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Elist January 7, 2009

Blue Ridge Chapter Weekly E-list Update

January 7, 2009

Contents: 

Programs:

1. Save the Date: MS Action Day

2.  Advocacy Teleconferences

3. LINKS Teleconference Series

Other News:

4. Researchers Funded in Part by Society’s Promise: 2010 Campaign Use Novel Technology to Identify Antibody Patterns in Blood Samples from People with MS

5. IVIG Shows Mixed Results in Two Studies

 

Programs:

1. Save the Date: MS Action Day 

On January 25-26, 2009, Blue Ridge Chapter volunteers and staff will travel to Richmond for MS Action Day, a time to speak with your representatives about meaningful and important legislative issues.  If you would like to learn more about how you can participate in MS Action Day or the advocacy efforts of the Society, email Darren Ball at darren.ball@nmss.org. 

 

2. Advocacy Teleconferences

Want to learn more about the Blue Ridge Chapter advocacy efforts in 2009?  Participate from the comfort of your own home in one or both of these free, one hour teleconferences:

2009 Virginia MS Legislative Platform

Monday, January 12, 2009 at 7pm

Learn about key MS issues that you can advocate for this year, including the need for affordable accessible housing and a prescription assistance plan for people with MS in Virginia. Additional topics will include state budget cuts and a new statewide MS caucus.  The guest speaker will be Eldon James of Eldon James and Associates.  

Advocacy Teleconference: Tips for Visiting & Communicating with State Legislators

Wednesday, January 21, 2009 at 7pm

Legislators need to hear from their constituents, but with so many competing voices, how can we be sure that MS issues receive attention?  Learn tips on how to communicate effectively with your legislator.

Please call 1-800 344 4687 or email vab@nmss.org at least three days prior to each teleconference to register. 

 

3. LINKS Teleconference Series: January-March 2009

8 opportunities to learn about MS from the comfort of your home

Tired of Being Tired? A Discussion on Fatigue

Guest Speaker: Kathy Costello, Adult Nurse Practitioner and the MS Program Director for the Maryland Center for Multiple Sclerosis at the University of Maryland located in Baltimore, MD.  January 22, 2009 at 7:00 p.m.

Health Insurance: Your Rights and Responsibilities

Guest Speaker: Kim Calder, MPS, Senior Manager of Insurance Initiatives for the National MS Society January 29, 2009 at 7:00 p.m.

Financial Planning and MS

Guest Speaker: Representative from Financial Education Partners. February 5, 2009 at 7:00 p.m.

Finding Your Emotional Balance

Guest Speaker: Louise B. Lubin, Ph.D., Licensed Clinical Psychologist and Community Faculty member, Department of Psychiatry and Behavioral Sci­ences at the Eastern Virginia Medical School in Norfolk, VA.  February 12, 2009 at 7:00 p.m.

Making Your Home More Accessible

Guest Speaker: William Edward Fuller, Ph.D., VHDA Virginia Housing Development Authority in Richmond, VA. February 19, 2009 at 7:00 p.m.

Vision and MS

Guest Speaker: Warren L. Felton, III, M.D., Professor and Associate Chair of Clinical Activities in the Department of Neurology; Professor of Ophthalmology; Chair of the Division of Ophthalmology at Virginia Commonwealth University in Richmond, VA. February 26, 2009 at 7:00 p.m.

Current MS Research

Guest Speaker: Peter Calabresi, M.D., Associate Professor of Neurology at Johns Hopkins University and the Director of the Johns Hopkins Multiple Sclerosis Center in Baltimore, MD. March 5, 2009 at 7:00 p.m.

Change Happens Through MS Activism

Guest Speaker: Shawn O’Neail, Vice President Federal Government Relations, National MS Society. March 12, 2009 at 7:00 p.m. 

 

Here’s How to Participate!

Register for one or more of these free teleconferences by calling the number below at least one week prior to the call(s) you would like to participate in.

1-800-344-4867

 

Other News:

4. Researchers Funded in Part by Society’s Promise: 2010 Campaign Use Novel Technology to Identify Antibody Patterns in Blood Samples from People with MS

A team funded by the National MS Society used novel technology to screen the immune response in blood samples from people with various courses of MS, and were able to differentiate between different types of MS and MS patterns of damage, based on distinct immune antibody signatures against different immune targets. Francisco Quintana, PhD, Howard Weiner, MD (Harvard Medical School, Boston) and colleagues reported findings that involved a collaboration with Claudia Lucchinetti, MD (Mayo Clinic, Rochester, MN). Dr. Lucchinetti is lead investigator of the Society’s MS Lesion Project, funded through the Promise: 2010 campaign. The results could ultimately lead to laboratory tests that help diagnose MS and predict its course. (Proceedings of the National Academy of Sciences U S A. 2008 Dec 2;105(48):18889-94)

Background: MS is a highly unpredictable disease that is often difficult to diagnose because there is no specific, single clinical or laboratory test that can tell whether a person has the disease. Not only are the symptoms or even timing of attacks unpredictable, there are also no laboratory or clinical tests that can predict the future course of the disease. The study of other autoimmune diseases has shown that autoantibodies, a family of proteins produced by the immune system, can be used to monitor disease.

Novel technologies such as “antigen microarrays” could help to discover molecules that may be used as “markers” to predict MS disease activity and progression. Antigen microarrays are glass slides dotted with thousands of molecules that are often attacked in autoimmune diseases. When a blood sample from a person without autoimmune disease is put on the array, the person’s antibodies largely ignore the molecules. In people with autoimmune disease, however, antibodies from the blood will latch on to their target molecules; a fluorescent probe is then added to detect and count the attacking antibodies.

