Top 10 MS stories of 2023

Throughout 2023, Multiple Sclerosis News Today brought consistent coverage to our readers of the latest scientific research, developments in treatment, and clinical trials for multiple sclerosis (MS).

Here is a list of the top 10 most-read stories we published last year, along with a brief description. We look forward to continuing to serve the MS community in 2024, and wish all our readers a bright and happy new year!

No. 10 – Ketogenic diet may provide sustained benefits in MS

There isn’t any one diet that’s recommended for people with MS, but keeping healthy dietary habits may be an important part of managing the disease. One diet that’s been studied in MS is the ketogenic diet, which involves eating fewer carbohydrates — less carbs — and more fats. U.S. researchers conducted a trial in which 64 people with relapsing-remitting multiple sclerosis (RRMS) followed a ketogenic diet for six months. After the half-year study, most participants reported losing weight, and many said their MS symptoms had eased. A follow-up assessment done three months later showed most patients who completed the study were continuing to follow the diet, and some benefits seen after the study ended were still evident.

No. 9 – Immune responses against SARS-COV-2 protein may trigger MS

It’s not known exactly what causes MS to develop, but one hypothesis is that infections may lead to MS through so-called molecular mimicry. In this phenomenon, proteins from an infecting virus have a shape similar to that of healthy proteins in the body — so when the immune system attacks the virus, it also accidentally attacks similarly-shaped healthy proteins. In this study, scientists found that the nucleocapsid protein from SARS-COV-2, the virus that causes COVID-19, has structural similarities to several proteins that have been implicated in the autoimmune attack that drives MS. While the findings don’t prove that COVID-19 can cause MS, they provide a plausible mechanism for how this might theoretically happen.

No. 8 – Antibodies against cow milk proteins linked to more severe disease

Some studies have suggested that cow milk and dairy products may worsen inflammation in MS, possibly due to molecular mimicry between certain milk proteins and proteins in the brain that are targeted in multiple sclerosis. Scientists tested for antibodies against several milk proteins in 35 people with MS and 20 individuals without the disease, who served as controls. The MS patients had notably higher levels of antibodies against cow milk proteins, but not proteins from plant-based milks — and the levels of a specific antibody were linked to more severe disability. The researchers said these findings support the idea that the immune system’s reaction against milk proteins also may prime immune attacks against brain proteins that drive MS.

No. 7 – High GFAP levels may predict silent progression

Most people with MS experience relapses or flares where symptoms suddenly worsen, followed by periods of remission during which symptoms ease. The term “silent progression” refers to disease worsening that occurs independent of relapse activity. In this study, researchers looked for biomarkers that could be used to predict this type of progression. Their findings indicated that high levels of GFAP, a marker of damage to star-shaped cells in the brain called astrocytes, are a good predictor of silent progression. Neurofilament light chain, or NfL, a marker of nerve damage, wasn’t as robust for predicting this type of disease progression.

No. 6 – Gut microbiome and immune system may communicate via receptor

The human digestive tract is home to billions of bacteria and other microorganisms, collectively called the gut microbiome. The microbiome has profound effects on health and disease, but how it may impact MS remains incompletely understood. In this study, researchers working in mouse models found that mice lacking an immune cell receptor called aryl hydrocarbon receptor or AHR had significantly faster recovery from MS-like disease. Further experiments indicated that this effect was due to changes in the microbiome, implying that AHR helps to facilitate signaling between immune cells and the gut microbiome that may influence disease progression in MS.

No. 5 – Mayzent, vitamin D combination eased MS symptoms in mice

No. 4 – Bacteria may promote inflammation and disability worsening in SPMS

Secondary progressive multiple sclerosis (SPMS) is a type of MS marked by continuous disease progression, with or without relapse activity, that can develop after RRMS. Scientists in Japan found that a specific type of bacteria — referred to as “bacteria X” due to patent protections — was enriched in the gut microbiomes of people with SPMS. Patients with higher amounts of this bacteria tended to report more severe disability, and when the researchers transplanted the bacteria into the guts of mice, the animals had more severe disability and greater activation of certain inflammatory immune cells known to drive MS.

No. 3 – Antihistamine clemastine triggers myelin repair in MS patients

Clemastine, available under the brand name Dayhist and others, is an over-the-counter antihistamine. Some studies suggest it may be able to promote myelin repair, which is seen as a major goal of MS treatment. A previous Phase 2 trial (NCT02040298) compared clemastine against a placebo in MS patients who were on stable treatment; the results were modest but consistent with the idea that the therapy may promote myelin repair. In this study, scientists used an MRI technique to assess a measure of myelin health called the myelin water fraction, or MWF, and results were indicative of myelin repair in certain regions of the brain for patients given clemastine.

No. 2 – Spinal fluid antibodies trigger PPMS but not other disease types

Most people with MS initially are diagnosed with relapsing-remitting disease, but a minority will have primary progressive multiple sclerosis (PPMS) that’s marked by continuously worsening symptoms from disease onset. There’s been debate among scientists as to whether PPMS is the same disease as relapsing MS, or if it’s a distinct disorder. In this study, scientists working in a mouse model found that antibodies in the spinal cord are a major driver of PPMS but not other forms of MS, which supports the idea that PPMS is its own distinct disease entity.

No. 1 – Coconut oil and green tea may improve balance and gait

Scientists in Spain conducted a pilot clinical trial (NCT03740295) that enrolled 51 adults with MS, all of whom were taking standard treatments and eating a Mediterranean-style diet. Participants were given supplements of coconut oil and epigallocatechin gallate — also known as EGCG, it’s a green tea extract — or a placebo, for about four months. The results indicated that, compared with patients on the placebo, those given the supplements had significant improvements in objective measures of balance and walking speed.

***

We at Multiple Sclerosis News Today hope these stories and all of our reporting in 2023 have been a helpful resource for everyone affected by MS, and we look forward to continuing to be a service for the community in the new year.