MS Research Spotlight: 25 Years of Research, TWEAK Biomarker, and More

MS Research Spotlight covers key research news from the past two weeks.

Evolution of clinical trials in MS

FEBRUARY 21, 2019 || Therapeutic Advances in Neurological Disorders

A recent review of MS research since 1974 shared interesting conclusions.

Generally, it confirmed that 25 years of research have led to substantial developments, with therapies emerging that were the direct results of clinical trials.

More specifically:

• Both disease course understanding and clinical trial characteristics have been redefined with the advent of disease-modifying therapies
• Current trial populations do not share the same baselines as their peers from 1974; people with MS today are diagnosed earlier and experience milder disease due to more and better treatment options.
• Efficient and adaptive study designs exist today that could lead to seamless transitions between phase II and phase III clinical trials, reducing costs and expediting trial outcomes.
• Current imaging techniques measure key parameters (brain volume and atrophy, for example) in addition to traditional ones, such as disability scoring and MRI data.
• Efforts to improve our understanding of MS include remyelination and neuroprotection as well as innovations reserved for progressive forms of MS.

High levels of serum soluble TWEAK are associated with neuroinflammation

FEBRUARY 20, 2019 || Journal of Translational Medicine

Recent research points to a specific new serum marker which shows promise in testing for ongoing inflammation in the central nervous systems of people with MS.

The Maarouf et al. study took a closer look at a transmembrane protein (TWEAK) to see if it could serve as a blood biomarker for identifying inflammation in people with MS. TWEAK belongs to the TNF ligand family, identified in 1984 as instrumental in cell-to-cell signal transfer as part of its regulation of immune cells.

Levels of TWEAK were found to be significantly higher in MS patients when compared to their healthy cohorts in the study, especially during relapses. The study suggests that using TWEAK as a blood biomarker could help neurologists in choosing the best window for performing MRI and “optimizing disease control in patients.”

Scientists create new map of brain's immune system

FEBRUARY 19, 2019 || University of Freiburg via Science Daily

Thanks to German researchers, a new map of the brain's unique immune system has been created for both humans and mice. The map and its companion study were published this month in the journal, Nature.

It’s the first time scientists have been able to capture the core signature of the brain structures, known as microglia, to visually demonstrate their functions.

The healthy brain’s key immune defense system rests in these microglia, which form a network around neurons and adapt to conditions that allow disease to occur. This network produces new cells that typically aid in limiting brain damage.

However, in MS, these cells become dysregulated and cannot inhibit immune-system damage to the brain.

The scientists were also able to map these cell behaviors during active disease.

Dr. Marco Prinz, medical director of the Institute of Neuropathology at University of Freiburg Medical Center, told Science Daily that, in creating this new “immune cell atlas,” “we were able to show that there is only a single type of microglia in the brain that exists in multiple flavours.”

A new high-resolution method for analyzing single cells allowed his team to make these discoveries, heralded as critical for understanding brain disease.

"In MS patients, we managed to characterize microglia in a state that is specific for multiple sclerosis,” said Prinz.

Landmark study estimates nearly 1 million in the U.S. have MS

FEBRUARY 15, 2019 || National Multiple Sclerosis Society

New research estimates that nearly 1 million adults were living with MS in the US in 2017, according to NMSS-sponsored research published recently in Neurology.

This number more than doubles previous estimates made in 1975 and the subsequent updates ever since.

The objective of the NMSS research was to develop more “scientifically sound and economically feasible” estimates of disease incidence and prevalence in the US.

Delivering more accurate reflections of the economic burden on people with MS, their families, and society could improve our understanding of MS, isolate geographic clusters of MS to look for new risk factors and triggers, and provide agencies with greater ability to connect to and support patients.

NMSS president Cyndi Zagieboylo said of this important new data that “this study tells us many things, but one thing in particular—twice as many people need a cure. …We need to raise more money to fund more research; we need to fund the programs and services that help people with MS live their best lives; and we need to make sure the voices of people living with MS are heard and their rights to have quality, affordable health care are protected.”