Epstein-Barr Virus Might Kick-Start Multiple Sclerosis

Researchers have found that patients with multiple sclerosis (MS) carry a population of immune cells that overreact to Epstein-Barr virus. The virus, which causes mononucleosis and may contribute to some cancers, has long been suspected to play a role in MS. However, the mechanism linking the virus to the disease was poorly understood. Scientists think that MS—which can cause vision problems, muscle weakness, and difficulty with coordination and balance—is a result of the immune system attacking the body's own nervous system. Not everyone who is infected with Epstein-Barr develops MS, but the results of the new study, published in the June 2006, issue of the journal Brain, suggest that some individuals' unusually strong reaction to the virus may trigger the disease. The findings could lead to new therapeutic strategies for better control of the damage caused in this autoimmune disorder. The culprit, the researchers say, may be a population of T cells that helps boost other components of the immune system in response to the virus. "What we discovered in the peripheral blood of the MS patients were T cells that appeared to be primed for action against EBV," said Nancy Edwards, an HHMI-NIH research scholar at the National Institutes of Health (NIH) and co-author of the paper, which was published in advance online. © 2006 Howard Hughes Medical Institute.

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When Ellen Bramble was 49 she stepped off a flight of stairs into thin air. She tumbled down, her laundry flying "every which way" and her limbs relaxed, as if she didn't even know she was falling. "I just kind of rolled and bounced on the concrete stairs…and I didn't get hurt, just a couple of bruises," says Bramble, a photographer from Portland, Oregon. This was the first of three falls that later led doctors to diagnose Bramble with multiple sclerosis (MS). MS is a disease in which the body's own white blood cells attack and erode the protective insulation around nerve fibers in the brain, spinal cord, and optical nerves, causing patients' bodies to go numb and lose track of what they're doing. As her disease progressed, Bramble, who is now 59, learned to deal with her physical limitations. But what's been most frustrating is that she's often felt lost in a "fog." Bramble has "cognitive dysfunction," a symptom shared by half of America's 400,000 multiple sclerosis patients, which makes it difficult for her to think clearly and to do simple things many people take for granted — remembering words, reading, keeping track of her daily chores, or even knowing where she's going when she pulls out of her driveway. (C) ScienCentral, 2000-2005.

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Take a chill pill, T cell

By Tia Ghose In people with autoimmune diseases like multiple sclerosis and asthma, infection-fighting cells go haywire and wage war against the body’s own tissue, causing inflammation. Existing treatments can prevent the immune system from getting out of control, but can also compromise a person’s ability to fight some infections. But a new study suggests that a specific receptor on immune cells holds promise as a target for treating such disorders, perhaps without affecting immunity. The receptor, called DR3, lies on the surface of T cells, which help the body combat infection. When a molecule called TL1A binds to the receptor, it spurs the T cells into action. But this same interaction can also lead the T cells to attack healthy tissue. Turning off the gene for this receptor seems to quell this inflammation in mice, researchers report online June 19 in the journal Immunity. It wasn’t far-fetched to think DR3 may play a role in autoimmune disease. DR3 is part of a family of TNF receptors, which are involved in activating immune cells and have been implicated in autoimmune disease, says Michael Croft, an immunologist at the La Jolla Institute for Allergy and Immunology in California, who was not involved in the study. What’s more, DR3 looks very similar to another receptor implicated in inflammation, says Richard Siegel of the National Institute of Arthritis and Musculoskeletal and Skin Diseases in Bethesda, Md, who was involved in the study. © Society for Science & the Public 2000 - 2008

Advances Cited in Research on Multiple Sclerosis

By NICHOLAS WADE Medical researchers have made a significant advance in understanding multiple sclerosis, a common neurological disease that causes symptoms ranging from muscle weakness to paralysis. The disease is one in which the body’s immune system mistakenly attacks the electrical insulation of nerve fibers. The cause is part genetic and part environmental, but researchers trying to identify the relevant genes have endured repeated frustration. Their approach has been to guess what genes might be involved and see if patients have abnormal versions. This guesswork has produced more than 100 candidate genes in recent years, none of which could be confirmed except for long-known variants in the mechanism used by the immune system to recognize proteins that are foreign to the body. In three articles published online yesterday in The New England Journal of Medicine, three teams of researchers say they have identified, by separate routes, new genetic variants that contribute to the disease. One team used a new, advanced gene-hunting method called Whole Genome Association, which has racked up a string of successes with major diseases in the last few months. The other teams used the candidate gene approach, but because all three teams identified the same gene, the researchers say they are confident they have opened a new window into the cause and possible treatment of multiple sclerosis. Copyright 2007 The New York Times Company

