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MS news archive February 2016

Biomarkers may predict MS progression (25/02/16)
The degree of meningeal inflammation and cortical pathology might prove useful for stratifying patients with early progressive multiple sclerosis (MS), new research suggests.

The findings, from European investigators, evaluated gene and protein expression in cerebrospinal fluid (CSF) and correlated the profiles with cortical damage as visualized by neuropathology and by MRI.

"Different CSF molecular profiles are associated with specific levels of gray matter (GM) damage, thus suggesting that this may represent a useful approach for patient stratification at disease onset, and for individualising therapy," said Roberta Magliozzi, MD, from the University of Verona, Italy, and Imperial College London, United Kingdom.

Dr Magliozzi and senior investigator Richard Reynolds, MD, also from Imperial College London, described the findings here at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2016.

In an interview with Medscape Medical News, Dr Reynolds explained the study. "We are trying to identify markers in the CSF of patients that will predict who will progress more rapidly."

"We started with post mortem findings in patients who did progress rapidly and had more brain damage. We saw an increase in certain immune-related molecules.

"Then we came back to the patient studies, and we could already see some of those changes at an earlier stage.

"We analysed these by combining imaging measures of grey matter damage with the immune profile. We saw that with more grey matter damage, there was an increase in the same molecules we saw post mortem."

In her presentation, Dr Magliozzi noted that GM damage provides the best correlate of the variable accumulation of physical and cognitive deficits and is one of the main substrates of disability progression in MS.

"The changing clinical course of MS is a matter of grey matter," she commented.

Source: Medscape Multispeciality Copyright © 1994-2016 by WebMD LLC (25/02/16)

New protein identified as target of autoantibody production (25/02/16)
Researchers have identified the chloride-channel protein anoctamin 2 (ANO2) as a new target for autoantibody production in multiple sclerosis (MS) patients.

The study, Anoctamin 2 Identified As An Autoimmune Target In Multiple Sclerosis, was published in the Proceedings of the National Academy of Sciences of the United Sates of America (PNAS) journal.

A team of researchers at the Royal Institute of Technology (KTH) in Stockholm, Sweden, and colleagues tried to identify the autoantibody repertoire (an autoantibody is produced by the immune system and directed against one or more of an individual’s own proteins) in MS by screening 2,169 plasma samples from MS patients and population-based controls.

The screen was based on a list of antigens previously identified by the team, but also included proteins associated with MS risk, such as Epstein–Barr virus nuclear antigen-1 (EBNA-1), and the potassium channel protein KIR4.1 That channel has been previously proposed as an autoimmune targets in MS.

An increased production of autoantibodies against the chloride-channel protein anoctamin 2 (ANO2) was identified in the MS population compared to the control group. ANO2 has never been reported as an autoimmune target in MS. Moreover, they observed a strong interaction between the presence of ANO2 autoantibodies and the HLA complex MS-associated DRB1*15 allele, one of the strongest genetic risk factors for MS.

Looking at human MS brain tissue, the team also observed that ANO2 was expressed in small cellular aggregates located within or near MS brain lesions.

In conclusion, the study represents one of the largest reports investigating the autoantibody repertoire in MS, supporting a potential role for ANO2 autoreactivity in MS patients. The research team highlighted that future studies should further investigate the pathogenic role of ANO2 autoantibodies in MS.

Source: Multiple Scelrosis News Today © Copyright 2014 - 2016 BioNews Services, LLC (25/02/16)

MS ‘unrelated to concentrations of radon gas’ (24/02/16)
Researchers at the University of Northampton’s Radon and Natural Radioactivity Research Group (RNRRG) have developed a method to study whether radon gas, an invisible and radioactive gas known to cause lung cancer, might be a contributing factor in multiple sclerosis. They concluded that the link between the two was weak and not statistically significant.

The U.K. study, Is Environmental Radon Gas Associated With The Incidence Of Neurodegenerative Conditions? A Retrospective Study Of Multiple Sclerosis In Radon Affected Areas In England And Wales, was published in the April issue of the Journal of Environmental Radioactivity.

To explore the geographical link between domestic radon gas concentration and MS incidence, the research team looked at five per cent of the English population over the course of eight years (2005–12), a study population comprising over 20 million person-years of clinical monitoring and representing a mean annual population of 2.5 million individuals. The groups were studied using an England and Wales clinical extraction database, The Health Improvement Network (THIN).

The main finding of the study was that, even though a weak correlation between raised domestic radon concentration and a risk of developing MS could be seen, the correlation was modest and statistically insignificant, and could be attributed to coincidence. However, researchers are confident that the methodology the RNRRG team developed may be useful in future studies with large patient numbers, such as the proposed U.K. national patient database.

University of Northampton funded the majority of the research project, through the Research Excellence Framework grant scheme in 2013, with an extra help from Northamptonshire NHS.

“This paper is a culmination of over ten years collaboration between the School of Science and Technology, the School of Health, local and national NHS institutions and the team managing the clinical database, to develop a viable methodology for such analyses. We look forward to extending our work when larger patient databases become available,” Tony Denman, an emeritus professor of medical physics, said in a press release.

Source: Multiple Scelrosis News Today © Copyright 2014 - 2016 BioNews Services, LLC (24/02/16)

Aging ovaries may signal imminent MS progression (23/02/16)
In women with multiple sclerosis (MS), ovarian aging is associated with a reduction in gray matter volume and higher levels of disability, independent of chronologic age and disease duration, a new study suggests.

Jennifer S. Graves, MD, from the University of California, San Francisco (UCSF), School of Medicine, has now reported that lower levels of anti-Müllerian hormone (AMH), a marker of fertility, may herald the onset of disability.

"The advantage of a marker like AMH is that it's starting to capture this biological transition in a very early stage, even before women have perimenopausal symptoms and before they develop progressive disease," she said.

"This biomarker could let you know if there are imminent changes in the biology of the disease, and this could help you determine if it's time to change the focus of treatment."

The findings were presented at Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2016.

"We know women have more relapses and inflammation, but men may have earlier or faster progression. After the age of 50, however, we see less 'dimorphism' and women 'catch up' to men in terms of disability," Dr Graves said.

The age at which disability starts to accelerate, therefore, seems to correspond to the perimenopausal period. The mean age of onset of primary progressive and secondary progressive MS is approximately 45 years, she pointed out.

The effects of age and sex differences are "conspicuous-looking" enough to suggest that "ovarian aging may have a role in the transition of phenotype for women with MS," she said.

Dr Graves and her colleagues, therefore, examined whether ovarian aging might contribute to the development of progressive disease, specifically whether AMH levels were associated with clinical disability or brain atrophy. To do so, they looked at levels of AMH, which explains more than 80% of the variability of age of menopause and serves as a surrogate for ovarian reserve in fertility clinics.

Ovarian reserve is an early marker of the aging process that is more specific than chronologic age. Follicular cells have 10 times the mitochondria and are more sensitive to stress than other cells, she noted.

The study presented here included 412 women with MS and 180 healthy controls from a longitudinal cohort at UCSF. Median age was approximately 44 years, median disease duration was 6 years, and median Expanded Disability Status Scale score (EDSS) was 1.5.

