Multiple sclerosis: World MS Day
To mark the awareness day, we talk to one of the UK’s experts in the field of multiple sclerosis about current & future treatments, MS research and problems in the workplace for people with MS.
26th May 2010 - Today is World MS Day, raising awareness of this chronic disease. It is one of the most common disabling neurological conditions amongst young adults. More than two million people in the world have MS - 85,000 of them in the UK.
To mark the awareness day, we spoke to David Bates, Professor of Neurology, Newcastle University, one of the UK’s leading experts on MS, about current &amp; future treatments, MS research and problems in the workplace.
In 2010, what do we know about MS?
Our understanding of the disease is still incomplete, but greater than it was even a decade ago. We now recognise that there are risk factors within the human genome. In other words there are genes which predominately affect the immune system of the individual and create a risk of developing multiple sclerosis.
Multiple sclerosis is not an inherited disease, but certain genes make it possible to develop the disease, and it is possible that there are some genes which are protective.
There is a human genome screening [project] going on at the moment and results are expected this year. In addition, there is increasing recognition of other factors - those are environmental factors. Some appear to be ‘macro environmental’ like, potentially, exposure to ultra violet light, sunshine, vitamin D; and others are ‘micro environmental’, like exposure to infection, for example, the Epstein Barr virus which causes infective mononucleosis.
The general recognition is that there is a combination of both a genetic and an environmental factor or factors that causes the disease.
What further advances would you expect in 10 years’ time?
I think that the information from genetics will have increased, though it may not be more significant. I think we now know the most important parts of the genetic link and the other one will tend to be smaller and less relevant.
Where I think there will be improvements will be in term of recognition of the environmental factor, and that may come from studies of populations, particularly in those areas in the world where the disease frequency is changing. It may come from studying the risks of infections, the occurrence of infections and also changes that are being made in populations, such as supplementing vitamin D in some populations and the consideration of immunisation against virus infections in others.
What’s the situation with regard to treating MS?
Treatments are relatively stable. We have moved little in the past 15 years in treatment since the advent of the first disease modifying therapies - beta interferons and glatiramer acetate. We’ve had one extra drug come into our armamentarium in the past decade, and that is Natalizumab, a monoclonal antibody that blocks the ingress of cells to the nervous system. The problem there is an attendant risk of an intercurrent virus infection called progressive multifocal leukoencephalopathy, or PML, which can occur to people treated with this agent. The risk is small, but it is a severe disease.