Multiple Sclerosis (MS)

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Bone marrow treatments restore nerves, expert says

Tue May 6, 2008


BETHESDA, Maryland (Reuters) - An experiment that went wrong may provide a new way to treat multiple sclerosis, a Canadian researcher said on Tuesday.

Patients who got bone marrow stem-cell transplants -- similar to those given to leukemia patients -- have enjoyed a mysterious remission of their disease.

And Dr. Mark Freedman of the University of Ottawa is not sure why.

"Not a single patient, and it's almost seven years, has ever had a relapse," Freedman said.

Multiple sclerosis or MS affects an estimated 1 million people globally. There is no cure.

It can cause mild illness in some people while causing permanent disability in others. Symptoms may include numbness or weakness in one or more limbs, partial or complete loss of vision, and an unsteady gait.

Freedman, who specializes in treating MS, wanted to study how the disease unfolds. He set up an experiment in which doctors destroyed the bone marrow and thus the immune systems of MS patients.

Then stem cells known as hematopoeitic stem cells, blood-forming cells taken from the bone marrow, were transplanted back into the patients.

"We weren't looking for improvement," Freedman told a stem cell seminar at the U.S. National Institutes of Health.

"The actual study was to reboot the immune system."

Once MS is diagnosed, Freedman said, "you've already missed the boat. We figured we would reboot the immune system and watch the disease evolve. It failed."

STEM CELL REPAIR

They had thought that destroying the bone marrow would improve symptoms within a year. After all, MS is believed to be an autoimmune disease, in which immune system cells mistakenly attack the fatty myelin sheath that protects nerve strands.

Patients lose the ability to move as the thin strands that connect one nerve cell to another wither.

Instead, improvements began two years after treatment.

Freedman reported to the seminar about 17 of the patients he has given the transplants to.

"We have yet to get the disease to restart," he said. Patients are not developing some of the characteristic brain lesions seen in MS. "But we are seeing this repair."

MS patients often have hard-to-predict changes in their symptoms and disease course, so Freedman says his team must study the patients longer before they can say precisely what is going on.

"We are trying to find out what is happening and what could possibly be the source of repair," Freedman said.

But he has found some hints that may help doctors who treat MS by using drugs to suppress the immune system.

"Those with a lot of inflammation going on were the most likely to benefit (from the treatment)," he said.

"We need some degree of inflammation." While inflammation may be the process that destroys myelin, it could be that the body needs some inflammation to make repairs, Freedman said.

Immune cells secrete compounds known as cytokines. While these are linked with inflammation, they may also direct cells, perhaps even the stem cells, to regenerate.

The treatment itself is dangerous -- one patient died when the chemicals used to destroy his bone marrow also badly damaged his liver.

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Novartis MS Drug, Rival to Bayer's, Wins EU Approval (Update4)

May 26, 2008 (press release)~ Novartis AG won European approval for a multiple sclerosis drug that's identical to Bayer AG's Betaseron, the German company's second best-selling medicine.

Extavia, an interferon beta-1b, was approved for use in patients with early and relapsing forms of MS, Basel, Switzerland-based Novartis said today. Betaseron, also known as Betaferon, was first approved in Europe in 1996.

Novartis, Switzerland's second-biggest drugmaker, plans to start selling the injected treatment in the first half of 2009, giving it a foothold in the multiple sclerosis market before the planned introduction of its experimental drug fingolimod. Fingolimod, which could be the first oral MS disease medicine, may generate more than $1 billion in annual sales, analysts say.

Approval of Extavia ``is fundamentally positive because Novartis can now prepare and build up to the launch of their own product,'' Andrew Weiss, an analyst at Bank Vontobel in Zurich, said in an interview.

Weiss forecasts peak sales of $340 million annually for Extavia. Novartis' best-selling drug, the Diovan high-blood pressure treatment, had sales of more than $5 billion last year. The company is looking for new treatments to help it weather the loss of patent protection on Diovan and the Gleevec cancer medicine in the next few years.

Betaseron generated 1.03 billion euros ($1.62 billion) in global sales last year, about 3 percent of Bayer's total revenue of 32.4 billion euros.

Shares Fall

Novartis fell 80 centimes, or 1.5 percent, to 53.45 Swiss francs at the close of Zurich trading. Bayer shares declined 18 cents, or 0.3 percent, to 54.52 euros in Frankfurt.

The introduction of Extavia ``was expected and we've had to reckon with it,'' Carsten Kunold, an analyst who follows Bayer at Merck Finck in Munich, said in an interview.