The women had up to 10 years of follow-up, including scoring on the Multiple Sclerosis Functional Composite (MSFC) and the EDSS along with periodic MRI. Their AMH levels were measured on stored plasma samples from baseline, year 3, year 5, and years 8 to 10.

"We first asked whether AMH behaves the same in MS patients as in healthy controls, and we found no differences after adjusting for age, body mass index [BMI], birth control and smoking," Dr Graves reported.

AMH levels were similar in patients with MS and controls, implying normal follicular reserve and rate of ovarian decline.

"This is what we expected. The results further support the finding that fertility is normal in women with MS," she added.

However, the investigators did find a relatively strong association between AMH levels and the two disability metrics. Decline in ovarian reserve, as determined by a two-fold decrease in AMH level, was significantly associated with both EDSS and MSFC after adjustments for chronologic age, she reported.

Similar associations between baseline ovarian reserve and several MRI metrics were also observed, especially a strong association between gray matter metrics and, to a lesser degree, an association with total brain volume.

When disease duration and BMI were added to these analyses, "slight shifts in the magnitude" of the associations were seen but the patterns were consistent, she said.

For the longitudinal analysis, the investigators constructed a multivariable random-intercept/random-slope model that allowed them to use all observations over time, with both within- and between-subject comparisons, adjusting for age. They observed the same pattern of a strong association between reduced AMH and the clinical metrics of disability and the gray matter metrics on MRI; no association was seen with white matter or T2 lesion volume.

Source: Medscape Multispeciality Copyright © 1994-2016 by WebMD LLC (23/02/16)

More work needed say stem cell researchers (23/01/16)
Dr Andrew Goodman of the University of Rochester, has told the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) in New Orleans that stem cell therapies, while promising, are not yet ready for widespread clinical use.

Dr Goodman, a professor of Neurology, chief of the Neuroimmunology Unit, and director of the Multiple Sclerosis Centre at the university, reviewed current stem cell therapy approaches, including the use of “hematopoietic stem cell reconstitution following immunoablation, mesenchymal stem cells, and oligodendrocyte precursor cells” in a presentation titled “Stem Cell Therapy for MS.”

Numerous issues still need to be answered regarding the safety and effectiveness of stem cell therapy, Dr. Goodmand said, such as understanding whether immune system restoration via stem cells should be combined with transplantation of nervous system cells, specifically oligodendrocytes and neurons. Goodman also considered whether autologous (self-derived) stem cells should be used, or if they may have intrinsic deficiencies, since they come from a person with a neurodegenerative disease.

Dr Goodman said: “Several types of cell-based therapeutic strategies are under investigation, with different risks, benefits, and goals. Some of these strategies show promise but significant methodological questions need to be answered. Stem cell transplantation is not yet appropriate for general use to treat MS.”

One issue Dr Goodman highlighted was the need for extensive genetic screening of cells to assure that possible cancer-causing mutations are not introduced.

Source: Multiple Sclerosis News Today © Copyright 2014 - 2016 BioNews Services, LLC (23/01/16)

High Biotin dosage ‘benefits progressive MS patients’ (23/02/16)
New research claims to have discovered that high doses of biotin improve neurologic function in a small percentage of patients afflicted with progressive MS.

To determine the efficacy and tolerability of high dose biotin in persons with progressive MS, Gary Birnbaum, MD, Minneapolis Clinic of Neurology, and colleagues evaluated three groups of patients with clinically definite MS:

1. Those with relapsing disease well controlled on disease-modifying therapy yet having progressive disability
2. Patients with secondary progressive MS, no longer on disease-modifying therapy
3. Patients with primary progressive disease

At the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2016 Forum, Birnbaum shared findings from their latest study.

The team prescribed each patient to take one capsule per day of a 300mg dose of pharmaceutical grade biotin. The researches cautiously monitored neurologic exams and blood work for toxicity at baseline and at three-month intervals.

A total of 21 patients were treated – 11 with secondary progressive MS, four with primary progressive MS, and six with stable relapsing remitting, yet progressive MS. Also, 10 patients were on several disease-modifying therapies.

The tests and MRI results showed no serious adverse event, and one patient’s EDSS scores were even reported to improve. Furthermore, another patients noted significant improvement in energy with a 10 per cent improvement in 25-foot timed walk.

According to the findings, “High dose biotin, administered daily to persons with progressive MS is well tolerated and results in improvement of neurologic function is a subset of such individuals, “ concluded the authors.

Source: MD All Specialties Copyright MD Magazine 2006-2015 Intellisphere, LLC (23/02/16)

MS patients willing to change diet, survey finds (22/01/16)
Obesity, along with the composition of the microbiome in the gut, have been suggested as being elements that may contribute to the risk of Multiple sclerosis (MS).

In a study presented at the ACTRIMS Forum in New Orleans, University of Virginia researchers J. Nicholas Brenton and colleagues found that MS patients surveyed said overwhelmingly that they would be willing to modify their diet in an attempt to improve or treat their illness.

The study involved a survey mailed to 604 MS patients at the University of Virginia’s MS clinic.

Of those who received it, 199 subjects returned the survey, of whom 70 per cent were women with a mean disease duration of 12 years.

Most (71.4 per cent) had relapsing-remitting MS.

The respondents had generally not tried to change their diets as therapy; only 17 per cent said they had done so.

But 91.5 per cent said they would like to try that therapy and that willingness was not affected by age, gender, disease duration BMI, current diet, MS subtype or other factors.

Asked which diet they wanted to try, most chose paleo (53.8 per cent). High carbohydrate, low salt, modified Atkins were next popular, chosen by a range of 41 per cent to 48 per cent of respondents; vegetarian and vegan options were the least popular.

The authors said the survey’s positive findings should be useful to researchers who want to test the effectiveness of diet-modification in treating MS.

Source: MD All Specialties Copyright MD Magazine 2006-2015 Intellisphere, LLC (22/02/16)

'Better measure' for disease progress offered (22/02/16)
Researchers at the National Institutes of Health in Bethesda, MD, have reported at the ACTRIMS Forum in New Orleans on the effectiveness of 58 measurements of patients’ disease status.

Those measurements included clinical, electrophysiological, optical coherence tomography, and MRI outcomes.

Reporting in an abstract, they offered findings.

Eleven out of 58 tested measures demonstrated significant disease progression over one year.

“Surprisingly, MRI markers did not provide a significant benefit over clinical scales, had limited and poorly-validated correlations with clinical scales, and general low signal-to-noise rations,” the team noted.

Clinical measures were more accurate than the MRIs, they wrote.

“A better performance of the clinical measures and the fact that each of them reflects a somewhat different disability domain” led the researchers to use mathematical modeling to develop a new scale they called CombiWISE, for combinatorial weight-adjusted disability score.

That score uses the expanded disability status scale, Scripps neurological rate scale, the performance on a 25-ft. walk and nine-hole peg test.

“CombiWISE outperformed all tested biomarkers, correlated strongly with standard disability measures” and also required fewer subjects per arm to detect the effectiveness of therapeutic drugs. The authors said their new scale “shows high sensitivity for longitudinal change” in tracking patients’ illness.

