Multiple Sclerosis

Posted on autoimmune conditions, Multiple Sclerosis

New study finds a promising combined therapy for multiple sclerosis

The authors of the study, from left to right: Esteban Ballestar (IJC), Cristina Ramo-Tello (IGTP), Federico Fondelli (IJC-IGTP), Eva Martínez-Cáceres (IGTP) and Jana Willemyns (IGTP)

The authors of the study, from left to right: Esteban Ballestar (IJC), Cristina Ramo-Tello (IGTP), Federico Fondelli (IJC-IGTP), Eva Martínez-Cáceres (IGTP) and Jana Willemyns (IGTP) Credit Josep Carreras Leukaemia Research Institute

Multiple Sclerosis (MS) is a chronic disease in which the immune system mistakenly attacks the protective layer around nerve cells, known as the myelin sheath. This results in nerve damage and increasing disability. Current treatments, such as immunosuppressants, help reduce these harmful attacks but also weaken the overall immune system, leaving patients susceptible to infections and cancer. Scientists are now investigating a more targeted therapy using special immune cells, called tolerogenic dendritic cells (tolDCs), from the same patients.

TolDCs can restore immune balance without affecting the body’s natural defences. However, since a hallmark of MS is precisely immune system dysfunction, these cells’ effectiveness for autotransplantation might be compromised. Therefore, it is essential to better understand how the disease affects the starting material for this cellular therapy before it can be applied.

In a study published in the prestigious Journal of Clinical Investigation, researchers examined CD14+ monocytes, mature dendritic cells (mDCs), and Vitamin D3-treated tolerogenic dendritic cells (VitD3-tolDCs) from MS patients who had not yet received treatment, as well as from healthy individuals. These cells are loaded with myelin antigens to help “teach” the immune system to stop attacking the nervous system. This approach is groundbreaking as it uses a patient’s own immune cells, modified to induce immune tolerance, in an effort to treat the autoimmune nature of MS.

The research, conducted by Dr. Eva Martinez-Cáceres and Dr. Esteban Ballestar from the Josep Carreras Institute, with Federico Fondelli as the lead author, discovered that immune cells from MS patients (specifically monocytes, which are precursors of tolDCs) maintain a “pro-inflammatory” signature even after being transformed into VitD3-tolDCs, the therapeutic cell type used in treatment. This signature reduces the effectiveness of these cells compared to those derived from healthy individuals, resulting in them not fully realizing their potential benefits.

Using advanced research methods, the researchers discovered a pathway called the Aryl Hydrocarbon Receptor (AhR) that is associated with this changed immune response. By using a drug that affects AhR, the team was able to restore the normal function of VitD3-tolDCs from MS patients in a lab setting. Interestingly, they found that Dimethyl Fumarate, an approved MS drug, had a similar effect to AhR modulation and restored the cells’ full effectiveness with a safer toxic profile.

Finally, studies in MS animal models showed that a combination of VitD3-tolDCs and Dimethyl Fumarate led to better results than using either treatment alone. This combination therapy significantly reduced symptoms in mice, suggesting enhanced potential for treating human patients.

Posted on Multiple Sclerosis

Selma Blair shares health update on her MS remission: ‘My spirit is really good’

Actor Selma Blair and designer Isaac Mizrahi join TODAY to discuss a new inclusive fashion line that’s created to be accessible and adaptive. Blair also gives an update on her health since being diagnosed with multiple sclerosis.

Posted on Multiple Sclerosis

Paralyzed, Blind & Hospitalized-Aggressive MS at 23

At the beginning of 2019, I was diagnosed with a very severe, rapid-onset form of multiple sclerosis. This first attack of MS Caused Optic neuritis-related blindness in both eyes, Paralysis, And I was hospitalized for four months. This is the story of my diagnosis, treatment and recovery.

