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Research Update from ACTRIMS: Day 2

February 28, 2020

The second day of the Americas Committee for the Treatment and Research of MS (ACTRIMS Forum) in West Palm Beach, Florida featured new results on gut microbiome, light therapy, emerging therapies and many more. (Check out highlights from Day 1) Here are a few highlights – follow the links provided below to read the scientific summaries (abstracts).
 
Continuing on the Networks theme, Dr. Sergio Baranzini of the University of California, San Francisco commented on the “explosion” of network science, which enables the analysis of very large amounts of data by high-powered computers. The results may reveal new insights and patterns – like zooming out from a close-up a photo to reveal that the pixels make up patterns to create a face.
 
He is working with others on a project called SPOKE, compiling many, many points of data – such as gene studies, symptoms, medications, lab tests, and others, from 1 million people to begin creating individual and compiled profiles of diseases. In the future this approach might contribute to personalized medicine – finding the best treatment approach for one individual – and may also reveal clues to what’s going wrong in MS. (Abstract)
 
Another frontier, Epigenetics: Many factors combine to make people susceptible to MS. Besides genes, there is the environment, but how can something in the environment change MS risk? Dr. Maja Jagodic of the Karolinska Institute in Sweden described the field of epigenetics, which she described as basically the way DNA is packaged and used within cells. The environment changes this packaging, and those changes can influence MS risk and also disease course, suggested Dr. Jagodic. There is also some evidence that some epigenetic changes may be reversible.  (Abstract)
 
Dr. Patrizia Casaccia of the City University of New York gave a talk later in the day that further explored epigenetics in cells from people with MS. She showed that disease-modifying therapies could cause positive changes to one type of epigenetic mechanism known as DNA methylation. In another study conducted with collaborators, obesity was shown to cause negative changes to DNA methylation, causing increased numbers of immune cells that were linked to brain volume loss and worsening disease. Obesity in adolescence has been identified as a factor that can increase the risk of getting MS; this study suggests it may also impact the disease course in adults. (Abstract)
 
Epigenetics is a fast-growing field that has a lot of potential to increase our understanding of MS and also holds potential for new therapies.
 
Gut microbiome: The topic of gut microbiome in becoming more popular not just in MS but other disorders, as results begin coming in on the influence that the friendly and unfriendly “bugs” that reside in the gut have on the brain and MS disease activity. Dr. Emmanuelle Waubant (University of California, San Francisco) and collaborators in the U.S. Pediatric MS Centers reported today that an abundance of bacteria in two orders, Pasteurellales and Enterobacteriales, were linked with reduced risk of later relapse in children and teens with MS. The team is now analyzing any links to MRI-detected disease activity. More research by this team and others will help determine whether altering the quantities of normal gut bacteria may impact disease in both children and adults with MS. This study was supported by the NIH and the National MS Society (Poster P187) More microbiome studies will be presented tomorrow.
 
Light Therapy for Fatigue: Student Andre Vogel and colleagues at Massachusetts General Hospital did a pilot study to test the feasibility of using bright white light to treat MS fatigue, since it has been shown helpful treating fatigue in other disorders. They divided a group of people with MS who had fatigue into two groups: half received bright white-light boxes and half received red dim light boxes as a control. Both groups used the boxes at home for one hour, two times per day for four weeks. Although this pilot study wasn’t designed to detect effectiveness, both groups reported benefits, suggesting a strong placebo effect. They plan to use their results to design a larger, longer study of bright white light therapy to treat MS fatigue. (Poster P293)
 
Toward making MRIs more standard: The Consortium of MS Centers convened experts to make recommendations for how brain and spinal cord MRIs should be done so that these become part of the standard of care for people with MS. Adoption of these standards, which have been harmonized with those recommended by the European group, MAGNIMS, would improve the types of information that can be gathered from MRIs to improve care. The group has plans for publishing and widely disseminating these standards. (Poster LB310)

Still to come from ACTRIMS: Networks in the Brain, imaging, and a whole session on microbiome
 

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system. Symptoms range from numbness and tingling to blindness and paralysis, and there is currently no cure for MS. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. An estimated 1 million people live with MS in the United States. Most people with MS are diagnosed between the ages of 20 and 50, and it affects women three times more than men.

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