If you’ve been diagnosed with multiple sclerosis then you have probably found yourself Googling everything you can about the disease – particularly when it comes to the latest research.
Recently there have been major strides in a number of areas that, while not directly multiple sclerosis research, have profoundly improved our understanding of the disease and opened up new avenues of investigation. Take the field of immunology, for example, the study of how the immune system works. Although there are also other hypotheses under discussion, many believe that MS is an autoimmune disease – which basically means that the symptoms are caused by the immune system attacking the body’s own tissue (in the case of MS, the myelin sheath of the nerves that extend throughout the central nervous system).
MS and the immune system
Thanks to painstaking immunological research, we know so much more about the role of the immune system in than we did 15 years ago. Like the fact that multiple sclerosis appears to be driven by a malfunction of white blood cells known as T cells. Researchers have identified three main culprits: killer T cells, which directly attack and destroy other cells, helper T cells, which gear up the rest of the immune system and regulatory T cells, which dampen down the immune response. In people living with MS, the balance between these different T cells is disturbed, resulting in damage to the central nervous system.
This knowledge has indeed furthered multiple sclerosis research. One study, for example, demonstrated that specific T cells of a person living with MS could be activated by common viruses such as herpes simplex and Epstein-Barr, suggesting that the disease might be triggered by viral infections. Scientists have also managed to zoom in on the proteins responsible for triggering T cells, which may hold the key to a cure. Recently, researchers in the UK described how they were able to alter the behaviour of aggressive T cells in a preclinical animal model and actually stop them attacking the body; the key was desensitising them through gradual exposure to the substances they were attacking. Not only did they manage to disable the aggressive behaviour of the T cells, they successfully converted them into cells capable of protecting against disease. The significance of these preclinical animal model data in humans remains to be evaluated.
Understandably, there’s a huge buzz around this area right now, with the hope that scientists will be able to develop treatments that target specific T cells, without harming the rest of the immune system – a promising breakthrough for all autoimmune diseases.
What about my genes?
Genomics is another area of biomedical research helping to shine light on multiple sclerosis. By analysing genomes (the complete set of genetic material of an organism), scientists can look at which genes, when modified by natural mutations, might increase or decrease the risk of getting a certain disease.
All this builds on the foundations of the Human Genome Project, an international scientific research project that set out in 1990 to reveal the entire sequence of the human genome. Completed in 2003, the painstaking work has since helped scientists discover more than 50 regions in the genome that are associated with MS. This means, if somebody has a certain variation in one of these genetic regions, their likelihood of developing MS is slightly increased. Many of these “additional risk regions” are near genes which are related to the immune system, unsurprising given that multiple sclerosis is a disease that is closely associated with inflammation.
There is hope that personalised medicine (aka targeted therapy) will transform healthcare through earlier diagnosis, more effective prevention and treatment of diseases including multiple sclerosis. For example, in people living with MS, genomic sequencing might allow doctors to devise a personalised treatment plan that tailors management to their genomic profile, since, for example, certain genetic types respond better to certain drugs. If that all sounds too sci-fi to be true, bear in mind that it’s already a reality in the diagnosis and treatment of certain cancers. And who knows, in the future, joint efforts of scientists in the fields of genomics and immunology may even allow the detection of MS risk from birth and prevent the disease developing altogether!
With every breakthrough in every field of medicine, we get closer to finding a cure for multiple sclerosis. It is unlikely that we will find a cure overnight, but it’s reassuring to know that there are thousands of scientists working hard to do just that. Our understanding of MS has vastly increased in the last 20 years alone, but the next 20 years look set to herald the biggest breakthroughs of all.