MS News That Caught My Eye Last Week: EBV, Stem Cell Transplant, NurOwn, Progression Without Relapse
Columnist Ed Tobias comments on the week's top MS news
The evidence of a link between the Epstein-Barr virus (EBV) and multiple sclerosis (MS) continues to mount. The current thinking is that the immune responses that fight EBV may drive the attacks against the myelin nerve coating, which is characteristic of MS. Interestingly, these researchers report that people with MS being treated with Tysabri (natalizumab), which traps T-cells in the lymph nodes, had particularly strong T-cell behavior against EBV, but not other viruses.
People with multiple sclerosis (MS) have significantly more T-cells equipped with receptors that specifically recognize the Epstein-Barr virus (EBV) than do healthy individuals, a study revealed.
Notably, no such differences were detected for T-cells with receptors specifically against other viruses.
This is a very small study, but it adds to the growing mountain of evidence that stem cell transplants (aHSCT) can be useful for people with MS. There is no doubt in my mind, based on the interactions I’ve had with people with MS, that many would like to see this treatment more readily available. It isn’t approved for MS in the U.S., except experimentally; it’s hard to get in the U.K., and it’s very expensive in private clinics in Mexico and Russia.
As I’ve said in the past, let’s get moving on this. The National Multiple Sclerosis Society supports aHSCT for patients with very aggressive relapsing-remitting MS who have responded poorly to other disease-modifying therapies.
Autologous hematopoietic stem cell transplant (aHSCT) — commonly called stem cell therapy — lessens fatigue and improves quality of life in people with highly active relapsing multiple sclerosis (MS), according to a small study in Lithuania.
These gains in the physical and social domains of quality of life were linked to a reduction in disability levels for up to two years after transplant in this study. That suggests that clinical improvements from aHSCT may drive boosts in life quality for MS patients.
This experimental treatment removes mesenchymal stem cells (MSC) from the bone marrow of someone with MS. Those cells are then expanded and matured into cells that produce high levels of molecules that promote nerve cell growth and survival, called neurotrophic factors or NTFs. The MSC-NTFs are then injected into the patient’s spinal canal. Researchers hope the procedure will repair myelin, reduce the likelihood of further nerve cell damage, reduce neuroinflammation, and potentially slow MS progression. It sounds almost too good to be true, but let’s hope it is true.
NurOwn, a stem cell therapy being developed by BrainStorm Cell Therapeutics, showed a good safety profile among people with progressive forms of multiple sclerosis (MS) in an open-label Phase 2 clinical trial, according to new data.
The data show the experimental therapy also was associated with promising effects on patients’ walking ability, finger dexterity, cognition, and vision.
There’s no doubt in my mind that MS can progress without relapses. That’s been my position for many years. The real problem, as these researchers indicate, may be the fact that MS is classified by stages, and a move from one stage to another isn’t spotted quickly. So you may continue to be diagnosed with relapsing MS while you’re actually progressing. That’s how it has been with me. Does it matter whether my MS is called relapsing or progressing? Not to me, but it may to my insurance company.
Nearly two-thirds of people with relapsing-remitting multiple sclerosis (RRMS) report disease progression independent of relapses, according to a survey involving more than 4,500 multiple sclerosis (MS) patients in Germany.
This finding supports evidence pointing to progression independent of relapse activity (PIRA) as an underestimated contributing factor in RRMS. And it suggests that some of these patients may have transitioned to secondary progressive MS (SPMS) but hadn’t been yet diagnosed, the researchers noted.
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