Multiple Sclerosis

Multiple Sclerosis (MS) is a disease which causes the nerve cells of the brain and spinal cord to demyelinate. Myelin is an insulating cover around the axons of nerves which allow messages to be conducted along the axon without being disrupted by outside interference.

MS can result in physical, mental and psychiatric problems. Physical symptoms can include double-vision, blindness, sensory issues, coordination issues, and muscle weakness. Symptoms can "flare up" periodically, followed by remissions of about 30 days. This is called "relapsing remitting multiple sclerosis" (RRMS) and is the most common type (85%). If the symptoms are progressive and don't involve flare ups, then it is "progressive multiple sclerosis".

There is potentially a cure on the way for MS, based on some work done by Dr. Su Metcalfe of Cambridge University, but at this moment, all that is available to the cure is a number of treatments designed to reduce the effect of the disease on the body.

About 20,000 people die each year worldwide from MS, and survivors have a ten-year lower life expectancy. Because there is no cure publically available, the world graph of deaths by MS is generally steady at an average of about 0.031% likelihood per year that a person might die of it.

It has been noted that MS is more prevalent in people that were born in countries that are far from the equator. Because of this, it is thought that MS is related to vitamin D deficiency (which is synthesised by the body in response to sunlight). More than 70% of Irish people are deficient in vitamin D.

Treatment of MS

Treatment mostly revolves around trying to prevent relapses (flare ups), trying to return function after an attack, and trying to prevent the attacks from causing disabilities.

Flare ups can be minimised in their immediate effects by using corticosteroids such as methylprednisolone. This helps reduce the damage the immune system does to the nerves, and reduces stress caused by inflammation. This is a short-term treatment, though, and doesn't improve the life expectancy of the patient (see 4.4.1 in this book by the NHS).

Treatment to reduce the effects of RRMS is done using drugs such as interferon or glatiramer, which can reduce relapses by up to 30%, or fingolimod, which can reduce relapses by up to 50% over two years. There are 14 drugs that have regulatory approval for RRMS.

Many RRMS sufferers are treated with rituximab, which is a drug that destroys B-cells (which lead to activation of T-cells, which lead to immune system attacks on the nerves), even though rituximab has some serious side effects. The drug has been shown to be many times more effective than the more common ones, though. In a trial conducted in Sweden, it was shown that only 1.8% of people give rituximab had relapses in the following 1.5 years, vs 17.6% of people given fingolimod.

Potential Cures

In 2017, Dr. Su Metcalfe of Cambridge University discovered that there is a "binary switch" controlled by a cytokine (a type of protein used in signalling) called LIF, which can regulate whether the immune system is active or not. Her idea was to saturate the body with LIF to help regenerate the myelin sheaths.

LIF does not survive longer than 20 minutes outside the cell, though, so Su worked with Yale University to develop a nano-particle wrapper for the proteins that can dissolve over time in the body.

Human trials will start around 2020, led by the company LIFNano. If it works, there is potential in this therapy to also cure diabetes and psoriasis.

Another scientist, Hector DeLuca in the US, has discovered that two ingredients of sunscreen, homosalate and octisalate, can halt MS in its tracks.

He and his colleagues were studying the effect of ultraviolet light on mice which had a rodent version of MS. In particular, light at 300-315 nanometres. The experiment was designed such that light was shone onto the backs of mice that had been shaved to allow the light to reach the skin easier. Some of the mice had sunscreen applied to lessen the effect. Some mice had neither light nor sunscreen, and some mice had sunscreen but no light. It was expected that the ultraviolet light would help lessen the MS. But it was found instead that the greatest effect was visible in mice that had the sunscreen applied, even if no ultraviolet light was applied to them.

After experimentation, it was found that the ingredients causing the effect were homosalate and octisalate. Dr DeLuca suspects that the reason the drugs work is that they suppress the creation of cyclooxygenase, which is found in MS lesions.