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Potential risks of powerful MS drug are weighed

Roxanne Khamsi A multiple sclerosis drug, voluntarily withdrawn from sale by its manufacturers following complications in patients, has shown substantial benefits in slowing the progression of the disease in a new study. Natalizumab (branded Tysabri), made by Biogen Idec and Elan Pharmaceuticals, reduced the risk of sustained progression of disability from MS by 42% in a study of about 1000 patients. Results from the two-year trial which began in 2001 and received supported by Biogen, were published in the New England Journal of Medicine on Wednesday. Natalizumab also decreased the frequency of clinical relapses, which could involve a dramatic reduction in sight or muscle function due to MS, by 68%. By comparison, current MS drugs on the market reduce these relapses by about one-third, comments Allan Ropper, at the Caritas-St. Elizabeth’s Medical Center in Boston, US, also an associate editor at NEJM. However, another study published alongside these results, following more than 3000 participants has estimated that patients treated with natalizumab have a one in 1000 chance of developing a potentially fatal disease of the central nervous system called progressive multifocal leukoencephalopathy (PML). PML, symptoms of which include mental deterioration and problems with speech, can be caused by a latent virus present in the kidneys of over 60% of people. The virus remains latent in healthy humans, but suppression of the immune system can allow it to become active and cause damage. © Copyright Reed Business Information Ltd.

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New treatment for multiple sclerosis tested

A new pathway for treating multiple sclerosis may have been found, if “exciting” results in mice can be replicated in humans. MS is an incurable degenerative disease caused by the body’s immune system attacking the protective myelin sheath encasing the nerves that make up the central nervous system. The nerve fibres become increasingly damaged by scar tissue, known as sclerosis, which leads to paralysis and loss of speech and vision. But researchers trying a novel therapy on a mouse version of MS report that the mice showed “almost no inflammation of the myelin sheath and no nerve damage”. Furthermore, MS is characterised by periods of remission and relapse, but the mice recovered with fewer and far less severe relapses. The therapy targets immune system cells called T-cells. These malfunction in MS patients, producing inflammatory molecules that destroy the myelin sheath. The new treatment, which uses a class of molecules called kynurenines, works by inhibiting the T-cells’ production of inflammatory molecules and prompting them to produce agents that “mop up” the molecules. © Copyright Reed Business Information Ltd.

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Leprosy bug provides clues to early nerve degeneration

Possible insight to multiple sclerosis and other neurodegenerative diseases that destroy nerve cell 'insulation' In the May 3 issue of Science, scientists at Rockefeller University and New York University School of Medicine report that the nerve damage that leads to a loss of sensation and disability of people with leprosy occurs in the early stages of infection. The nerve damage, a hallmark of leprosy previously thought to be a byproduct of the immune system’s response to the leprosy bacteria, now seems to be a direct result of the leprosy bug attaching itself to specialized nerve cells called Schwann cells, the glial, or supporting, cells of the peripheral nervous system (PNS). The findings suggest that the body’s immune response does not play a significant role in the early stage of neurological injury.

Common cholesterol drug prevents, reverses MS symptoms in mice

Lipitor ™ (atorvastatin), the most frequently used cholesterol lowering agent in the world, also has the ability to influence the immune system and proved effective in reversing paralysis in a mouse model of multiple sclerosis. Dr. Sawsan Youssef, a postdoctoral fellow in the laboratory of Dr. Lawrence Steinman, Stanford University, reported the study on April 23 at the Experimental Biology 2002 meeting in New Orleans. Multiple sclerosis is caused by the immune system attacking the body’s own central nervous system, breaking down the myelin that sheathes and protects CNS nerves, impairing the body’s ability to move normally, and eventually causing paralysis. The T lymphocytes of the mice with which the research team worked are sensitized to brain antigens so that they produce an over-abundance of cytokines, pro-inflammatory chemicals that inflame the CNS, causing demylination of nerve sheaths through the same mechanism and in the same manner as happens in human multiple sclerosis. As in humans with MS, this mouse condition (called experimental autoimmune encephalomyelitis or EAE) can occur in either an acute or relapsing form. The researchers found that oral treatment with lipitor could prevent both the acute and relapsing form of the multiple sclerosis-like disease in the mice, and could also reverse symptoms in mice with the ongoing chronic relapsing form of the disease.