Source: MD All Specialties Copyright MD Magazine 2006-2015 Intellisphere, LLC (22/02/16)

Robotic exoskeleton may help multiple sclerosis patients to walk (22/01/16)
Walking with a wearable robotic exoskeleton may enable people with multiple sclerosis to walk more efficiently by reducing the energy and muscle activity needed to do so, according to research presented this week at the Association for Academic Physiatrists Annual Meeting in Sacramento, Calif.

The suits are designed to facilitate walking in people with neurological conditions, but few studies have been conducted to evaluate the amount of assistance they can provide when walking. Researchers from The University of Texas Health Science Center at Houston (UTHealth), TIRR Memorial Hermann and Texas Women's University recently studied the feasibility and effectiveness of using an exoskeleton to help people with MS walk.

The researchers studied a 33-year-old female with relapsing-remitting MS who had a score of 6.0 on Expanded Disability Status Scale. This scale quantifies disability in MS based on a scale of zero (no disability) to 10 (death due to MS). The participant received 12 training sessions in exoskeleton-assisted walking and was then asked to perform a series of tests at the end of her training: a timed up-and-go (or TUG) test, which measured the amount of time it took her to go from a sitting to standing position, walk three meters, turn around, return to her chair and sit back down; a 25-foot walking test at both a self-selected and fast pace; and a six-minute walk. For all tests, the researchers assessed the amount of energy expended as well as the muscle activity in both the upper and lower body. The results of these tests were compared to the results of the same tests completed at the end of the study without the exoskeleton.

"Our study participant told me when she was in the study, 'I am looking at the quality of the rest of my life, not quantity of the days I can live,' explains Shuo-Hsiu "James" Chang; assistant professor at UTHealth; Neurorecovery Research Center at TIRR Memorial Hermann; and lead investigator in the study. "It is a strong message telling us that rehabilitation plays a critical role in helping people with MS to live better quality lives. I believe exoskeleton-assisted training and walking is one of the most effective strategies that can promote quality of life and community reintegration in this population."

During the six-minute walking test, the participant maintained an approximately six percent lower heart rate and required 7.5 percent less oxygen to complete the test in the exoskeleton when compared to walking without it. However, during the 25-foot walking test at a fast speed, the participant's heart rate was 10 percent higher and oxygen consumption was three percent higher when wearing the exoskeleton. Finally, the researchers noticed all muscles in the lower body — with the exception of the semitendinosus, one of three hamstring muscles — showed less activity during the 25-foot walking test at a self-selected speed and the six-minute walking test when assisted by the exoskeleton. And, similar to energy expended, muscle activity increased during the 25-foot walking test at a fast pace in the exoskeleton. When attempting the TUG test, the participant found it difficult to operate the exoskeleton.

"To promote walking for people with MS, we need to be creative and develop novel strategies. Wearable exoskeletons offer the feasibility of assisted overground walking and may be effective assistance devices to promote efficient walking, and better quality of life," says Dr. Chang, who notes the wearable exoskeleton is one of the advanced technologies that could further promote effectiveness of rehabilitation strategies.

"We need to conduct more studies - such as larger trials with larger populations (looking at MS, stroke and other diseases and conditions) and effectiveness studies - to perform a systematic investigation and analysis that studies effectiveness of exoskeleton-assisted rehabilitation in MS," says Dr. Chang. "In our research center, we have another ongoing exoskeleton study that is designed to develop an algorithmic-based evaluation and treatment approach for wearable exoskeleton-assisted rehabilitation that focuses on physiological changes and gait in patients with stroke, spinal cord injuries and MS. We expect the results will help us to understand better how we can utilise exoskeletons and design effective exoskeleton-assisted rehabilitation programs."

Source: News-Medical.net Copyright AZoM.com Limited Copyright 2000-2016 (22/02/16)

Nanomedicines are focus of new approach (22/02/16)
Parvus Therapeutics has announced the publication in Nature of a paper describing the discovery and applications of a novel therapeutic approach employing nanomedicines, referred to as Navacims, to reprogram white blood cells to become regulatory cells capable of blunting autoimmune responses and restoring the equilibrium of the immune system.

Navacims are nanoparticles (NPs) coated with disease-relevant peptide-major histocompatibility complexes (pMHCs) that alter the behavior of pathogenic T lymphocytes by binding directly to their antigen receptors. The peer-reviewed article, titled Expanding antigen-specific regulatory networks to treat autoimmunity reports on a body of work, including results in multiple in vivo disease models, built on more than eight years of research by Parvus Founder and Chief Scientific Officer, Pere Santamaria, M.D., Ph.D.

Dr. Santamaria said: “Autoimmune diseases, including type 1 diabetes, multiple sclerosis, and rheumatoid arthritis, are extraordinarily complex responses of our immune system against some of our own tissues (e.g. pancreas, brain and joints, respectively), leading to chronic organ inflammation, organ dysfunction, and, in some cases, premature death. Blunting these incompletely understood immune responses without suppressing the normal components of our immune system that protect us against infection and cancer is not currently possible.

"However, our work offers a pharmaceutical solution to this fundamental problem.

"Navacims essentially re-program disease-causing white blood cells to become disease-suppressing cells, known as regulatory cells, leading to sustained therapeutic effects in various spontaneous and experimental autoimmune diseases, as reported in our article in Nature. Essentially, we have found that Navacims can be tailored to treat a wide range of autoimmune diseases, while sharing a common structure. Importantly, they have been shown to affect human white blood cells in the same manner as they do murine cells. Furthermore, Navacims have shown promising safety findings in preclinical in vivo models. Based on our results to date, we believe Navacims represent a therapeutic platform with broad-ranging health care implications."

Source: News-Medical.net Copyright AZoM.com Limited Copyright 2000-2016 (22/02/16)

Potential new therapeutic for Relapsing MS patients (19/02/16)
RADIANCE phase 2 trial of ozanimod, an investigational selective S1P 1 and 5 receptor modulators for relapsing multiple sclerosis (MS) patients results showed significant reductions in the cumulative number of total gadolinium-enhancing (GdE) lesions.

Experts shared their research results at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2016 Forum. In the 48-week blinded extension part of the study, the patients who were initially randomised to ozanimod continued their assigned dose of 0.5mg, while patients in the placebo group were randomised to either 0.5mg or 1mg dose of ozanimod.

For patents administered ozanimod consistently through week 72, the proportion of patients who were GdE lesion free at week 72 was 73% for the 0.5mg group and 88% for the patients who received a dose of 1mg.

However, both doses saw a higher proportion of patients who were free of GdE lesions at week 24: 84% and 89%, respectively. This reported decrease in unadjusted annualised relapse rate (uARR) between weeks 24 and 72 persisted for all treatment groups, but was more prevalent within the group of patients who received the 1mg dose.

The most commonly reported non-laboratory treatment-emergent adverse events were minor infections: nasopharyngitis, upper respiratory tract, and urinary tract; back pain; and headache.

