Ongoing medical research into multiple sclerosis
Multiple sclerosis has perplexed medical experts for decades, but scientific breakthroughs using stem-cell treatment may mark the winds of change in the treatment of the disease, presenting what look to be more positive, potentially long-term results.
What exactly is multiple sclerosis (MS)?
Multiple sclerosis (MS) is an auto-immune disease in which the body attacks the myelin sheath – the protective covering of the nerves that enables them to rapidly conduct impulses between the brain and different parts of the body. In multiple sclerosis, the T-cells from the body’s immune system attack and destroy the myelin sheath of the central nervous system – the brain and spinal cord – leaving the nerve cell fibres unprotected. This interrupts the transmission of signals to the rest of the body.
Depending on where the damage is, warning signs can be anything unusual regarding the brain, optic nerve or spinal cord. Examples vary from muscle weakness and numbness to sudden loss of vision in an eye or difficulty with balance and reduced coordination.
MS is not a rare disease but it is uncommon, and the condition is lifelong. While research into MS has been considerable, there are still unanswered questions. What science does know is that women have a higher risk than men, and that the common age of diagnosis is between early 20s to mid-40s.
MS is sub-categorised as four different types where one type may develop into another type:
- Clinically Isolated Syndrome (CIS): a first episode of neurological symptoms lasting for at least 24 hours. When an MRI shows that CIS is accompanied by lesions on a brain, the person has a high likelihood of a second episode of neurologic symptoms and diagnosis of relapsing-remitting MS, according to the National MS society.
- Relapsing-remitting MS (RRMS). The most common disease type which is characterised by clearly defined attacks of new or increasing neurologic symptoms. These attacks (relapses) are followed by periods of partial or complete recovery (remissions).
- Primary progressive MS (PPMS). PPMS is characterised by worsening neurological function (accumulation of disability) from the onset of symptoms, without early relapses or remissions. About 15% of MS sufferers have PPMS.
- Secondary progressive MS (SPMS). Most people who are diagnosed with RRMS will eventually transition to a secondary progressive course in which there is a progressive worsening of neurologic function (accumulation of disability) over time.
How is MS treated?
Jade Hartland, 35, was diagnosed with relapse-remitting MS (RRMS) in 2015, just three weeks after developing intense vertigo. She has since had two mild attacks, during which she lost feeling down her right leg and on the left side of her face, but in both cases the symptoms were halted using medication. Jade’s chronic vertigo is ongoing, and she also suffers from chronic fatigue, a symptom common to most MS sufferers.
Dr Dion Opperman, a neurologist at Mediclinic Cape Town, explains that for the progressive course of MS, there is currently no treatment available. For the relapsing form, however, there are at least seven disease-modifying therapies available in South Africa.
‘There are two management strategies for MS,’ Dr Opperman explains. ‘The first is disease modification to prevent the MS from getting worse. The second is symptomatic treatment for the effects of the attacks the patient has already had.’
He adds that there are constantly new drugs available to treat MS and improve the quality of life of sufferers. ‘A pill for first-line therapy was launched at the beginning of February, and we expect another eight or nine drugs in the next five years.’
Dr Opperman says the use of stem-cell transplants is the most exciting MS breakthrough to date. Although still in an experimental stage, there are already at least two patients in South Africa with particularly aggressive MS undergoing this treatment.