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MS rates higher farther from equator, atlas shows

Multiple sclerosis is more common among people living in northern latitudes, but they aren't the only ones affected, according to a new report. The World Health Organization and the London-based Multiple Sclerosis International Federation published the MS Atlas on Wednesday. It summarizes information on the disease in 112 countries, none of which were free of the disease. MS is a neurodegenerative disease that attacks the brain and spinal cord, and can lead to paralysis and sometimes blindness. Some people with MS experience little disability during their lifetime. But up to 60 per cent are no longer fully able to walk 20 years after onset, which has major implications for their quality of life and costs to society, the report said. Symptoms appear around 30 years of age on average. “The Atlas of MS reveals how these implications impact women more than men, by at least two to one, at an age when they are starting a family and developing a career,” said Dr. Benedetto Saraceno, director of the WHO's department of mental health and substance dependence. The study confirms that MS is a global disease, not solely of the more developed “northern” and “western” countries, the report said. © CBC 2008

Some With MS Put Their Hopes in a Diet

By JANE E. BRODY What you are about to read is not an endorsement of any particular diet as a therapy for multiple sclerosis. Nor is it a suggestion to forgo established medical treatments. But so long as it is part of a medically approved treatment program, the diet described here is unlikely to hurt, except perhaps to make meal planning a challenge. And on the testimony of those who have followed it, the plan may be worth trying, despite the lack of scientific evidence to support it. The diet has not been subjected to a placebo-controlled, randomized clinical trial, the gold standard for determining the value of any therapy. But Ann D. Sawyer and Judith E. Bachrach, co-authors of “The MS Recovery Diet,” say this should not dissuade people struggling with the debilitating symptoms of the degenerative disease. The diet they outline extends one developed decades ago by Dr. Roy L. Swank, an emeritus professor of neurology at Oregon Health Science University. It severely restricts saturated fat and increases essential fatty acids like fish and vegetable oils, measures endorsed by the National Multiple Sclerosis Society as part of a healthy diet. Copyright 2008 The New York Times Company

From Multiple Sclerosis, a Multiplicity of Challenges

By JANE E. BRODY When it comes to understanding, preventing and treating chronic diseases, multiple sclerosis ranks among the most challenging. The word “multiple” is apt in more ways than one. Various suggested causes include early-life exposure to certain viruses or toxic agents, geographic and dietary influences, inherent immunological defects and underlying genetic susceptibilities. MS is highly unpredictable. Rarely are any two patients alike in the presentation, duration and progression of symptoms; even the underlying cause of disability in MS is being reconsidered. And rarely do any two patients respond in the same way to a given therapy, be it medically established or alternative. Trial and error is the name of the game, experts say, because it is often not possible to know in advance what will work best for individual patients. These are the frequent underpinnings of confusion and distrust among those afflicted and their families. They sometimes give rise to claims that the organizations raising large amounts of money to support research and patient services and the scientists studying the disease have no intention of finding a cure, lest it put them out of business. It is a ridiculous notion on its face, since many of those involved in fund-raising and research have watched loved ones suffer and succumb to diseases like MS. Copyright 2008 The New York Times Company

Experimental MS surgery done under radar

A handful of Canadians with multiple sclerosis have had an experimental surgical procedure under the radar in this country, despite lack of proof of its safety or effectiveness. The surgery is based on the theory that blocked veins in the neck and chest contribute in some way to symptoms of MS. It's thought that opening up the veins using balloon angioplasty improves the condition. The procedure is officially not available in Canada. But Bill Harrison said he had the surgery in Victoria just over three weeks ago, paid for by B.C.'s health plan. Harrison, who has now moved to Toronto, was about to spend to $19,000 to travel to India for the surgery when he had the procedure at Victoria General Hospital. Dr. Mark Godley of False Creek Healthcare Centre in Vancouver arranged Harrison's surgery as a routine vascular procedure to fix a circulation problem. "The treatment was performed based on the fact that there was a disorder, a vascular disorder, and there was not the label of the association with MS," Godley said. Harrison said he couldn't have waited any longer because he was days away from being bed-ridden. "I do not understand what the obstacles are," Harrison said, sitting on a park bench in Toronto. "What I hear is, 'It takes time, it has to be tested.' I've already tested it. It works. I got my life back, yes!" © CBC 2010