According to the authors, these data suggest ozanimod has the potential to provide a new oral therapeutic option for patients with relapsing multiple sclerosis who require therapies with “different benefit-risk profiles to help manage their chronic disease.”

Jeffrey Cohen, MD, Director of the Experimental Therapeutics Program, Cleveland Clinic's Mellen Center for Multiple Sclerosis Treatment and Research, commented, “The results of the phase 2 RADIANCE trial and extension support the efficacy and advantageous safety profile of ozanimod. The ongoing phase 3 RADIANCE and SUNBEAM trials are intended to confirm and extend those findings.”

Source: MD All Specialties Copyright MD Magazine 2006-2015 Intellisphere, LLC (19/02/16)

FDA grants ocrelizumab 'breakthrough therapy designation' for primary progressive MS (18/02/16)
Roche Holding AG announced yesterday that it had received 'breakthrough therapy designation' from the U.S. Food and Drug Administration for the multiple sclerosis treatment ocrelizumab. This will likely speed up market authorisation in six to seven months instead of the usual 10 to 12 months.

If positively assessed, ocrelizumab could go on sale in the second half of 2016.

Currently there are no approved treatments for PPMS, a debilitating form of MS characterised by steadily worsening symptoms and typically without distinct relapses or periods of remission.

Multiple sclerosis affects an estimated 2.3 million people around the world and there is currently no cure. The disease occurs when the immune system attacks the insulation around nerve cells in the brain, spinal cord and optic nerves.

Damage to these nerves can cause symptoms that include muscle weakness, fatigue and visual disturbances. A phase III trial of Ocrelizumab presented last year showed the treatment “significantly reduced disability progression,” Roche said.

Sandra Horning, Roche’s chief medical officer and head of global product development said, “With no approved treatments for primary progressive MS, ocrelizumab has the potential to address an important unmet need,” “We are committed to working with the FDA to bring ocrelizumab to people with primary progressive MS as quickly as possible.”

Roche plans to pursue marketing authorisation for the treatment of both PPMS and the more common form of MS, relapsing and remitting multiple sclerosis, and will submit data from three pivotal phase III studies to global regulatory authorities in the first half of 2016.

Source: The Wall Street Journal Copyright ©2016 Dow Jones & Company, Inc (18/02/16)

Can Zebrafish help in the fight against MS? (17/02/16)
Tiny zebrafish may help in new research into the cause of multiple sclerosis. It is hoped the translucent minnow-sized fish will help scientists discover how a protein found on the surface of immune cells causes them to attack the central nervous system (CNS) in multiple sclerosis by tracking a protein - named CD46 – which controls the movement of immune cells into the brain.

It is thought in MS CD46 may not be activated properly, but until now research has only been carried out in the laboratory, providing limited information.

Researchers will use zebrafish to learn more about immune cell activity by fluorescently ‘labelling’ the CD46 protein, making it easy to track inside the fish. Zebrafish are ideal for this study because of their transparency and their genetic similarities to humans.

The research team, led by Dr Anne Astier, will also look at whether vitamin D can influence the movement of the zebrafish’s immune cells into the brain. Research now indicates that a lack of Vitamin D may be linked to the developement of MS. Scotland has among the highest prevalence of MS in the world. Some experts have linked this to the lack of naturally occurring vitamin D because of the nation’s scarcity of sunlight.

Dr Astier commented: “We’re very excited to be involved in this new research as it will be the first time we can observe this protein operating in a living organism.

“By putting a fluorescent CD46 protein in this tiny fish - with the help of zebrafish specialist Dr Dirk Sieger - we’ll be able to observe how the protein operates. This could help us find a way to stop it functioning abnormally as observed in people with MS.”

Source: The Scotsman © 2016 Johnston Publishing Ltd (17/02/16)

Gene expression between men and women differs during relapse and remission in MS (15/02/16)
A new study in Spain has highlighted differing patterns of small non-coding RNA (sncRNA) molecules regulate relapse and remission in multiple sclerosis and that this differs between men and women.

The research team from the Biodonostia Institute, San Sebastian, Spain, wanted to explore if sncRNAs play an important role in this type of gene regulation and how it affects the cycles in relapsing-remitting MS (RRMS). They collected blood samples from 24 individuals with RRMS and an equal number of controls. Two blood samples were drawn from the MS patients, during remission and again during relapse.

The researchers isolated RNA from immune cells in the blood samples, and analysed the relative amounts of sncRNAs. Since rates and clinical features differ between men and women, the team analysed the results based on sex, but also analysed the group as a whole.

To exclude any possibility that MS treatment may induce changes in RNA levels, only patients who were receiving the same treatment in both groups were included in the comparison between those in relapse and those in remission. This resulted in two groups of patients — 13 receiving the same treatment during relapse and remission, and another 11 who received different treatment. When the team compared patients with healthy controls, all 24 MS patients were included in the analyses.

Investigating the expression of sncRNAs using a microarray, the team identified 23 sncRNAs that were dysregulated in relapse. The results, published in the journal Scientific Reports, also showed that when dividing the analysis by sex, 38 sncRNAs were differentially expressed in women and none in men. Likewise, the team observed 51 altered sncRNAs in remission when looking at all samples, as well as 42 in samples from women, and seven in samples from men.

The scientists hypothesised that if some of these sncRNAs were dysregulated in both relapse and remission states, these might be important for the biology of the disease. The team identified 10 sncRNAs that were common between relapse and remission states, and different from controls. When only including women, eight sncRNAs remained altered. Among these, almost all were dysregulated in opposite directions during remission and relapse.

The team then continued analysing possible biological pathways affected by these sncRNAs. Using databases and prediction algorithms, researchers created maps of how these factors interact with genes. They observed that in women during relapse, a number of biological processes seemed to be involved. Among these processes, the team noticed regulation of glucose and carbohydrate transport, biosynthetic processes of cell membrane lipids, control of cell division and of the interferon-gamma (IFN-γ) inflammatory signaling pathway, and a regulation of phosphate metabolic processes. In remission, the analysis indicated genes involved in the regulation and execution of innate immune responses, as well as homeostasis of several cell types.

Men, during remission, were of low complexity involving relatively few genes, with no particular biological processes over-represented among the genes, in contrast to the complex networks of genes and sncRNAs observed in women.

The study clearly showed that expression of sncRNAs vary between the different states of RRMS. Also, these differences are not the same for men and women, particularly in relapse, where men did not show any alterations of sncRNA expression. Sex hormones have been implicated in differences in sncRNA expression, and the results clearly show that sex need to be taken into account when treating MS patients. The opposite expression patterns seen in the two MS phases may also give researchers clues about the mechanisms involved in triggering relapse and remission states.

Source: Multiple Sclerosis News Today © Copyright 2014 - 2016 BioNews Services, LLC (15/02/16)

'Mini-brains' could reshape brain research, drug testing (15/02/16)

Researchers have created miniature human brains that contain a network of neurons and other cells and replicate the structure and functionality of the brain, to study the effects of neurological diseases.

The researchers say they can be mass produced in labs to allow new drugs to be tested for safety and effectiveness without the need for animals, which often do not mirror how human cells work. "And even though we are not balls of cells either, you can often get much better information from these balls of cells than from rodents".