Posted on Multiple Sclerosis

Multiple sclerosis symptoms at onset linked to long-term disability

A new study has found a potential connection between specific initial symptoms and long-term disability outcomes in multiple sclerosis (MS) research. This discovery could have significant implications for early intervention strategies and treatment decisions in MS care.

Dr. João Pedro F. Gonçalves from the Federal University of Bahia, Brazil, led a study that analyzed data from 195 MS patients. The study focused on the symptoms at disease onset and subsequent functional outcomes. The team’s findings challenge some previously held beliefs about MS progression and open up new avenues for personalized treatment approaches.

“Our research indicates that patients who experience acute blurry vision or sphincter dysfunction when first diagnosed with MS may be at higher risk for developing more severe disability over time,” explains Dr. Gonçalves. “This information could be crucial for healthcare providers in determining initial treatment strategies and monitoring protocols.”

Key findings of the study include:

– Patients presenting with acute blurry vision at onset had 20% higher odds of worse functional outcomes.

– Those experiencing sphincter dysfunction (such as bladder or bowel issues) at onset had 24.5% higher odds of developing more severe disability.

– Contrary to some previous studies, symptoms like acute paralysis and hypoesthesia were not independent predictors of worse outcomes in the long term.

The study used the Expanded Disability Status Scale (EDSS), a widely recognized tool for quantifying disability in MS patients. This approach enabled the researchers to objectively correlate initial symptoms with long-term functional status.

Dr. Gonçalves and his team’s work raises intriguing questions about the underlying mechanisms of MS progression. Why do visual disturbances and sphincteric symptoms herald a more challenging disease course? Could these symptoms indicate more extensive initial damage to the central nervous system, or do they perhaps reflect a different subtype of MS that warrants more aggressive early treatment?

Moreover, the findings prompt consideration of how this knowledge might be integrated into current MS treatment guidelines. Should patients presenting with these specific symptoms be fast-tracked for more intensive therapies? What role might emerging biomarkers play in conjunction with these clinical indicators to further refine prognostic accuracy?

The study emphasizes the intricate connection between different symptoms of multiple sclerosis (MS) and their effect on the quality of life of patients. Although symptoms such as sudden paralysis may initially appear more severe, research indicates that less apparent issues like blurred vision or bladder dysfunction could be more indicative of long-term difficulties. This raises important questions about how to prioritize symptom management in MS care and whether current assessments of quality of life adequately encompass the complete range of MS-related disability.

“Dr. Gonçalves points out, “These findings have the potential to change the way we make initial treatment decisions for MS. By identifying patients at higher risk for severe disability at an early stage, we can consider more aggressive intervention, which could potentially change the progression of the disease.”

The research team recognizes certain limitations of the study, including possible bias in recalling symptoms and the necessity for prospective studies to validate their findings. Nonetheless, this work marks a noteworthy advancement in comprehending MS progression and tailoring patient care.

As the global MS research community digests these findings, several questions emerge: How might these prognostic indicators interact with genetic and environmental risk factors for MS? Could targeted interventions for patients with these high-risk symptoms lead to improved long-term outcomes? And how might these findings influence the development of next-generation MS therapies?

Posted on Multiple Sclerosis

Study finds some Multiple Sclerosis therapies may not slow disability progression