The Study: Dr. Weiner and colleagues developed an antigen microarray using 362 molecules relating to nerve fiber-insulating myelin (a major target in MS), inflammation, or antigens associated with other neurological diseases. In one study, they identified a pattern of antibody reactivity that distinguished 38 people with relapsing-remitting MS from 30 controls without MS with a significant degree of accuracy. Among these 94 antibody reactivities, 90 demonstrated increased activity and 4 had decreased activity in MS versus controls. To determine if such patterns were specific for MS, the team investigated blood samples as well from people with systemic lupus erythematosus (an autoimmune disease), and adrenoleukodystrophy and Alzheimer’s disease (diseases with neuroinflammatory components). They found that antibody patterns detected on antigen microarrays discriminated MS from these other diseases.

Dr. Weiner’s group also used microarrays to compare the immune response in 37 people with primary-progressive MS and 37 controls without MS. Again, they identified unique antibody patterns. Unlike relapsing-remitting MS, in primary progressive MS, most of the antibodies were decreased in activity compared to non-disease controls rather than increased. Also, heat shock proteins (small, possibly protective proteins released by cells) were reacted to by people with RR MS, but not those with PP MS. Comparing 37 people with RR MS and 30 people with secondary-progressive MS, the team found different antibody signatures, and again, greater responses to heat shock proteins in RR MS.

Collaboration with The MS Lesion Project

Finally, the group compared findings to samples obtained from Dr. Lucchinetti and the MS Lesion Project. Project investigators have amassed a large collection of tissue samples from people with MS and have found four distinct types of lesions (patches of disease activity and damage) that differ in the pattern of myelin damage and immune response.

Examining samples from 62 people and comparing the results with antigen microarrays, Dr. Weiner’s team found that unique antibody patterns were associated with different lesion patterns. Previous research suggested that people with one of these patterns respond to plasma exchange therapy a treatment used occasionally to treat individuals experiencing severe MS attacks that do not respond to standard steroid therapy. This suggests that in the future, a non-invasive blood test may be able to distinguish an individual’s underlying pathology and help with treatment decisions.

Comment: “These findings show why we live in a truly exciting time for MS research,” said John Richert, MD, Executive Vice President Of Research & Clinical Programs at the National MS Society. “The use of microarrays by Dr. Weiner’s team, and their collaboration with MS Lesion Project investigators, show how advances in technology are moving us toward the day when a blood test could help doctors diagnose and track MS, and immediately identify patients who will respond to specific treatments.”

5. IVIG Shows Mixed Results in Two Studies

Intravenous immunoglobulin G (IVIG), a treatment involving infusions of pooled antibody proteins, showed mixed results in two recent studies in people with MS. Alexandros C. Tselis, MD, PhD (Wayne State University, Detroit) and colleagues found significant improvement in a small group with MS and optic nerve inflammation, and Franz Fazekas, MD (Medical University of Graz, Graz, Austria) found no significant effect in a study of 127 people with relapsing-remitting MS. These studies point to the need for larger studies that can better define the patient populations and circumstances in which this treatment may be beneficial.

Background: Immunoglobulins are antibody proteins that are produced by white blood cells called B-lymphocytes and by plasma cells in response to various substances and infectious agents that provoke immune responses. Although the primary function of antibodies is to fight infection, when administered intravenously in very high doses, antibodies can reduce immune responsiveness, instead. Intravenous immunoglobulin G pooled from the blood of many people has proven to be useful in the treatment of a number of autoimmune diseases, but its role in the treatment of MS remains uncertain.

Tselis Study: This team administered IVIG (400 mg/kg/day for 5 days, then five additional monthly doses of 400 mg/kg) to 23 people with MS and optic neuritis (inflammation of the optic nerve, a common symptom of MS) who had not responded to intravenous corticosteroid treatment, while 24 controls received only intravenous corticosteroids (European Journal of Neurology 2008 Nov;15[11]:1163-7). All participants had 20/400 vision or worse in the eye with optic neuritis, and had been affected for between 2 and 3 months. There was significant improvement in the IVIG group with 18/23 people reaching 20/30 vision or better, compared with 3/24 in the control group. The authors comment that these results, which are better than those of previous studies, may indicate that prompt initiation of IVIG therapy can result in significant recovery of optic neuritis that does not respond to corticosteroids, but the results warrant validation in a larger, rigorously controlled trial.

Fazekas Study: This group recruited 127 people who had had relapsing-remitting MS for no more than five years. People with this type of MS experience clearly defined attacks of worsening neurologic function followed by partial or complete recovery periods. The investigators administered 200 or 400 mg/kg of IVIG, or inactive placebo, every 4 weeks for 48 weeks (Neurology 2008 Jul 22;71[4]:265-71). The primary endpoint studied was the proportion of relapse-free patients, and a secondary endpoint was disease activity as observed on MRI scans. There were no significant differences between the groups in these endpoints. Treatment with IVIG was safe and well tolerated. Since previous studies have shown some benefit for IVIG treatment in relapsing MS, the authors speculate that perhaps this patient population had a milder level of disease activity, which would improve placebo group outcomes, or that a higher dose might have been more effective.

“These studies evaluated different types of patients and used different outcome measures and study designs,” says John Richert, MD, executive vice president of research and clinical programs for the Society. “There is some evidence that this treatment may have a role to play in MS treatment, but as these studies show, we still need to determine the clinical situations in which this form of treatment may be of value.”

-- Research and Clinical Programs Department

 

Click here to view the very latest research news on the National MS Society website. 

  The Blue Ridge Chapter of the National Multiple Sclerosis Society is proud to be a source of information about multiple sclerosis.  Our comments are based on professional advice, published information, and expert opinion, but do not represent therapeutic recommendation or prescription.  For specific information and advice, consult your qualified physician.

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