According to an abstract published for the American Association for the Advancement of Science conference in Washington, DC, the researchers used a method developed in Japan to derive stem cells from skin samples. The 'mini-brains', just 350 µm across, consist of 10,000-20,000 individual brain cells and represents more or less a two-month-old brain of a foetus.

After cultivating the mini-brains for about two months, the brains developed four types of neurons and two types of support cells: astrocytes and oligodendrocytes, the latter of which go on to create myelin, which insulates the neuron’s axons and allows them to communicate faster.

The researchers could watch the myelin developing and could see it begin to sheath the axons. The brains even showed spontaneous electrophysiological activity, which could be recorded with electrodes, similar to an electroencephalogram, also known as EEG. To test them, the researchers placed a mini-brain on an array of electrodes and listened to the spontaneous electrical communication of the neurons as test drugs were added.

Study leader Thomas Hartung, professor of health sciences at the Bloomberg School, added that ninety-five percent of drugs that look promising when tested in animal models fail once they are tested in humans at great expense of time and money. The research could also create a breakthrough in personalized medicine as mini-brains can be grown from the skin samples of any person. It can help in the research on Parkinson’s disease, Alzheimer’s disease, stroke, multiple sclerosis and viral infections. The skin cells of several healthy adults were used to develop the mini-brains.

Source: Various (15/02/16)

Can brain cell death trigger multiple sclerosis? (12/02/16)
One trigger for multiple sclerosis (MS) might the death of brain cells that make myelin, according to a study published in the journal Nature Neuroscience.

Researchers from the University of Chicago and Northwestern Medicine developed genetically engineered mice models in order to investigate whether cell death could cause this autoimmune response.

The researchers used the mice to target the brain cells that make myelin, called oligodendrocytes. Then, the investigators killed the oligodendrocytes and observed the changes in the way the mice walked.

After the initial cell death, the central nervous system in the mice regenerated and the animals’ gait returned to normal. However, after 6 months, the MS like symptoms, including impaired walk, came back in the mice models.

“Although this was a study in mice, we’ve shown for the first time one possible mechanism that can trigger MS – the death of the cells responsible for generating myelin can lead to the activation of an autoimmune response against myelin,” study co-senior author Brian Popko, PhD said in a press release. “Protecting these cells in susceptible individuals might help delay or prevent MS.”

The researchers believe that oligodendrocyte death can be caused by a variety of factors, including developmental abnormalities, viruses, bacterial toxins, or environmental pollutants. For human patients, it may not be until years after an initial injury that the brain triggers oligodendrocyte death, the study authors hypothesise.

The study also allowed the researchers to test new drugs that work against progressive MS in the mice models. The researchers administered nanoparticles, which created tolerance to the myelin antigen in order to prevent progressive MS from continuing. The drugs that were tested are in the development stages for use in human patients.

“We’re encouraged that the nanoparticles could stop disease progression in a model of chronic MS as efficiently as it can in progressive remitting models of MS,” study collaborator Stephen Miller, PhD, added.

The results of this study offer the idea that MS might begin from the patients’ brains, regardless of their susceptibility to genetic predispositions, the authors continued in the statement. They explained that the damaged or dead oligodendrocytes might cause an outright immune response, causing demyelination and the continuation of the MS progression cycle. The researchers concluded by saying that the exact nature of this process in humans will be exciting to unravel as will the search for effective therapies.

Source: MD All Specialties Copyright MD Magazine 2006-2015 Intellisphere, LLC (12/02/16)

Study finds lipid antibodies reflect changes in brain volume and lesions (10/02/16)
Brigham and Women’s Hospital researchers are claiming that antibodies directed at lipids are associated with magnetic resonance imaging (MRI) measures of brain degeneration in patients with multiple sclerosis (MS), and may potentially serve as biomarkers for monitoring disease status.

While the hyperintense brain lesions detected by MRI are crucial for diagnosis and therapeutic monitoring, they have proven to be of little value in predicting disease progression. Measurements of brain atrophy might associate better with clinical status. Earlier studies have shown that atrophy in the brain’s grey matter is more closely linked to disease status than atrophy in its white matter, and that compartment-specific measures need to be used when analysing disease progression.

In the study “Serum lipid antibodies are associated with cerebral tissue damage in multiple sclerosis,“ researchers explored the possible relationships between immune factors, measured by an antigen array, and brain changes measured by MRI.

The research team, led by Rohit Bakshi, recruited 21 patients with relapsing-remitting MS (RRMS), and measured 420 different antigens present in serum samples taken from them. The patients also underwent MRI scans to assess the gray matter and white matter regions, as well as total brain tissue volume. Finally, researchers investigated lesion load based on the MRI scans.

The results, published in the journal Neuroimmunology and Neuroinflammation, showed that certain patterns of antibodies could be associated with the various brain regions investigated, as well as with lesion volume. The team specifically observed that there was little overlap between the immune signatures associated with grey and white matter volume, respectively. Also, the immune signature associated with lesion load differed from the signatures associated with the degeneration of grey and white matter.

Further analyses found that antibodies of the IgG type, directed at lipids, were associated with a reduction in whole brain tissue volume. By calculating an index for each of the MRI measures, based on antibody reactivity to lipids, the team showed that each index correlated with gray matter volume, whole brain tissue volume, and lesion volume. A similar trend toward such correlations was also found in another 14 MS patients who served as a validation sample.

Study results indicated that different pathological mechanisms lie behind disease processes in the gray and white matter of the brain. It also showed that the antibody response in MS is mainly lipid-directed. More studies are needed to confirm if the appearance of anti-lipid antibodies predicts the development of MS or of MS deterioration. If the findings are confirmed, the authors argued, such antibodies could serve as biomarkers for monitoring disease pathology and progression.

Source: Multiple Sclerosis News Today © Copyright 2014 - 2016 BioNews Services, LLC (10/02/16)

New recommendations on MRI diagnosis of multiple sclerosis (10/02/16)
New revisions to the MRI criteria for the diagnosis of multiple sclerosis have been proposed.

The revisions, published online in The Lancet Neurology, have been put forward by the European collaborative research network that studies MRI in MS (MAGNIMS).

MAGNIMS member and co-author of the paper, Maria A. Rocca, MD, San Raffaele Scientific Institute, Milan, Italy, explained to Medscape Medical News that diagnosis of MS relies on proof of disease "dissemination in space and time" — meaning symptoms or lesions need to be seen in different locations and at different times.

The new recommendations for MRI diagnosis mainly relate to the "dissemination in space" criteria, which Dr Rocca says currently lead to MS being over-diagnosed. "We have proposed slightly stricter conditions for some of these criteria, which we believe will lead to more accurate diagnosis," she said.

The recommendations are the product of discussions at a MAGNIMS workshop that had the goal of providing an "evidence-based and expert-opinion consensus on proposed modifications to MRI criteria for the diagnosis of multiple sclerosis." Travel expenses for the workshop were paid by Novartis through a provider.