Novartis gained rights to Extavia through its acquisition of Chiron Corp. in 2005 and in agreement with Bayer, which gained Betaseron with the 2006 purchase of Schering AG. Bayer last year agreed to pay Novartis, which makes Betaseron under contract, $110 million for a California plant and another $90 million for inventories of the drug.

Betaseron competes with Biogen Idec Inc.'s Avonex, Merck Serono SA's Rebif, Teva Pharmaceutical Industries Ltd.'s Copaxone and Elan Corp. and Biogen's Tysabri for share of the MS market.
By Eva von Schaper and Dermot Doherty

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The MS Society of Canada, Fredericton and area Chapter, has partnered with Fredericton Public Library to educate the community about multiple sclerosis and provide resources for people living with MS.

"We are so pleased to present the Fredericton Public Library with two books related to multiple sclerosis," said Stephen Colwell, president of the Fredericton and area chapter. "In making this gift, we recognize the common interest in education shared by the Fredericton Public Library and the MS Society of Canada since part of our mission is to educate the public about multiple sclerosis."

The books donated by the Fredericton and area chapter are: Multiple Sclerosis for Dummies and Yoga and MS: A Journey to Health and Healing. By obtaining the most up-to-date information about the disease and healthful living, people affected by MS are more aware of resources and better able to make informed decisions and cope more readily with the unpredictable nature of the disease.

An estimated 50,000 to 75,000 Canadians (4,000 to 5,500 Atlantic Canadians) have MS and three more are diagnosed every day. Multiple sclerosis is a chronic, often disabling disease of the brain and spinal cord. It is the most common neurological disease of young adults in Canada. Most people with MS are diagnosed between the ages of 15 and 40, and the unpredictable effects of MS last for the rest of their lives. Symptoms may include: vision disturbances such as double or blurred vision; extreme fatigue; loss of balance; problems with co-ordination; stiffness of muscles; speech problems; short-term memory problems, and even partial or complete paralysis. The MS Society provides services to people with MS and their families as well as research funding to help find the cause and cure.

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Local Teen to Walk 1500 Miles for a Cure

A local teenager is taking his first steps to a cure, walking more than a thousand miles from Idaho Falls to Chicago.

Nineteen-year-old John Crum taking his journey to make a statement and raise money for multiple sclerosis, a disease his mother's been diagnosed with.

Crum says people are aware of multiple sclerosis, but he wants the entire nation to recognize the disease.

So with each footstep, Crum puts his energy into finding a cure.

"One step at a time is all it takes."

And at four miles an hour, John Crum estimates it will only take him 43 days to hike it all the way to Chicago.

He's stepping up to find a cure for multiple sclerosis, a condition that attacks your immune system.

His mom has been struggling to fight off M.S. for close to 12 years.

"I always see how much she's in pain.  Some mornings she can't even get out of bed because she feels like she's been hit by a freight train, and I can't imagine that.  I don't know about anyone else," Crum explained.

He looks like he's about to go on a backcountry camping trip, but in reality he's making a cross country statement attempting to raise a million dollars to put towards M.S. research.

And on his 1500-mile journey, he's cutting donors a deal.

"I was hoping for people to donate 20 cents for every mile that I walk for up to 1000 miles," Crum said.

His 60 pound bag is filled with all sorts of necessities: sunscreen, mace, sandals, so his feet can breathe, emergency meals called M.R.E.'s in case he can't make it to town for a night.

As he walks the sounds of speeding traffic rattle through his head, but Crum finds his peace with an I-pod, relaxing to Enya.

"It's just basically like just keep going you have to keep looking forward you have to keep going to what you haven't done and get it completed just one step at a time is all it takes."

After only 20 miles, Crum says he's already been offered a couple of rides.
He says he kindly refused because he has to do this on his own.
Visit John's Website:

http://main.nationalmssociety.org/site/TR?pg=fund&fr_id=7540&px=5064157&JServSessionIdr009=8ha3wido51.app329b

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Cancer Drug Appears to Help With Aggressive MS
Use of cyclophosphamide sees 87% improvement in physical, mental function, study says

June 12, 2008

High doses of a drug used to fight cancer may reduce disease activity and disability in people with aggressive multiple sclerosis, results of a small trial suggest.

In relapsing-remitting MS, the most common type of the disease, patients experience periods of symptoms followed by stretches of symptom-free remission when they used the immunosuppressant drug cyclophosphamide.

In the two-year open label trial that included nine patients with aggressive relapsing-remitting MS, six men and three women with the average age of 35, received 50 milligrams per kilogram per day of cyclophosphamide intravenously for four consecutive days.

After an average of 23 months follow-up, the patients experienced an average 39.4 percent reduction in disability and an 87 percent improvement on scores of physical and mental function. MRI imaging showed a decrease in the average number of MS-related brain lesions, from 6.5 to 1.2 lesions.