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Multiple sclerosis 'blood blockage theory' tested

By Michelle Roberts US scientists are testing a radical new theory that multiple sclerosis (MS) is caused by blockages in the veins that drain the brain. The University of Buffalo team were intrigued by the work of Italian researcher Dr Paolo Zamboni who claims 90% of MS is caused by narrowed veins. He says the restricted drainage, visible on scans, injures the brain leading to MS. He has already widened the blockages in a handful of patients. The US team want to replicate his earlier work before treating patients. Experts welcomed the research saying it was important to confirm the basic science before evaluating any therapy. MS is a long-term inflammatory condition of the central nervous system which affects the transfer of messages from the nervous system to the rest of the body. The Buffalo team, led by Dr Robert Zivadinov, plan to recruit 1,100 patients with MS and 600 other volunteers as controls who are either healthy or have neurological diseases other than MS. Using Doppler ultrasound, they will scan the patients to see if they can find any blockages within the veins of the neck and brain. BBC © MMIX

Experimental MS surgery draws Canadian interest

The Multiple Sclerosis Society of Canada will finance some research into an experimental Italian treatment but urges patients not to stop treatment until more is known about the procedure.The Multiple Sclerosis Society of Canada will finance some research into an experimental Italian treatment but urges patients not to stop treatment until more is known about the procedure. (M. Spencer Green/Associated Press) The Multiple Sclerosis Society of Canada will be asking Canadian scientists to propose their own research into a procedure that has ignited the hopes of patients in Europe and North America. The procedure is known as chronic cerebro spinal venous insufficiency, or CCSVI, and involves removing a blockage in the veins that carry blood to and from the brain. An Italian vascular surgeon, Dr. Paolo Zamboni, a professor of medicine at the University of Ferrara in Italy, has reported success in reducing the symptoms of people who suffer from multiple sclerosis. The Canadian MS organization has reacted to Zamboni's research with caution. On Monday, however, the society said that after receiving so many inquiries about the procedure, it has decided to offer a grant to researchers in Canada. Details of the program will be announced Tuesday. In the meantime, the society urged people with MS to be patient and continue with their regular treatment until there is more evidence about the experimental procedure. © CBC 2009

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Experimental drug helps MS patients walk better: study

An experimental drug seems to help some people with multiple sclerosis to walk better, which could improve their quality of life, researchers said. In this week's issue of the medical journal the Lancet, neurologist Dr. Andrew Goodman of the University of Rochester Medical Center and his colleagues reported the results of their trial comparing Acorda Therapeutics' drug fampridine with a placebo. A progressive decline in mobility is a common feature of MS, and there are few pharmaceutical options to complement physiotherapy. "The data suggest that, for a sub-set of MS patients, nervous system function is partially restored while taking the drug," Goodman said in a statement. Goodman has served as a consultant to the company. "As a clinician, I can say that improvement in walking speed could have important psychological value; it may give individuals the potential to regain some of the independence that they may have lost in their daily lives," he added. The study looked at 301 adults in Canada and the U.S. with MS for 14 weeks. About 35 per cent of subjects who previously had trouble walking increased their walking speed after taking fampridine, compared with eight per cent in those randomly assigned to take a placebo. © CBC 2009

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Multiple sclerosis 'reversed' with stem cell therapy

by Linda Geddes For the first time, some of the disability associated with the early stages of multiple sclerosis appears to have been reversed. The treatment works by resetting patients' immune systems using their own stem cells. While randomised clinical trials are still needed to confirm the findings, they offer new hope to people in the early stages of the disease who don't respond to drug treatment. Multiple sclerosis is an autoimmune disease in which the fatty myelin sheath that wraps around nerve cells and speeds up their rate of transmission comes under attack from the body's own defences. Clean slate Richard Burt of Northwestern University Feinberg School of Medicine in Chicago and his colleagues had previously tried using stem cells to reverse this process in patients with advanced stages of the disease, with little success. "If you wait until there's neuro-degeneration, you're trying to close the barn door after the horse has already escaped," says Burt. What you really want to do is stop the autoimmune attack before it causes nerve-cell damage, he adds. In the latest trial, his team recruited 12 women and 11 men in the early relapsing-remitting stage of MS, who had not responded to treatment with the drug, interferon beta, after six months. © Copyright Reed Business Information Ltd.