The author of an accompanying editorial, Dr Robert J. Fox, of the Cleveland Clinic, Ohio, who is not part of the MAGNIMS group, told Medscape Medical News that the new recommendations were a "helpful step forward" in diagnosing MS.

He explained MRI has become an invaluable tool for MS diagnosis and following the evolution of the disease over time. "But how MRI is used to confirm or exclude MS and the specific criteria needed for an MS diagnosis change over time as new studies are reported."

He noted that if there is more than one clinical episode in different locations in the body, an MRI is not needed to diagnose MS. "But it is helpful to confirm the diagnosis and to stage the disease. But if there has been only one clinical symptom, then an MRI is often conducted to look for characteristic lesions to confirm the diagnosis."

There has always been the requirement that lesions should be found in at least two different locations, Dr Fox added. "The new recommendations still specify this requirement but instead of four different possible locations to consider they have added in another one — the optic nerve. This will widen the diagnosis a little. But they have also raised the requirements when considering lesions in the periventricular space, which will narrow the diagnosis. The net result is that an MS diagnosis should now be more precise."

Source: Medscape Multispeciality Copyright © 1994-2016 by WebMD LLC (10/02/16)

Microsoft and Novartis team up to tackle multiple sclerosis (10/02/16)
Microsoft and Novartis are joining forces to help people living with multiple sclerosis.

Using Microsoft’s Kinect, they have developed a tool called Assess MS which can monitor and evaluate a patient’s movements to determine if the disease is progressing or not.

For years, Novartis has been trying to find more consistent ways to quantify whether the treatments it is developing for multiple sclerosis are working, but assessing whether a patient’s symptoms are stabilizing or getting worse is complicated.

Using a tool like the Kinect, the motion sensor system used on Microsoft’s X-Box games consoles, researchers at Novartis hope to get a more consistent reading of how a patient performs on a set of standardised tests for MS patients, bringing a new level of uniformity that would help doctors better assess the progress of the disease. That, in turn, could speed up the process of getting the right treatments to patients.

Assess MS uses the Kinect motion camera and machine learning software to track physical movements and repeat the same tests months apart. Neurology experts scored video clips to teach the software algorithm how to recognise degrees of impairment.

“Patients often see different doctors each time they are assessed,” said Cecily Morrison, a Microsoft researcher at the Human Experience & Design research group in Cambridge, UK. “And the question is—did I change or was there a change in the way the doctor scores it?”

Imprecise measurements also effect new drug trials and raise costs for pharmaceutical companies such as Novartis.

“The beauty of computers is they don’t get tired, can be used in different settings and use the same criteria—unlike neurologists,” said Paul Matthews, head of the brain sciences division at London’s Imperial College.

The end goal is not to replace doctors. “You want to bolster the expert,” said Abigail Sellen, a principal researcher in the Human Experience and Design group at Microsoft’s Cambridge lab.

“What we’re doing is giving them a set of data that they can then weave into their judgment.”

“Novartis is leveraging digital technologies to transform patient care and drug development,” said Vas Narasimhan, global head of development at Novartis Pharmaceuticals.

“We are excited about our collaboration with Microsoft Research to develop Assess MS, a more consistent way to measure motor dysfunctions caused by multiple sclerosis, which could lead to the development of better therapies and care for patients.”

“One of the scariest things about MS is the unknown,” said Morrison. “And measurement is one way to help.”

Source: Brandchannel (10/02/16)

Treatment improves brain inflammation in multiple sclerosis (09/02/16)
A novel therapeutic approach to multiple sclerosis (MS) patients may be effective in reducing brain inflammation, according to findings published in the Journal of Neuroinflammation.

Researchers from the University of Alberta Faculty of Medicine & Dentistry in Canada have been evaluating the effect of the serine protease granzyme B (GrB) inhibition in mice models of MS.

Previously, the researchers demonstrated that GrB was a mediator of axonal injury and neuronal death, backed by other studies that suggest inflammatory cells influence the pathogenesis of MS likely through the use of GrB. Typical treatments for MS act on the immune system to reduce brain inflammation, the researchers explained in a press release, but negatively affect the immune system to the point that patients have to counteract significant side effects.

GrB was targeted in this study as a source of brain inflammation that did not significantly suppress the immune system response in mice.

“We can interfere with some of the weapons these cytotoxic cells use to induce damage to the nerve cells in the brain, but without disrupting the other positive functions that these cells have,” senior author Fabrizio Giuliani added in the statement. “This molecule, serpina3n, will block the damage caused by GrB that induces the neurodegeneration in this disease, and the neurodegeneration strongly correlates with the disability.”

Additionally, the researchers argue that targeting GrB can slow the progression of MS. The condition does not disappear completely in their models, Giuliana continued, and is still there.

However, there is not as much damage in the nerve cells to indicate or induce permanent disability. The GrB functioned as a “weapon,” the study authors said, by damaging nerve cells and other components in the brain. When they suppressed GrB using serpina3n, a recently discovered inhibitor, the progression of MS in both human cells and preclinical models was slowed. “The importance of this is that you can see where it’s leading,” concluded Giuliani.

“You can see almost an immediate target. This could eventually open the door to a new stream of treatments. If we can induce neuroprotection, there is a good possibility we can decrease the rate of disability that is associated with inflammation in the brain. If it works as we think, this will make an impact on the treatment of MS patients.”

Source: Specialty Pharmacy Times Copyright Specialty Pharmacy Times 2006-2016 Intellisphere, LLC (09/02/16)

Brain scars reveal possible cause of taste problems (09/02/16)
Taste deficits appear to be more prevalent among multiple sclerosis (MS) patients than previously reported and correlate with brain lesions, a new study from the University of Pennsylvania's Smell and Taste Centre and the department of Radiology has found.

The more lesions spotted on an MRI, the worse the taste function of the patient, the multi-institutional team reported in the Journal of Neurology.

The researchers, including lead author Richard Doty, PhD, director of Penn's Smell and Taste Centre and professor of Psychology in Otorhinolaryngology: Head and Neck Surgery at Penn's Perelman School of Medicine, administered a standard taste test (sweet, sour, bitter, and salty) to 73 MS patients and 73 controls subjects, along with MRI of 52 brain regions known to be impacted by MS in both groups.

They found the neurological disease significantly influenced the ability to identify tastes, especially salty and sweet. Fifteen to 32 percent of MS patients — which is nearly twice as high as previous studies found — had taste scores below the 5th percentile of controls. What's more, taste scores were inversely correlated with lesion amounts and volumes in the large sectors of the frontal and temporal lobes, the higher regions of the brain, identified on the MRI.

"This study represents the most comprehensive study preformed to date on the influences of MS on the ability to taste," Doty said. "It appears that a sizable number of these patients exhibit taste deficits, more so than originally thought. This suggests that altered taste function, though less noticeable than changes in vision, is a relatively common feature in MS.

"These findings give us a better insight about that relationship, as well as the areas of the brain that are more likely to impact the dysfunction when scarred from the disease.

"Future studies investigating the relationship between taste and MS may help better diagnose and understand the disease, as well as better manage symptoms."

