Innovative approaches in the treatment of multiple sclerosis

Will Frostick|23rd January 2019

Multiple Sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system (CNS), leading to progressive and permanent disability. It is estimated that 2,500,000 people across the world suffer from MS. The disease impacts everyone differently, with the symptoms ranging from fatigue and vision problems to mental health issues and mobility problems, along with issues with speech and swallowing, and loss of bladder function (to name a few). Sadly, the age of onset is typically 20-40 years and MS is the leading cause of nontraumatic neurologic disability in young people.

The pathogenesis of MS consists of two key components: focal inflammatory demyelination, and neurodegeneration. Nerve function is dependent on the ability of electrical signals to flow through the wire-like axons of neurons, which are wrapped in and insulated by myelin sheaths. In the central nervous system (CNS, which includes the brain, optic nerves and spinal cord), myelin extends from octopus-like arms of oligodendrocytes. This myelination supports neuronal signal conductance and the survival of the neurons themselves.

However, in MS, lymphocytes mount an auto-immune attack on myelin, leading to damage of the myelin sheath. The demyelinated neurons can then no longer function properly and begin to atrophy and degenerate, causing the symptoms of MS.2 As damage can occur anywhere in the CNS, symptoms are highly varied.

THE TWO TYPES OF MS

There are two main clinical presentations of MS – Relapsing Refractory MS (RRMS) and Progressive MS (PMS).

In RRMS symptoms are intermittent but relapses gradually become more frequent, severe and longer-lasting as the disease progresses. However, PMS is characterised by a progressive worsening of symptoms between flareups, without remission. Pathophysiologically, the disease courses of both types overlap. As a result, patients can transition between the types of MS, making monitoring and treating the disease more challenging.

For example, PMS is characterised by focal inflammatory lesions (an area of damage or scaring in the CNS, also referred to as plaques) in the early stages only, with more diffuse damage becoming common later on. Focal inflammatory lesions are also a feature throughout RRMS, and it is also possible for RRMS patients to show progressive symptoms in the later stages of the disease.

 

 

 

Empowered patients: shaking the foundations of healthcare

Blue Latitude Health|16th August 2019

Precision medicine represents a new paradigm in healthcare.This new approach to treating and preventing disease views the patient holistically, analysing their genes, environment and lifestyle, and using this information to make a more accurate treatment decision. Here we discuss the barriers, opportunities and potential outcomes of the precision medicine era in healthcare.

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A uniquely English genomic medicine service

Natasha Cowan|26th July 2019

The UK National Health Service is developing one standardised approach to embedding precision medicine across the whole of England. Blue Latitude Health speaks to Dr Tom Fowler, Deputy Chief Scientist and Director of Public Health at Genomics England, to find out how the NHS is achieving this goal.

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Diagnosing the lag in neuropsychiatric treatments

Sana Rahim|16th July 2019

The number of mental health research programmes in larger drug firms has shrunk by 70% in the past decade. Blue Latitude Health Senior Associate Consultant Sana Rahim explores this drop in investment and explains why developing a market-orientated model is vital for making progress.

 

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