"High-dose cyclophosphamide (sold commercially as Cytoxan or Neosar) induced a functional improvement in most of the patients we studied," wrote lead author Chitra Krishnan of the Bloomberg School of Public Health at Johns Hopkins University in Baltimore, Md. "In many of those patients, the functional improvement was sustained through the length of the study (up to 24 months) despite the absence of any immunomodulatory therapies beyond the initial high-dose cyclophosphamide treatment," she concluded.

The study was published online this week in the journal Archives of Neurology and was expected to be in the August print issue.

Cyclophosphamide has been used in combatting a number of cancers, including lymphomas, multiple myeloma, leukemia, mycosis fungoides, neuroblastoma, ovarian carcinoma, retinoblastoma and breast cancer. The drug affects the function of immune cells known as T and B cells.

Multiple sclerosis is an inflammatory disease in which the protective coating covering nerve cells degenerates. Autoimmune dysfunction -- in which the body attacks itself -- is believed to be linked with MS.

"This immunoablative regimen (an immune-related therapy involving the destruction of a cell population) of cyclophosphamide for patients with aggressive MS is worthy of further study and may be an alternative to bone marrow transplantation," the study authors concluded.
More information

The U.S. National Institute of Neurological Disorders and Stroke has more about multiple sclerosis.

http://health.usnews.com/articles/health/healthday/2008/06/12/cancer-drug-appears-to-help-with-aggressive-ms.html

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The VOLANT Charitable Trust

This Trust was set up by the author J K Rowling to support charitable causes.

The Trust has two broad areas of funding:

    * Research into the causes, treatment and possible cures of Multiple Sclerosis.

      The Trust is currently committed to funding several long-term research projects of this type and is not considering further applications for funding in this area at the present time.
    * Charities and projects, whether national or community-based, at home or abroad, that alleviate social deprivation, with a particular emphasis on women’s and children’s issues.
http://www.volanttrust.com/

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MS Patients at Higher Risk for Restless Legs Syndrome
But more study is needed to confirm the link, one expert said

June 28, 2008~People with multiple sclerosis are at a greater risk than the general population for developing restless legs syndrome (RLS), a new Italian study suggests.


"This is important, because RLS is one of the symptoms that can seriously affect an MS patient's quality of life, even more than a lot of other problems MS patients face," said lead researcher Dr. Giovanni Cossu, a neurologist at Brudzu Hospital in Cagliari, Italy. "Therapies for RLS [such as] dopamine agonists are normally very effective and can restore this quality of life, " he added.

Cossu and his colleagues were expected to present their findings this week at the Movement Disorder Society's International Congress of Parkinson's Disease and Movement Disorders, in Chicago.

The authors delved into a possible association between MS and RLS by analyzing questionnaires completed by a little more than 200 Italian male and female MS patients throughout 2007, as well as a similar number of people without MS.

Those indicating symptoms of possible RLS were further examined by a neurologist.

According to the study, almost 15 percent of the MS patients were diagnosed with RSL, while less than 3 percent of those without MS had the syndrome.

Based on these results, MS patients run a significantly higher risk for RSL than the general population, the team concluded. They said MS should be "definitively" noted as being highly associated with RSL.

Cossu said that further research -- focused on crunching MRI and neurological data -- is ongoing in order to "better define the clinical profile of those MS patients who are also likely candidates for RLS."

However, Dr. John Richert, executive vice president of research and clinical programs with the National Multiple Sclerosis Society, New York City, expressed some reservations about the findings.

"A lot of people with MS have involuntary movement of the legs, related to spasticity and jerks during sleep," he observed. "So, my question would be whether or not there is any confusion on the part of the investigators as to what is actually RSL versus what is the kind of abnormal movement that MS patients can have that is not RSL? And so, it would be important to see this study replicated by MS experts to be sure what were looking at."

"But if we assume that this finding is, in fact, accurate, then the obvious message would be that health care professionals taking care of patients with MS need to be alert to the possibility that their patients may be experiencing symptoms of RSL," added Richert. "And be ready to apply the appropriate therapeutic options."

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Coffee could help beat MS: study

July 1, 2008


A strong cup of coffee may do more than just wake you up in the mornings. It could also help you stave off multiple sclerosis (MS), according to a new study.

Scientists in Oklahoma found that mice which had been immunized to develop an MS-like condition appeared to be protected from the disease by drinking the equivalent of six to eight cups of coffee a day.

"This is an exciting and unexpected finding, and I think it could be important for the study of MS and other diseases," said Linda Thompson, from the Oklahoma Medical Research Foundation who worked in collaboration with Cornell University and Finland's University of Turku.

