Management and Care – The Changing Landscape of Multiple Sclerosis

Management and Care – The Changing Landscape of Multiple Sclerosis

Lee Cindy, Patrick Wong
Published: European Neurological Review - Volume 3 Issue 2
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Management and Care – The Changing Landscape of Multiple Sclerosis
In early June 2008, the 18th meeting of the European Neurological Society (ENS) welcomed over 3,000 neurologists and physicians from all over the world to Nice, France. Among the multitude of symposia, oral sessions and scientific programmes on the latest in the progress made in neurodegenerative diseases were presentations by leaders in the field of multiple sclerosis (MS). Noted key points discussed included new developments in research, and the concept that drug efficacy varies depending on the treatment stage: beginning treatment earlier in the course of the disease may be more beneficial. With strong evidence presented in support of initiating treatment earlier, neurologists have been offered the opportunity to protect patients against disease progression. By implementing early intervention it may be possible to improve the prognosis of this debilitating neurodegenerative disease.

Latest Developments in Multiple Sclerosis
In a symposium discussing autoimmune disorders of the nervous system, Professor Giancarlo Comi (Italy) addressed important new issues arising from recent MS research on disease prevalence, causal factors, disease evolution and MS therapy. Recent epidemiological studies have suggested an increase in the prevalence of MS in a number of European nations – Spain,1 France,2 Greece,3 Germany4 and Italy5,6 – particularly in the last five years. There is a trend for a nearly exclusive increase of the disease in women compared with men, says Professor Comi, attributed to lifestyle changes in women or improvements in hygiene and control of early childhood infections.7

The role of genetics and environment as causal factors of MS continues to be debated. The genome-wide approach has identified interleukin-7 receptor alpha (IL-7 rα) and interleukin-2 receptor alpha (IL-2 rα) alleles as risk factors for developing MS.8 There is also evidence of an association between developing MS and low exposure to sunlight and vitamin D,9,10 and much research is being conducted on the relationship between MS and Epstein-Barr virus (EBV) and, more recently, varicella zoster virus (VZV). EBV RNA11 and EBV antigens12 have been detected in a high proportion of brain tissue samples from MS patients, indicative of a role for EBV in MS immunopathology. There is also evidence of a very strong correlation between the viral load of VZV in cerebrospinal fluid (CSF) and blood samples and the appearance of an MS attack.13

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