While briefly what Multiple Sclerosis was discussed in
class, I thought it would be good do dive deeper into what MS really is.
Multiple Sclerosis is an autoimmune disease in which our
immune system attacks you myelin, the protective sheath of protein and
phospholipids around a nerve fiber, leaving the nerve fiber to be scarred and
damaged. This damage causes interruptions in signaling and overall decline in
function, leaving the person with problems walking, vision problems, numbness
and dizziness just to name a few symptoms that can gradually worsen over time.
Multiple Sclerosis can be broken down into four major types:
Relapsing Remitting
MS (RRMS): This is the most common type of MS which is characterized by clearly
defined times of flare ups which can then be followed by times of recovery.
Secondary-Progressive
MS (SPMS): this type of MS is characterized by a relapse, then a steadier
worsening after the relapse. Nearly half of the people diagnosed with Relapsing
MS will reach a point of Secondary- Progressing MS within 10 years.
Primary-Progressive
Relapse MS (PPMS): This type of MS
accounts for 10% of patients diagnosed and is an overall neurological worsening
over time.
Progressive-Relapsing
MS (PRMS): this is a more rare form of MS where there is a steady decline
of neurological function with attacks of clear worsening along throughout its
progression.
There is no cure for this neurodegenerative disease; there
are pharmacological methods to help recovery from attacks, manage symptoms and
slow the diseases progression.
Treatments for MS attacks include: Corticosteroids and
plasma exchange, a procedure in which a portion of your plasma is removed where
it is mixed with protein albumin and then replaced.
Treatments that modify progression of the disease include a
list of drugs that can be administered as oral medications of injection that
work to reduce relapses of the disease and work to block the movement of the
damaging immune cells.
Treatments of symptoms include medications for fatigue,
pain, bowel and bladder control, muscle relaxants to help control muscle
stiffness and spams and physical therapy.
Physical therapy can be a useful tool in patients with MS in aiding with
issues of balance, coordination, stretching to prevent muscle spasms, exercise
to increase range of motion, an skills to prevent falling
Something that is not often explained to those who don’t
have multiple sclerosis is what exactly a MS relapse, also refereed to as a
attack, exacerbation, or episode is. While the relapse is never the same for
any person, it tends to be an acute flare up of that causes new symptoms or
worsening of other symptoms. These relapses could occur in an episode of
balance issues, severe fatigue, or optic neuritis, which causes impairment of
vision. An relapse or attack is defined
as something that lasts at least 24 hours.
While there is still no cure to MS there is much research targeting three different approaches into treating MS, topping the disease progression all together, restoring what has already been lost to MS and the finally ending the disease all together. There is current research looking for genes of associated with MS, finding triggering factors for MS, restoring tissue damage due to MS, and into the immune system and understanding the cascade of events within this autoimmune disease
"About Multiple Sclerosis
(MS)." Understanding Multiple Sclerosis. Genzym, 2013. Web. 12
Nov. 2014.
"Managing Relapses." National
Multiple Sclerosis Society. N.p., n.d. Web. 12 Nov. 2014.
"Multiple Sclerosis." Treatments
and Drugs. The Mayo Clinic, 10 July 2014. Web. 10 Nov. 2014.
"Research on the Immune System." National Multiple Sclerosis Society. N.p., n.d. Web. 12 Nov. 2014.
Senelick, Richard. "Benefits of Physical
Therapy for MS." WebMD. WebMD, 25 Oct. 2014. Web. 12 Nov.
2014.
Amy, I found your post to be very interesting, as I had no idea there were four different types of MS. After reading about them I started to wonder if there are any mechanistic differences between the different types that lead to the varying symptoms/relapse intensities. I think that if we could figure out any differences between the four types we would then be able to develop more specific treatments. With many of the inflammatory diseases we have discussed so far, improving quality of life for patients has been stressed whenever discussing new drugs. I think that one of the main ways to do that is to first better understand the disease you are treating. In that way, I think further studying the differences between the categories of MS could eventually lead to improved patient quality of life.