Caffeine prevented adenosine, one of the four building blocks in DNA, from mixing with its receptor in mice.

Adenosine is common molecule in humans and plays a large role in helping to control the biochemical processes for sleep and suppressing arousal.

When the molecule is blocked from binding with its receptor, the body's infection-fighting white cells cannot reach the central nervous system and trigger the reactions which lead to experimental autoimmune encephalomyelitis, or EAE, the animal form of MS.

The findings could have important implications for other auto-immune diseases such as lupus and rheumatoid arthritis, in which the body's own defense systems turn against itself.

But Thompson, co-author of the study in the Proceedings of the National Academy of Sciences, warned there was a lot more work to be done in fighting multiple sclerosis, a debilitating and progressive disease in humans.

"A mouse is not a human being, so we can't be sure caffeine will have the same effect on people prone to develop MS without much more testing," she said.

Further retrospective studies to track the caffeine intake of patients with MS and its effects might be the next major step.

"If you found a correlation between caffeine intake and reduced MS symptoms, that would point to further studies in humans," Thompson said.

Some 2.5 million people worldwide are thought to suffer from MS, a disorder of the central nervous system which leads to loss of muscle coordination.
source:AFP

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Society for Women’s Health Research
July 4, 2008

 There are approximately 400,000 people with multiple sclerosis (MS) in the United States today with 200 new patients diagnosed every week.

“No one knows what causes MS,” said Phyllis Greenberger, M.S.W, president and CEO of the Society for Women’s Health Research, a Washington, D.C. based advocacy organization. “We do know that it is at least 2-3 times more common in women than in men.”

Greenberger addressed congressional staff members on Capitol Hill at an educational briefing sponsored by the Society and the National Multiple Sclerosis Society on June 24.

“We regularly hold briefings for members of Congress and their staff,” Greenberger said, because their decisions determine how many federal dollars are devoted to searching for new treatments and cures.

Multiple sclerosis is an autoimmune disease that affects the central nervous system (CNS), which is made up of the brain, spinal cord and optic nerves.

“Normally, the immune system defends the body against foreign invaders, such as viruses or bacteria,” said Heidi Crayton, M.D., medical director of the MS Center of Greater Washington and an assistant professor of neurology at Georgetown University Hospital. “Instead, with the case of MS, the body’s immune system attacks the nerves.”

Crayton said MS is an inflammatory demyelinating disease of the CNS. In simple terms, that means MS causes inflammation throughout the CNS, which damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down or blocks messages between your brain and your body, leading to the symptoms of MS.

The symptoms of MS can vary greatly from patient to patient depending on which part of the CNS has been damaged. Symptoms can include:

• Vision problems
• Numbness and tingling in one’s hands and feet
• Difficulty thinking
• Bladder and bowel problems
• Weakness or poor coordination, and
• Muscle rigidity or stiffness

Henry McFarland, M.D., chief of neuroimmunology at the National Institute of Neurological Disorders and Stroke, spoke at the briefing about advances in MS research. Researchers have decided the main elements that contribute to an individual developing MS are the individual’s genetics and environment.

“Several studies show strong evidence of a genetic component to MS,” McFarland said. “Also, researchers discovered a genetic marker for MS in 2007.”

A positive test for this gene suggests that a person is susceptible to developing MS. It does not mean the person will definitely receive a diagnosis in the future.

Sarah Keitt, of Woodbridge, Va., provided a patient’s perspective on MS. In April 2000, she was diagnosed with relapsing-remitting multiple sclerosis, which is one of four internationally recognized forms of MS.

“When I received my diagnosis of MS,” Keitt said, “I felt that life as I knew it was coming to an end. As time went on, I discovered I was right. My life isn’t the same as if I didn’t have MS, but it is just as fulfilling.”

As a patient advocate with the National Multiple Sclerosis Society, Keitt often participates in forums to educate the public about MS. “I don’t stand up and give a sob story about living with MS,” she said. “I like to focus on the fact that I have a wonderful, supportive husband, two beautiful daughters and a very full life.”

Because of improved methods to limit disability, such as physical therapy, and treatments for complications of disability, the life expectancy of individuals with MS is now nearly the same as that of unaffected people.

Crayton noted that the FDA has approved five medications specifically for MS. “My patients and I work together to find the treatment options that work best for their specific symptoms,” she said.

“I tell my patients to make their life decisions as though they didn’t have MS,” Crayton said, emphasizing that patients can have full, productive lives, while working with their health care providers to manage their disease.
url back track www.newswire.com
On the Net:
Multiple Sclerosis Society: http://www.nationalmssociety.org

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