What is MS and is there a cure? – Telegraph.co.uk

Oct 8th, 2019

Until 1993, multiple sclerosis (MS) was untreatable. Thanks to incredible research developments, a range of options exists today for many who are diagnosed. But with lots of people still without treatment, the MS Society plans to take its research discoveries and transform them into new treatments that slow or even stop disability progression in the future.

MS is a condition that affects more than 100,000 people in the UK and is almost three times more common in women than men. In people with MS, the immune system mistakenly attacks a fatty substance called myelin the protective coating around the nerves in the brain and spinal cord. The damage caused disrupts the messages that travel along your nerves and so it can affect how you see, move, think and feel, depending on which part of the central nervous system is being attacked.

The cause is not known, but may be a combination of genetics and environmental factors. It may also be influenced by lifestyle, including smoking, being very overweight or low in vitamin D. People are most likely to experience first symptoms in their twenties and thirties, but these can also appear later in life.

There are three types of MS relapsing, primary progressive and secondary progressive. If you have relapsing MS, there will be times when symptoms are not as bad or you are symptom-free. About 85 per cent of people have this type at diagnosis, but it often turns into secondary progressive MS where the disability gets steadily worse. With primary progressive MS, the symptoms become worse over time, often without relapses.

There is a wide range of symptoms and not everyone will have all of them. Common symptoms include loss of balance and dizziness, stiffness or spasms, tremor (rhythmic trembling or shaking), fatigue, pain, bladder problems, bowel trouble, such as constipation and bowel incontinence, vision problems and difficulties with memory and thinking. If you are concerned that you have MS, see your GP as a starting point. They will not be able to give you an instant diagnosis if MS is a possibility, you would see a neurologist for further investigations, such as blood tests and MRI scans.

MS is a lifelong condition, there is no cure but there are ways to manage the symptoms.For people with relapsing MS, there are treatments called disease-modifying therapies (DMTs) that can help reduce the severity and frequency of relapses by reducing inflammation in your nerves. On the whole, DMTs have not been shown to work for people with primary progressive MS, with just one exception.

Symptoms can be managed with other interventions such as physiotherapy, cognitive behavioural therapy, exercise and a healthy, balanced diet. For secondary progressive MS, no treatments are licensed for use in Europe, however one has been shown to be modestly effective and will be going through the licensing process soon. The MS Society is funding a Phase 3 trial of a high-dose statin that shows promise for slowing its progression. The trial finishes in 2023.

The MS Society has channelled 220million into research since 1956, and is at the forefront of funding research into how disability caused by the condition can be slowed or even stopped. The advances that have been made are incredible, says Professor Alan Thompson, consultant neurologist at the National Hospital for Neurology and Neurosurgery in London and dean of UCLs Faculty of Brain Sciences. Twenty-five years ago, MS was an untreatable condition, but now we have a wide range of options available. There are few neurological conditions in which treatment has changed so dramatically over a relatively short period of time.

The use of magnetic resonance imaging (MRI) for scanning the brain, first employed in 1981, was a major step forward. For the first time, we could witness in real time what was actually happening inside the brain, says Professor Thompson. MRI allowed us to see which part of the nervous system was being attacked in the early stages, to monitor the progress of the disease and to study whether or not drugs were working long before the patient could report any changes.

DMTs, the drugs now used widely as a treatment for relapsing MS,are also a relatively recent development, with the first being licensed in 1995. In the late 80s, researchers were studying medications that produced a mild improvement in the early stages of the disease, says Professor Thompson. But they continued to discover other, more powerful drugs. Now we have a wide range of life-changing DMTs to offer.

Another vital area of research is myelin repair looking at ways to regenerate and protect the fatty coating to our nerves that comes under attack in MS. In 2005, the MS Society Cambridge Centre for Myelin Repair opened. Myelin repair (or remyelination) is an extremely challenging area and this centre brought the worlds top academics in to work on it, says Professor Thompson. It is leading the world in remyelination research. The MS Society Tissue Bank, which houses one of the largest collections of brain tissue samples in the world, has also made a huge contribution to research around the world.

Treatment for progressive MS is a pressing issue because we have just two drugs available and theyre only mildly effective, says Professor Thompson. Leading experts from across the world have come together in the International Progressive MS Alliance and theyre seeking to understand the different players at a cellular level, such as mitochondria and microglia. That will lead to better targets for treatment and, one day, the prevention of the disease progressing.

The other exciting area of research is precision or personalised medicine being able to take a detailed profile of a patient, their genetics, blood, MRI scans and environmental factors, and using that to tailor treatment, says Professor Thompson. Were able to treat effectively now, but this will be a different level of sophistication.

This article is brought to you by the MS Society and Telegraph Spark. The MS Society believes that with investment, MS can be stopped. Scientists can see a future in which no one with the condition need worry about it getting worse. But action is needed now.

Donate today and help the MS Society raise 100million to find treatments for everyone. Visit mssociety.org.uk/stop-ms-now

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What is MS and is there a cure? - Telegraph.co.uk

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