MS increasingly recognized as a childhood disease

It started when Levi Barron's right hand curled into a claw shortly after his 13th birthday. Always laid-back, he told his mom that he'd just learn to write with the other hand and not to worry. But the debilitating stiffness crept to his other hand, and soon the athletic hockey player was having trouble walking and even fell a few times. It took four doctors and a stint in hospital, paralyzed from the waist down and so dizzy he couldn't open his eyes without vomiting, for Levi to finally get a diagnosis of multiple sclerosis. "I remember just being so frightened and upset that I didn't know that kids got MS," says Karen Barron, Levi's mom. Once thought of as a young adult disease striking people in their 20s or 30s, it is increasingly being recognized that multiple sclerosis can actually emerge much earlier, says Jon Temme, vice-president of client services and research for the Multiple Sclerosis Society of Canada. "Certainly the likelihood of a child being diagnosed accurately is much greater now than it would have been a decade ago." © CBC 2009

A Suspect Diagnosis

By Sandra G. Boodman Whenever doctors told Ruben Galiano that his wife, Olga, had multiple sclerosis, he tried not to look as though he didn't believe them. To the former hotel cook, her symptoms resembled those he had seen in stroke patients. And the MS medication she had been taking hadn't done a thing. But the real reason Galiano clung to his skepticism was emotional. "If she had MS it would mean she wouldn't be cured," he said. That was a possibility Galiano could not entertain about his wife of nearly 40 years. Olga Galiano's problem surfaced about five years ago, shortly after the couple moved back to their homeland, Guatemala. They had spent their entire adult lives in the Washington area, where their children were born and raised, but Olga Galiano's mother was seriously ill and needed their help. Soon after they settled in Guatemala City, Olga Galiano got very sick. She collapsed on the floor and in the space of a week developed double vision and an uncontrollable tremor in her head and hands. She also lost her sense of balance, and her speech became badly slurred. The first doctor who examined her ruled out a stroke, then diagnosed Parkinson's disease, which he soon changed to MS, an autoimmune disease that affects the central nervous system. A second doctor concurred with the MS diagnosis. A third physician told them he had no idea what was wrong and recommended a witch doctor. © 2008 The Washington Post Company

Calming Factor: DNA vaccine for MS passes initial test

Nathan Seppa An experimental vaccine for people who have multiple sclerosis has proved safe, clearing a necessary first hurdle toward regulatory approval. The results of this initial trial also suggest that the vaccine can indeed quell the self-destructive immune reaction that many scientists believe causes the disease. Despite this early promise, the researchers caution that the findings are based on data gathered from a small group over a limited time. The researchers used a technique called DNA vaccination, which introduces a gene into the body to elicit an immune response. But rather than rile the immune system against a foreign foe, the new multiple sclerosis (MS) vaccine seeks to induce immune tolerance of myelin basic protein, a component of myelin. A fatty material that protects nerves, myelin is degraded in MS, robbing patients of muscle control. For the vaccine, researchers at Stanford University and Bayhill Therapeutics in Palo Alto, Calif., designed a DNA ring that encodes a slightly altered version of myelin basic protein. The changes replaced immune-stimulating parts of the protein with immune-suppressing ones. Scientists gave 30 MS patients four injections over 9 weeks and then tracked their progress for a year. The study was made public this week and will appear in the October Archives of Neurology. ©2007 Science Service

Testosterone protects brain in men with MS

Roxanne Khamsi Testosterone can help protect against brain shrinkage in men with multiple sclerosis (MS), a small, preliminary trial suggests. Patients who applied a gel containing the hormone every day for a year showed less brain shrinkage than expected for people of their age with MS. The study participants also showed an increase in muscle mass over the course of the one-year trial. Researchers say the new findings are encouraging and suggest testosterone could one day help men with MS preserve their mind and muscle function. In multiple sclerosis, the immune system is thought to turn on the body, attacking the protective coating on nerves that enables them to swiftly send signals. This process can ultimately lead to neurological problems such as poor coordination and paralysis. In many cases, people in their 40s and 50s who have had MS for more than a decade will start showing signs of impaired memory, says Rhonda Voskuhl at the University of California, Los Angeles, in the US. For example, they might have difficulty remembering three questions asked in quick succession. © Copyright Reed Business Information Ltd

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