As many as 2.5 million people worldwide suffer from MS and face chronic, sometimes disabling symptoms that can range from fatigue and muscle weakness to walking problems, vision problems, bladder and bowel dysfunction.
What Does MS Do?
MS causes the body to attack the myelin -- or fatty substance that insulates the nerve fibers -- and the nerve fibers themselves in the CNS. The damaged myelin forms scar tissue, also called sclerosis, which is how the disease’s name originated. This damage prevents nerve impulses traveling to and from the brain from transmitting properly, causing the signals to become distorted or interrupted and resulting in a wide variety of symptoms.
What Are Recent Advances in MS Research?
In the past few years, breakthroughs in understanding MS and related autoimmune disorders have been discovered and published. These advances have brought about new understanding of the disease's genetics, burgeoning drug treatment options, new techniques to repair MS damage and new insight into potential causes of the disease. Among these breakthroughs:
MS: The Genetic Link
Researchers have been able to uncover links to 34 possible genetic factors that contribute to the onset of MS. While these genes are not the cause of the disease, they may make people more likely to develop MS when exposed to certain environmental factors or viruses. While research is ongoing, at least 50 genetic links are expected to be identified, including some genes that may contribute to the risk of developing MS.
MS researchers hope that genetics breakthroughs will allow doctors to identify people who are at high risk for the disease and enable them to intervene with treatment in early stages, potentially even before symptoms appear. This will allow patients to manage the disease more effectively and will mean less permanent damage when treatment begins.
MS: Drug Treatment Options
Until recently, the FDA approved only eight medications to reduce the frequency of MS relapses and slow the progression of the disease, all of which had to be injected or taken intravenously. In 2010, Gilenya (fingolimod) became the first approved disease-modifying MS drug that could be taken orally. While this drug reduces the rate of MS relapse by 54 percent compared to placebo, it comes with serious side effects. However, other new drugs that can be taken orally are in clinical trials and, if approved, may offer a welcome treatment alternative for MS patients.
Experts speculate that eight to 10 new medications for MS will become commercially available within the next three to five years, both as MS research efforts come to fruition and medications approved for other diseases are found also to help MS patients.
MS: Damage Control
Restoring nervous system function and repairing the damage MS causes has been a strong focus in MS research. While previously it was believed that myelin, once destroyed, was damaged permanently, now it has been proven that there can be remyelination.
Researchers have had some success using human embryonic stem cells to generate myelin-producing cells and are currently studying the efficacy of adult stem cells. Growth factors, or substances that can affect cellular growth, are also being looked at for their ability to repair myelin-producing cells.
Scientists are making advances in the relationship between the axon, or nerve fiber, and the myelin sheath that insulates it. Myelin sheaths, essentially, regulate how active and functional the axons are. Scientists hope that having a better understanding of the interaction between the myelin and axon will help drive further breakthroughs in restoring the sheaths and preventing permanent damage in axons.
MS: The Vitamin D Link
Vitamin D has become a focus for many MS researchers. Some studies have shown that there may be a link between low levels of vitamin D in the body and a common MS genetic variant, which is believed to boost a person’s risk of developing the disease. Some in the scientific community view low vitamin D levels as potential environmental triggers for MS, which is troubling because about 35 percent of North Americans are vitamin D deficient.
While so much of the population is vitamin D deficient, MS patients have far lower levels than the general population. During acute MS attacks, vitamin D levels are particularly low, but when a patient is in remission, levels are nearly normal.
MS: The "Off" Switch
In 2014, researchers at the University of Bristol in the UK announced that they believe they discovered the "off" switch for autoimmune diseases. This breakthrough could benefit MS patients, as well as millions of other patients suffering from various autoimmune diseases around the world, including Type I diabetes, Graves’ disease and systemic lupus.
During their research, the team discovered how cells convert from being aggressive to protecting against disease, rather than the body’s immune system attacking its own tissues. Further, the team revealed that the administration of fragments of the proteins that are normally the target for the attack may lead to the correction of the autoimmune response. According to their findings, effective treatment can be achieved by gradually increasing the dose of the antigenic fragment injected.
This form of immunotherapy works because changes in gene expression as a result of receiving the treatment can lead to the conversion of aggressor cells into protector cells, restoring normal immune system function. This form of treatment may be able to restore self-tolerance, whereas the body’s immune system ignores its own tissues while remaining fully able to protect against infection.
While it's a grave diagnosis, living with MS is proving to be manageable, given proper health care and breakthroughs on the horizon.