In people with primary progressive multiple sclerosis (MS), a new study has found no difference in the amount of time before disability worsened between people taking certain medications and those not receiving treatment. The study is published in the September 25, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology. With MS, the body’s immune system attacks myelin, the fatty, white substance that insulates and protects the nerves. People with primary progressive MS experience a steady decline in symptoms. About 10 to 15% of people with the disease have this type of MS. The study looked at rituximab and ocrelizumab, anti-CD20 infusion therapies that target a protein called CD20 found on some white blood cells called B-cells. Removing these cells from the bloodstream is believed to reduce inflammation and damage that can occur to the myelin. Ocrelizumab is approved by the U.S. Food and Drug Administration (FDA) for primary progressive MS and for people with relapses, but rituximab is not. Rituximab is FDA approved for other diseases like rheumatoid arthritis and prescribed off label for MS. “MS is a disabling disease, so treatments that slow the progression to worse disability are sorely needed,” said study author Laure Michel, MD, PhD, of Rennes University in France. “Anti-CD20 therapies are widely prescribed, in part because there are few alternate treatments. However, our study suggests they may not slow disability from worsening for people with primary progressive MS.” The study involved 1,184 people with primary progressive MS who had an average age of 56. They did not take MS medications in the two years prior to the study. For the study, 295 people were treated with rituximab, 131 were treated with ocrelizumab and 728 were untreated. They were followed for an average of four years. Participants’ level of disability was measured on a scale with scores ranging from zero, meaning no symptoms, to 10 points, meaning death due to MS. At the start of the study, all participants had a score of 6.5 or less. Researchers then measured how long it took for people to advance to their first confirmed disability progression. For those whose score was less than 5.5 at the start of the study, advancing one point on the scale was considered progressing in disability. If their score was 5.5 or more, advancing 0.5 points on the scale was disability progression. After adjusting for possible differences between the treated and untreated groups, researchers found there was no difference in the time it took to progress to the next level of disability between those taking a medication and those taking no medication. “Medications for MS can be expensive and come with risks of side effects,” said Michel. “Our results indicate that there should be a constant evaluation of MS therapies to determine if the benefits outweigh the risks for people with primary progressive MS.” A limitation of the study is that it was a look back in time and did not follow people in real time. Also, among those taking medications, most were taking rituximab with fewer people taking ocrelizumab. More research is needed in larger groups of people to confirm the findings.
In people with primary progressive multiple sclerosis (MS), a new study has found no difference in the amount of time before disability worsened between people taking certain medications and those not receiving treatment.


With MS, the body’s immune system attacks myelin, the fatty, white substance that insulates and protects the nerves. People with primary progressive MS experience a steady decline in symptoms. About 10 to 15% of people with the disease have this type of MS. The study looked at rituximab and ocrelizumab, anti-CD20 infusion therapies that target a protein called CD20 found on some white blood cells called B-cells. Removing these cells from the bloodstream is believed to reduce inflammation and damage to the myelin.

Ocrelizumab is approved by the U.S. Food and Drug Administration (FDA) for primary progressive MS and people with relapses, but rituximab is not. Rituximab is FDA-approved for other diseases like rheumatoid arthritis and prescribed off-label for MS. “MS is a disabling disease, so treatments that slow the progression to worse disability are sorely needed,” said study author Laure Michel, MD, PhD, of Rennes University in France. “Anti-CD20 therapies are widely prescribed, partly because there are few alternate treatments. However, our study suggests they may not slow disability from worsening for people with primary progressive MS.”


The study involved 1,184 people with primary progressive MS who had an average age of 56. They did not take MS medications in the two years prior to the study. For the study, 295 people were treated with rituximab, 131 were treated with ocrelizumab and 728 were untreated. They were followed for an average of four years. Participants’ level of disability was measured on a scale with scores ranging from zero, meaning no symptoms, to 10 points, meaning death due to MS. At the start of the study, all participants had a score of 6.5 or less. Researchers then measured how long it took for people to advance to their first confirmed disability progression. For those whose score was less than 5.5 at the start of the study, advancing one point on the scale was considered progressing in disability. If their score was 5.5 or more, advancing 0.5 points on the scale was disability progression.

After adjusting for possible differences between the treated and untreated groups, researchers found there was no difference in the time it took to progress to the next level of disability between those taking a medication and those taking no medication. “Medications for MS can be expensive and come with risks of side effects,” said Michel. “Our results indicate that there should be a constant evaluation of MS therapies to determine if the benefits outweigh the risks for people with primary progressive MS.” A limitation of the study is that it was a look back in time and did not follow people in real time. Also, among those taking medications, most were taking rituximab with fewer people taking ocrelizumab. More research is needed in larger groups of people to confirm the findings.