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An overview of Multiple Sclerosis: the disease mechanism, the causes, the treatments
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MS: IN A NUTSHELLThe what and the why
This work is licensed under the Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/ or send a letter to Creative Commons, 171 Second Street, Suite 300, San Francisco, California, 94105, USA.
MS IS AN AUTOIMMUNE DISEASE
Instead of fighting off foreign objects (like viruses) your body’s immune system gets confused and attacks your own cells
THE TARGET OF THIS ATTACK IS THE PROTECTIVE COATING, THE MYELIN, OF THE NERVE CELLS IN YOUR BRAIN AND SPINAL CORD
http://training.seer.cancer.gov/module_bbt
THIS ATTACK LEAVES BEHIND SCARS, CALLED SCLEROSES.
When the myelin is damaged, signals from your brain get interrupted, causing the symptoms of multiple sclerosis.
Multiple sclerosis = many scars
WHEN THE MYELIN IS DAMAGED, SIGNALS FROM YOUR BRAIN GET INTERRUPTED, CAUSING THE SYMPTOMS. Fatigue Numbness Balance, walking
problems Coordination problems Bladder and bowel
dysfunction
Vision problems Dizziness and vertigo Pain Cognitive impairment Depression Tremor Speech disorders
Symptoms vary over time and from person to person
Source: www.nationalmssociety.org
FOUR TYPES OF MULTIPLE SCLEROSIS
EXCEPT IN VERY RARE CASES, MS IS NOT FATAL AND USUALLY DOES NOT SHORTEN LIFE SPAN
WHAT CAUSES MS?
GENETICS
ENVIRONMENT
INFECTIOUS
BEHAVIOR
GENETICS
Twice as common in women Most common in Caucasians of N. European
ancestry Heredity
Risk in general population = 1/750 Risk if close relative is affected = 1/40 Risk if identical twin is affected = 1/25
Scientists have found, to-date, 50% of the factors responsible for the genetic susceptibility to MS
Sources: National MS Society; Gregory, G., Schmidt, S., Seth, P. et al. (2007). Interleukin 7 receptor a chain (IL7R) shows allelic and functional association with multiple sclerosis. Nature Genetics, (39) 9, 1083-1091.
INFECTIOUS
Epstein-Barr If results in mononucleosis, 2-3 times increased
risk factor Human Herpes Virus 6
Associated more (and at higher levels) in people with MS versus other autoimmune disorders
Sources: Ascherio, A. & Munger, K. (2008) Epidemiology of multiple sclerosis: from risk factors to prevention. Seminars in Neurology, 28 (1), 17-28.; Virtanen, J.O., Farkkila, M., Multanen, J. et al. (2007). Evidence for human herpesvirus 6 variant A antibodies in multiple sclerosis: diagnostic and therapeutic implications. Journal of NeuroVirology, 13, 347-352.
ENVIRONMENT
Vitamin D Protective factor
Twin studies Reduced risk in Norway coastal villages with higher
fish consumption
Latitude Gradient Risk reduced in populations closer to equator
Sources: Islam, T., Gauderman, W.J., Cozen, W. & Mack, T.M. (2007). Childhood sun exposure influences risk of multiple sclerosis in monozygotic twins. Neurology, 69, 381-388; Ascherio & Munger, 2008
BEHAVIOR
Smoking Risk factor for developing MS Associated with increased risk of transition from
relapsing-remitting MS to secondary-progressive MS
Sources: Ascherio & Munger, 2008
THERE IS NO CURE FOR MS
Currently several disease-modifying treatments exist to reduce the number of relapses All injection or intravenous-based
Rehabilitation therapy can help to promote or maintain function
Severe exacerbations may be treated with corticosteroids
ON THE HORIZON
Several new oral therapies are in trials Continued work to determine remaining
genetic risk factors Researchers are working with several
techniques aimed to repair damaged myelin
For more information, visit www.nationalmssociety.org