Source: MedicalXpress © Medical Xpress 2011 - 2016, Science X network (09/02/16)

Study suggests remarkable approach to MS treatment (08/02/16)
A group of researchers at the Stanford Department of Neurology and Neurological Sciences exploring the use of a synthetic bile acid agonist in a mouse model of multiple sclerosis say they have seen some remarkable results.

They've published their results in the Proceedings of the National Academy of Sciences.

Farnesoid X receptor (FXR) is a nuclear hormone receptor that interacts with bile acid synthesis, transport, and cholesterol metabolism. Recent studies indicate that bile acid-FXR regulation plays an important role in hepatic and intestinal inflammation. Notably, FXR-knockout mice have been observed to express higher disease severity in a mouse model of multiple sclerosis called experimental autoimmune encephalitis (EAE).

The researchers treated mice exhibiting EAE with an oral drug called obeticholic acid (6-ECDCA), a synthetic FXR agonist that is currently in clinical trials for the treatment of a number of inflammatory diseases. They also tested the mice with a natural FXR ligand (CDCA); in both cases, the disease was significantly ameliorated. They also found that 6-ECDA was more effective than the natural ligand at suppressing the disease.

The researchers were particularly surprised to find that oral administration of 6-ECDCAwas much more effective at ameliorating the disease that intraperitioneal injection.

"The oral activity of obeticholic acid suggests further modulation of the drug by gut flora or gut enzymes or the importance of hepatic uptake," the authors write.

Given that existing interferon treatments for MS patients involve regular, painful intramuscular injections, this is a discovery that holds significant promise not only to alleviate the suffering caused by MS, but also that caused by the daily or weekly self-administration of interferon and its attendant side effects.

Nonetheless, human patients receiving experimental 6-ECDCA therapy have been observed to exhibit side effects. Concerns about long-term safety arose when 23 percent of patients in a separate study's trial group developed severe skin itching and unexpected increases in total cholesterol and LDL cholesterol. The authors note that changes in serum cholesterol and insulin resistance confer an increased risk of development of atherosclerosis. They write, "One possibility may be to combine a statin with 6-ECDCA. Nevertheless, our data provide a previously unidentified approach in treating MS through the bile acid-FXR interaction."

Source: Medical Xpress © Medical Xpress 2011 - 2016, Science X network (08/02/16)

Experimental therapy Trimesta fails to demonstrate efficacy (08/02/16)
Synthetic Biologics has revealed disappointing results from an independent third-party analysis of a Phase II clinical trial evaluating Trimesta as a treatment for relapsing-remitting multiple sclerosis (RRMS) in women.

The unfavourable findings have led the company to terminate its license and clinical trial agreements with the University of California.

Trimesta (oral estriol) is a potential drug for the treatment of relapses and cognitive dysfunction in people with MS. The Phase II clinical trial was to evaluate the rate of improvement in relapses through treatment with Trimesta plus Copaxone injections in a group of female patients diagnosed with RRMS, versus a patient group receiving placebo pills plus Copaxone injections.

Data from the analyses, both clinical and based on magnetic resonance imaging (MRI) results, showed no significant differences between the active drug group and the placebo group. Annualised relapse rates, brain volumes, and brain lesions all were not found to present significant differences between the groups at either 12 or 24 months.

Jeffrey Riley, chief executive officer of Synthetic Biologics, said in a press release, “We are disappointed with the outcome of the data analyses which did not demonstrate statistically significant treatment effects in this study. We intend to focus the Company’s resources on its other programs, including our two Phase 2 gut microbiome programs which have both demonstrated positive topline clinical results.”

Source: Multiple Sclerosis News Today © Copyright 2014 - 2016 BioNews Services, LLC (08/02/16)

Tysabri ‘more effective’ than Gilenya, study claims (08/02/16)
A retrospective analysis has found Tysabri is more effective than Gilenya in preventing relapses in patients with relapsing-remitting multiple sclerosis (RRMS).

The analysis was conducted by researchers in France, who collected data from 27 multiple sclerosis centres. The primary endpoint was patient relapse in the first year, and a secondary endpoint was patient relapse in the second year. Compared to Gilenya-treated patients, the proportion of patients with at least one relapse within the first and second year was lower in patients treated with Tysabri.

The authors of the study stressed that the ultimate choice between Tysabri or Gilenya as a treatment rests on a number of different variables.

Source: MPR Copyright © 2016 Haymarket Media, Inc (08/02/16)

Multiple sclerosis patients who undergo infertility treatments have higher relapse rates (05/02/16)
New research published in Annals of Neurology has found multiple sclerosis patients who undergo assisted reproduction technology (ART) face a higher risk of disease activity and multiple sclerosis relapse.

Researcher Dr. Jorge Correale from the study said: “When MS and infertility coincide, patients seek ART to achieve pregnancy. Given the role of some reproductive hormones in autoimmune diseases, those with MS receiving infertility treatments are at particular risk of exacerbating their disease.”

The researchers analysed clinical, radiological, and immune responses in 16 multiple sclerosis patients who underwent 26 ART cycles. The team recruited additional 15 MS patients not undergoing ART cycles and 15 healthy volunteers to participate as controls.

The findings found 75 per cent of multiple sclerosis patients experienced worsening of the disease following the ART treatment. Fifty-eight per cent of patients reported a relapse during the three months after the ART treatment. Patients also experienced worsening of existing symptoms, and some of them developed new symptoms.

Dr. Correale said: “Our findings indicate a significant increase in MS disease activity following infertility treatment. Neurologists should be aware of possible disease exacerbation so they may discuss the benefits and risks of ART with MS patients.”

Source: MyInforms.com © 2016 myinforms.com (05/02/16)

Natural protein points to new treatment (05/02/15)
Increasing the level of a naturally-produced protein, called tristetraprolin (TTP), significantly reduced or protected mice from inflammation, according to researchers at the National Institutes of Health.

The results suggest that pharmaceutical compounds or other therapeutic methods that produce elevated levels of TTP in humans may offer an effective treatment for some inflammatory diseases, such as rheumatoid arthritis, psoriasis, and multiple sclerosis. The report was published in the Proceedings of the National Academy of Sciences.

Inflammation has been proven to play a major role in a number of normal processes in humans, but it also fosters diseases, many of which are increasing in prevalence and severity. The development of new therapies for treating inflammatory diseases could greatly reduce the growing health burden.

With this goal in mind, Perry Blackshear, M.D., D.Phil., a researcher at the National Institute of Environmental Health Sciences (NIEHS), part of NIH, led the team that genetically altered the TTP gene in mice, so that the animals produced higher than normal amounts of the TTP protein. The mice were then tested using experimental models of rheumatoid arthritis, psoriasis, and multiple sclerosis. Experimental models are used to study processes thought to be involved in human diseases, and to evaluate and select therapies that affect these processes.

"Mice with more TTP in their bodies were resistant to the inflammation that accompanied these experimental models of disease," Blackshear said. "We also found evidence of how TTP is providing this protection."

Blackshear said TTP exerts its beneficial effect by targeting several messenger molecules that encode cytokines, proteins known to be involved in inflammation. TTP binds to these molecules and destabilizes them, resulting in lower levels of cytokines and, thus, decreased inflammation.

