With an interest multiple sclerosis (MS) before even starting college, Dr. Ellen Mowry has spent her entire research career investigating the disease. Her epidemiological studies led her to indications that vitamin D might be particularly important for people with MS, and she now dedicates her research to the topic — knowledge she will share at the upcoming Consortium of Multiple Sclerosis Centers (CMSC) 2016 Annual Meeting, a gathering of MS researchers and clinicians worldwide.
As an associate professor of Neurology and Epidemiology at Johns Hopkins University in Baltimore, she also explores other environment factors that might alter MS risk, or its prognosis, focusing on diet and the microbiome.
She is leading the Vitamin D to Ameliorate Multiple Sclerosis (VIDAMS) study, a multicenter trial sponsored by the National MS Society. The study is investigating whether vitamin D supplementation might reduce the frequency of relapses in patients with relapsing-remitting MS — a topic she recently discussed with fellow scientist Dr. Emmanuelle Waubant in a roundtable discussion organized by CMSC and covered by Multiple Sclerosis News Today.
To make sure that the vitamin D supplements recommended to MS patients are in a position to do good, she also conducted a pilot study analyzing if post-supplementation vitamin levels in the blood differed between patients and controls, or if the vitamin triggered different immune or gene expression changes in patients compared to healthy individuals.
Her talk, “Vitamin D-Research Update and Implications for Clinical Practice,” at the CMSC meeting — taking place in National Harbor, Maryland, on June 1–4 — aims to share with her audience what is now known about vitamin D supplementation and MS.
In an interview with Multiple Sclerosis News Today, she had words of encouragement for MS patients, and hints of the work still ahead. Below is the interview, in a Q&A format:
Q: As a researcher involved in several studies on the role of vitamin D and the course of MS, where do we stand now? Is there an evident correlation between vitamin D levels and MS? If so, should vitamin D supplementation be recommended as a therapeutic for MS patients?
Dr. Mowry: We have known that low vitamin D levels appear to be linked with increased risk of MS for about 10 years now. Recent evidence has raised the question about whether this is actually a vitamin D effect, or if it may be that it’s ultraviolet light from the sun that is important, and that perhaps vitamin D levels are just a marker of ultraviolet light exposures. Another new study showed that very low vitamin D levels of a mother during pregnancy is associated with an increased risk of MS in the offspring, raising the question of when in a person’s life it may be important to keep up vitamin D levels, if this does in fact reduce MS risk.
We also know that low vitamin D levels are linked with increased risk of relapses and new MS “lesions” on brain MRI. Some more recent data have also linked low levels of vitamin D with greater amounts of loss of a specific type of brain tissue, the “gray matter,” in people with early MS. However, there are no clinical trials of vitamin D supplementation that have been completed, so it’s not clear if supplementation is useful. Also unclear is what dose to use/what levels may be optimal, and if the optimal levels are the same for all people with MS.
As such, further studies are needed before vitamin D supplementation can be recommended for either MS prevention or treatment.
Q: You will present data from vitamin D studies at the CMSC 2016 meeting. Can you share with us, in broad terms, some highlights of your talk? What would be its take-home message, especially from a patient’s point of view?
Dr. Mowry: In addition to discussing some of the newer data supporting a link between vitamin D levels and MS risk and prognosis, there are newer data from small studies of people with MS, including one from our group at Johns Hopkins, showing that vitamin D supplementation leads to improved levels of substances in the blood that promote the kinds of inflammation that cause damage to the brain and spinal cord of people with MS. There is a discussion about the pros and cons of currently using vitamin D supplementation, and a presentation of new data we recently published showing that, at least in Caucasian women who have insufficient levels of vitamin D who were given a high dose of vitamin D each day for 90 days, those with MS had less of an increase in their levels than those without. Thus, the metabolism of vitamin D may be different in people with MS.
Q: What, in your opinion, is the importance of CMSC annual meetings in terms of both MS research and patient care?
Dr. Mowry: CMSC is a great opportunity for the sharing of ideas between clinicians and clinician-researchers. The sharing includes educational updates as well as research updates. This meeting also fosters collaborations in research. As such, the day-to-day care of people living with MS, as well as research to help people in the future, is greatly enhanced by this meeting.
Q: What do you consider to be the greatest unmet needs in MS today?
Dr. Mowry: Therapies to prevent or slow down progressive MS are necessary. Further, people with MS need some medications to treat symptoms that don’t have a lot of options currently, such as fatigue and memory problems.
Q: Do you have a particular message to share with MS patients?
Dr. Mowry: Many MS researchers are working hard every day to combat this illness. Participation in studies really makes a big difference, and we are indebted to our study volunteers who are working hand in hand with us to make big breakthroughs! We are inspired by the patients we serve.
Multiple Sclerosis News Today will offer its readers on-site coverage of the 2016 CMSC Annual Meeting, anchored by BioNews Services Group managing editor Ana de Barros, PhD, and Patrícia Silva, PhD, managing editor of Multiple Sclerosis News Today. Also attending will be Chris Comish, president and CEO of BioNews Services, Carol Jertson and Eileen Soler, contributing editors, and the BioNews Services’ social media director Isaura Santos and social media manager Andreia Peixoto.
The BioNews team’s on-site reporting will include feature articles, interviews, and social media coverage on Facebook, Twitter, and Pinterest. Social media accounts for Multiple Sclerosis News Today can be found in the upper righthand corner of its homepage.
Are your familiar with the coimbra protocol?
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