical animal model of the disease. “This is an early discovery but an avenue that bears further study," Dr. Joseph Murray, a Mayo Clinic gastroenterologist and the study's lead author, said in a press release. "If we can use the microbes already in the human body to treat human disease beyond the gut itself, we may be onto a new era of medicine. We are talking about bugs as drugs." By investigating how P. histicola modulated immune responses to suppress MS, researchers found that bacteria decreased the expression of two pro-inflammatory cytokines – interferon-gamma and interleukin (IL)-17. Overall results show that P. histicola has immune modulatory activity and can suppress abnormal immune responses, which ultimately prevent autoimmunity. This supports the idea that maintaining a healthy microbial community within our intestines is a potential therapeutic strategy for MS. "Our work is a classic example of a bedside-to-bench and potentially back to bedside study. Recent MS microbiome studies have shown the lack of Prevotella genus in patients with the disease and an increase when patients were treated with disease-modifying drugs," said Ashutosh Mangalam, the study's first author and an assistant professor of pathology at University of Iowa's Carver College of Medicine. "And it's not just for MS, because this may have a similar modulating effect on other nervous system and autoimmune diseases."

August 11, 2017 News by Patricia Inacio, PhD

Children and Teens with Multiple Sclerosis Consume Less Iron, Study Reports

Children with multiple sclerosis consume less iron, which may affect their immune and nervous systems, according to a study. Most MS cases occur between the ages of 20 and 40, but sometimes children under 18 develop it. Pediatric-onset MS, as it is called, is believed to account for 3 to 5 percent of cases that adults have now. Despite their low frequency, they are important because "the study of factors early in life which could affect their disease may provide important insight into the disease more generally," the researchers from the Network of Pediatric MS Centers wrote. One of the factors that could be important in the onset of MS is diet. But little has been known about how diet influences the risk and progression of the disease, particularly in pediatric MS. In a study funded by the National MS Society, researchers decided to investigate the association between diet and MS in children, according to a press release. The team recruited 312 MS patients 18 and younger from 16 children's hospitals in the United States, and 456 controls without MS. The participants, or their parents, answered a questionnaire dealing with the participants' medical history, their physical development, and whether they were exposed to potentially harmful environmental factors. The questionnaire also covered demographic information and race. Researchers used the Block Kids Food Screener questionnaire to obtain information about the participants' diets, including their intake of fiber, fat, carbohydrates, proteins, fruits, vegetables, dairy products, and iron. The analysis showed no meaningful link between the consumption of fiber, fat, carbohydrates, proteins, fruits, vegetables, and dairy products and children's development of MS. Children with the disease did have lower iron intake than the controls, however. Although in this exploratory study researchers didn’t look at whether there was a cause-and-effect relationship between iron and MS, the results suggested that children with the disease may be less likely to consume iron, a fact that warrants further investigation. Iron is a vital mineral for our body to function properly, and low iron intake may affect the immune and nervous systems. Future studies on the risk of children developing MS should "investigate the role of specific vitamins and minerals," the team said. They should also "investigate the influence of dietary factors on disease outcomes in already established" cases of MS.

August 10, 2017 News by Patricia Inacio, PhD

Catching the Flu Can Trigger an MS Relapse by Activating Glial Cells, Study Suggests

Coming down with the flu can provoke relapses in multiple sclerosis patients by activating glial cells that surround and protect nerve cells. In a study in mice, scientists found that activated glial cells increase the levels of a chemical messenger in the brain that, in turn, triggers an immune reaction and, potentially, autoimmune attacks. The flu is caused by the human influenza virus and, despite being unpleasant, usually resolves itself within days. However, for people with MS and other neurological conditions, the flu can lead to disease relapse. Researchers at the University of Illinois investigated what happens in the brain of MS patients during upper-respiratory viral infections, such as the flu. "We know that when MS patients get upper respiratory infections, they're at risk for relapse, but how that happens is not completely understood," Andrew Steelman, an assistant professor at the university and the study's senior author, said in a press release. "A huge question is what causes relapse, and why immune cells all of a sudden want to go to the brain. Why don't they go to the toe?" The team used a mouse model characterized by autoimmune responses within the brain and spinal cord — the type of deregulated immune responses seen in MS patients. Researchers infected the animals with a version of human influenza virus adapted to mice, and looked at changes that occurred in the animal’s central nervous system. While the virus was never detected in the animals' brains, upon infection some of the mice developed MS-like symptoms. "If you look at a population of MS patients that have symptoms of upper respiratory disease, between 27 and 42 percent will relapse within the first week or two," Steelman said. "That's actually the same incidence and timeframe we saw in our infected mice, although we thought it would be much higher given that most of the immune cells in this mouse strain are capable of attacking the brain." The team then investigated how a peripheral influenza infection could contribute to disease onset. They infected a wild-type (normal) strain of mice with the flu virus and looked at alterations in the brain and spinal cord. Scientists found that infection increased the activation of glial cells in the mice's brains. Moreover, it induced infiltration of several immune cells — T-cells, monocytes and neutrophils — into the brain within eight hours of infection. Overall, these findings suggest that the chemokine CXCL5 plays a key role in mediating an autoimmune attack in MS, and might be explored for therapeutic potential.

August 10, 2017 News by Patricia Inacio, PhD

Botulinum Toxin Treats MS Spasticity, But Support and Rehab Seen as Crucial to Long-term Use

Spasticity in multiple sclerosis patients can be eased through a combination of botulinum toxin type A (BoNT-A) injections and rehabilitation. However, caregiver support is required to keep patients on this treatment, according to results of a retrospective analysis. Spasticity, a muscle control disorder characterized by tight or stiff muscles, is a major MS symptom. The condition is significantly detrimental to patients’ quality of life, affecting their general mobility and balance. Several oral anti-spasticity drugs are available. However, “treatment of spasticity in MS is frequently challenging because of the complex clinical picture and the undesired effects associated with oral therapy, such as fatigue, dizziness, and hypotension,” the researchers wrote. Previous studies show that BoNT-A, a toxin that blocks nerve activity in muscles, is an effective therapy for the management of MS-related spasticity. The long-term effectiveness and persistence of BoNT-A use in patients with MS-related spasticity, however, remains poorly investigated. The research team in Italy proposed “to investigate the long-term persistence to treatment with BoNT-A for MS-related spasticity and the determinants of BoNT-A discontinuation in daily clinical setting.” In total, the researchers reviewed data from 185 patients, out of which 121 were considered in their final analysis. They observed that, at the end of the follow-up period, 44% of the patients in the analysis were still being treated with BoNT-A, but 56% had discontinued treatment. Overall, these results “confirm the beneficial effect of combining BoNT-A injections with rehabilitation and highlights the crucial role of caregivers for achieving better long-term outcomes in people with MS suffering from spasticity,” the team concluded.

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