Precision Medicine and MS – A Bespoke Approach

Gray clouds forming on the horizon when you’ve planned a picnic, your favourite sports team making it through to the final, not knowing which way the economy is likely to swing next…no one likes uncertainty, which is why a MS diagnosis can be so daunting. While your doctor can tell you how things are looking right now, it’s difficult to predict the future course of the disease.

The Uncertainty of MS

MS is a complex disease that manifests itself very differently from one person to the next . Some people experience only mild sensory symptoms, while others see marked changes in their mobility and cognitive skills. Not only does this make diagnosis tricky, it can make the future seem very uncertain.

Until now, the question of ‘How is my MS likely to progress?’ has typically been met with a sympathetic ‘I’m afraid we just don’t know’. Thankfully, advances in molecular biology and software technology are removing some of the doubt from life with MS, ushering in a new age of what experts are calling ‘precision medicine’.

Bespoke Biology

In the traditional model of medicine, everyone diagnosed with the same disease is more or less prescribed the same treatment, despite the fact that each person responds differently . Precision medicine takes a more informed approach, using a person’s DNA profile, as well as other detailed biological data, to allow treatment to be tailored specifically to that person’s genetic make-up and lifestyle .

This personalized approach is already improving treatment outcomes in other diseases such as breast cancer for example – and if research in America is anything to go by, then MS treatment is heading in the same direction.

Using Big Data to Predict the Future

Experts at the University of California in San Francisco have developed an impressive software package called MS BioScreen . This pioneering system allows users to track medical data using a simple app coupled to a cloud- database that integrates multiple dimensions of disease information, including clinical evolution, therapeutic interventions, brain, eye and spinal cord imaging; as well as environmental exposure, genomics and biomarker data . This could include everything from specific genes associated with MS, for example, to certain proteins present in the cerebro-spinal fluid. This can be very informative, as a recent German study concluded that different forms of MS appear to be associated with slightly different protein profiles – a field of research known as proteomics.

The system not only lets you see how your condition is progressing, it compares your data with data collected from other people with MS, giving your doctor new insights with which to predict future changes, and make more informed decisions on the most effective treatment options for you. If hundreds of people with MS sharing the same gene and protein profiles as you responded well to a certain treatment for example, it’s likely that treatment would be a good bet for you, too.

All of which means that the million-dollar question ‘How is my MS likely to progress?’ will soon be met with an in-depth discussion of all the available data, rather than a shrug. In place of vague predictions generalized to “the average MS patient”, your doctor will be able to talk you through the most likely outcomes, as well as the most effective plan of action tailored to you.

Eradicating MS

It may even be that precision medicine helps us prevent MS altogether one day. Scientists have identified certain genes that increase the risk of MS, so in the future people carrying these genes could use the latest software to calculate the likelihood of them developing the condition and eventually take drugs protecting the central nervous system from future attack.

If that all sounds a bit futuristic, bear in mind this is something that’s actually happening in brain medicine right now. Researchers in Arizona are already recruiting people with key Alzheimer genes , but no symptoms of the disease, to receive preventative treatment – building up a powerful database in the process.

Of course, you’ll have to watch this space for the outcome. In the meantime, all the evidence suggests one thing– that MS’s days are numbered.

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