Blackshear anticipates that TTP-based treatments would be cost effective and easy to administer. Future work will seek to identify compounds that have similar effects on the levels of TTP in the body.

"Many current therapies for these inflammatory diseases are expensive and require the medicines be introduced into the body under the skin, in the muscle, or by intravenous injection," said Sonika Patial, D.V.M., Ph.D., a research fellow in Blackshear’s research group and lead author on the paper. "Our ideal treatments would be administered orally in pill or liquid form."

Source: National Institutes of Health (05/02/16)

Nearly 14,000 have mobility cars taken away (05/02/16)
Nearly 14,000 disabled people who rely on a specialist motoring allowance have had their cars taken away from them following government welfare changes.
According to aa report by the BBC, almost half of those having to be reassessed for this support under the changes lost their Motability vehicle.

Many had been adapted to meet their owners' needs and campaigners warn it could lead to a loss of independence.

But the government says the new process is fairer and people can appeal.

More than 650,000 people currently use the Motability Scheme, which allows disabled people to lease a new car, scooter or powered wheelchair using their government-funded mobility allowance.

The scheme also helps towards the cost of adaptations - such as a hoist for a wheelchair or hand controls - that the individual requires.

Until recently, anyone receiving the highest rate of the "mobility component" of Disability Living Allowance (DLA) was eligible for the scheme.

However, as part of Department for Work and Pensions welfare changes, the Personal Independence Payment (PIP) began replacing DLA from April 2013.

Under DLA, most people completed their own application form and did not have to reapply once entered into the scheme.

With PIPs, everyone - new applicants and those already in receipt of DLA - will have to attend a face-to-face assessment by government-hired private companies, and only those scoring 12 points or more will qualify for support - currently £57.45 per week.

To date, Motability has seen around 51,200 people join the scheme using PIP.

Of those previously on higher rate DLA, 31,200 people have so far been reassessed for PIP, and of those, 55% - or 17,300 - have kept their car.

But the remaining 45% - 13,900 people - have lost the higher rate and therefore their car as well.

Some 360,000 people will eventually undergo PIP reassessments, including those currently on an "indefinite" or "lifetime" DLA award.

Disabled children will continue to receive DLA until they reach the age of 16 and those who were aged 65 or over on 8 April 2013 are also unaffected.
Liz Sayce, chief executive of Disability Rights UK, told the BBC "being disabled costs money".

"The Personal Independence Payment is supposed to help with those costs, but many people are being denied the benefit because they are not assessed properly.

"Sometimes that means people lose their cars; a massive blow which impacts on their ability to remain independent, take part in their communities or get and keep a job."

Some of the adaptations required by disabled drivers are expensive to install.

Minister for Disabled People Justin Tomlinson said people's circumstances changed over time and it was right they should be reassessed.

"But rightly we have a system that allows for an appeal, a mandatory reconsideration and then if they're not satisfied with that they can go for an independent appeal, so there are lots of opportunities if a claimant thinks a decision is wrong to have that looked at again."

Latest figures show that of all the appeals to do with PIP, 60% have found in the claimant's favour.

Motability says it provides a support package, including a £2,000 grant, to anyone forced to leave the scheme following a PIP reassessment.
The charity added: "This helps individuals to remain mobile, in many cases by purchasing a used car. Motability has already provided some £16m in support through this transitional package."

The government hopes to save £2bn as a result of the switch from DLA to PIPs.

To find out more about the Personal Independence Payment (PIP) please see our Choice leaflet or contact our Helpline.

Source: BBC News © British Broadcasting Corporation 2016 (05/02/16)

Biogen report drop in profits (04/02/16)
Pharmaceutical giant Biogen has reported declining fourth-quarter profits but still topped most expectations as sales of its treatment for multiple sclerosis took off.

Sales of the MS therapy Tecfidera jumped 8.4 per cent to $993m as sales of its other treatments for MS dipped.

The biotechnology company’s profit fell six per cent to $831.6m. Revenue rose 7.5 per cent to $2.84bn in the period, also beating Street forecasts.
The Massachusetts-based company said revenue from its other multiple sclerosis drugs, Avonex and Plegridy, fell 4.8 per cent to $740m. Sales of the MS treatment Tysabri fell slightly to $481m.

Costs and expenses rose 12.5 per cent to $1.67bn during the quarter.

For the year, the company reported profit of $3.55bn. Revenue was reported as $10.76 billion.

Shares in Biogen have decreased 15 per cent since the beginning of the year, while ratings agency Standard & Poor’s 500 index has dropped roughly 7 per cent. The stock has declined 28 per cent in the last 12 months.

Source: The Washington Times © Copyright 2016 The Washington Times, LLC (04/02/16)

New MRI technique offers faster multiple sclerosis diagnosis (02/02/16)
A new way of using MRI scanners to look for evidence of multiple sclerosis in the brain has been successfully tested by researchers at The University of Nottingham and Nottingham University Hospitals NHS Trust.

The team at Nottingham found a way to use clinical MRI to distinguish between MS lesions and other brain white spots which are found in MS. The study is published in the Multiple Sclerosis Journal.

They used a clinical MRI scanner of the type all neuroscience centres have to carry out a special type of scan called a T2-weighted imaging process which is able to reveal lesions in the brain's white matter that are centred on a vein—a known indicator of MS.

Leading the work, Dr Nikos Evangelou, said: "We already knew large research MRI scanners could detect the proportion of lesions with a vein in the brain's white matter, but these scanners are not clinically available. So we wanted to find out whether a single brain scan in an NHS hospital scanner could also be effective in distinguishing between patients known to have MS and patients known to have non-MS brain lesions. We are excited to reveal that our results show that clinical application of this technique could supplement existing diagnostic methods for MS."

A total of 40 patients were recruited from the neurology outpatients' department of Nottingham University Hospitals NHS Trust. Initially a test cohort of 10 patients with MS and 10 patients with non-MS white brain matter lesions were scanned. Anonymised scans were analysed blinded to clinical data and simple diagnostic rules were devised. The same rules were applied to a validation cohort of 20 patients (13 with MS and 7 with other lesions) by a blinded observer.

Within the test cohort, all patients with MS had central veins in more than 45 per cent of brain lesions, while the rest had central veins visible in less than 45 per cent of lesions. Then, by applying the same diagnostic rules to the second cohort, all the remaining patients were correctly categorised into MS or non-MS, by the blinded observer, taking less than two minutes per scan.

The new study is significant because currently among patients referred to MS treatment centres with suspected MS, fewer than 50 per cent are found to have it. This shows that diagnosing MS in a significant minority of cases can be challenging.

The Nottingham University team has now started a new study examining patients with real uncertainty about the diagnosis and aim to extend the study in other UK towns so more patients can participate in this important research. It is possible that in less than two years we will know if this new test is accurate as it appears to be. In that case, the way we will be diagnosing MS will probably be quicker and more reliable. The Nottingham team has already presented their data in the US and a similar US based study is planned based on the Nottingham results.

Source: Medical Xpress © Medical Xpress 2011 - 2016, Science X network (02/02/16)