ReplyDeleteLike Joel, I was not aware that MS was divided into subcategories. Thank you for the insight! As for possible therapies for halting MS, maybe areas of research could include tagging and destroying T cells and antibodies that have passed the blood brain barrier and have begun to attack self. Restoration of damaged neurons could be start with growing neuronal stem cells in vitro and then injecting them into damaged areas.
ReplyDeleteI also didn't know there were clearly defined subgroups of MS, all I was previously aware of was the fact that the progression of MS was different for every person. This was a really informative post. I can definitely attest to the concept of flare ups in my experience with my grandma. For her, flare ups always tended to occur during times of stress or trauma. For example when my grandpa died, or when she had a severe fall that resulted in the loss of the use of her arm (temporarily) and breaking her femur. These stressful times resulted in flare-ups in her symptoms, especially pain and loss of control in her legs.
ReplyDeleteI definitely agree with how I too was surprised by the four subgroups of MS. This does make it difficult to target exact treatment types as the stages and progression are overall very different form patient to patient.
ReplyDeleteIn understanding the progression of each of these you can better investigate what occurs in each of the situations. John I agree with you that tagging and having an understanding of the immune function that are destroying neurons and this could prove to be a great method of preventative medicine for the progression of MS as it must be a lot more difficult restore what is already damaged in the neurons.
It is very interesting to hear about first hand experience of this horrible disease. The functions of stress and other environmental stressors can play a detrimental role the progression of any disease, especially a disease that effects the brain.
Amy,
ReplyDeleteI really enjoyed your break down of MS. I have a family friend with MS and I had never really taken to time to fully understand the disease. This disease seems like a very complex and as you stated there is no cure for it. I was wondering if the consumption of alcohol could worsen the symptoms of MS? My family friend was also a diagnosed alcoholic and had continued to drink into the worsening of her disease. It seems like alcohol could lead to a worsening of the symptoms, but I'm not sure if it could cause the disease to progress more.
Hi Amy! Thanks for the article but there was another article I had read that mentioned that MS is not a fatal disease. But if flare-ups can happen and if with certain types of MS, the relapses tend to grow more severe with time, I was wondering if a person could still end up in a vegetative/comatose state. Either way, it's great to hear that research is being done for MS and hopefully we'll hear great news of a cure or solid treatment sometime in the near future!
ReplyDeleteHey Amy,
ReplyDeleteI enjoyed reading your overview of Multiple Sclerosis. Like many of the other students, I had no idea there were 4 types of MS. I also had no clue MS was such a come-and-go disease; I thought the symptoms were consistent and seen at all times. T-cell therapy seems to be a good idea to combat MS, although this creates some obvious problems such as potential immunodeficiency.
Amy, thanks for the post, MS is one of the scariest diseases out there, and information is always useful. I believe treatment should focus on stopping the disease progression and then on restoring the myelin sheath, or else, surely the myelin sheath will be destroyed again in the patient might experience a relapse. Any treatment for neurodegenerative diseases helps, but it is my understanding that there are numerous limitations on nervous tissue restoration.
ReplyDeleteI found your overview of the descriptions of MS and related terms very helpful, Amy. It helps to sort out the information that we talked about in discussion to recall the types of MS and what constitutes a flare up. I never associated MS with blindness and vision problems before this class, but I've since learned more about the disease.
ReplyDeleteThank you for the added background on MS, I found your summary really helpful. My curiosity was especially piqued by your discussion about relapses. I did some more digging and looked into the timing of MS relapse and subsequent remission. I thought remission took place on the time scale of days but was surprised to find out that it is often actually a process that takes place over months. There are some really interesting details in the paper I'll link below about how incomplete remission rates correspond to short term and long term relapses.
ReplyDeletehttp://www.ncbi.nlm.nih.gov/pubmed/17917457
I was unaware that MS was divided into four different categories based on type. The plasma exchange treatment was very interesting to me because I feel as if the albumin couldn't really contribute all too well, but apparently it helps! The relapse you mention seems terrifying for a patient as it lasts for 24 hours, something I can't even imagine going through. Once again thank you for going in depth on this disease since I wasn't all too familiar with it.
ReplyDelete