Multiple sclerosis could be stopped in next DECADE, researchers say

Multiple sclerosis could be stopped in the next DECADE, researchers say as they hail scientific breakthroughs that ‘pave the way to wiping out the condition’

  • Scientists say range of medications will be in late stage trials by as early as 2025
  • This year saw breakthrough with blood sugar and cholesterol-lowering drugs 
  • Currently only medications available for sufferers focus on easing symptoms 

Multiple sclerosis (MS) could be stopped within a decade, according to leading researchers.

A series of scientific discoveries have led to experts calling 2019 ‘the most significant and exciting time we have ever seen’ in treating the disorder.

Scientists say a range of medications for sufferers of the debilitating condition will be in late stage trials by as early as 2025.  

MS is thought to affect 100,000 people in the UK, with 14 patients being diagnosed every day, MS Society statistics show. 

And in the US, nearly one million are living with the condition, according to the National Multiple Sclerosis Society.

The disorder, which strikes twice as many women as men, damages nerves in the body, causing mobility loss, sight problems, fatigue and pain. 

There is no cure, with current treatments focusing on easing symptoms and preventing relapses.

Multiple sclerosis (MS) could be halted within a decade, scientists say on the back of a year full of scientific breakthroughs (file image)

This means that as a person’s condition progresses there is nothing to stop them becoming more disabled.

Professor Alan Thompson, consultant neurologist and chair at the International Progressive MS Alliance, said: ‘In the past decade we’ve made significant progress in treating MS, but there remains a huge unmet need in developing treatments for the progressive form of the condition. 

‘Now, for the first time, the international research community has come together and is aligned on what needs to be done to stop the condition, and, with a dramatic increase in investment, we could genuinely change people’s lives.

‘MS is relentless, painful, and disabling, but thanks to research improving our understanding, we’re now able to develop strategies that tackle the condition in new and different ways – including myelin regenerative and neuroprotective treatments – with the ultimate aim of stopping MS. 

‘This is the most significant and exciting time we have ever seen in the treatment of neurological conditions.’  

Earlier this year researchers discovered a way to regenerate lost myelin – the fatty sheath surrounding our nerves and is damaged in MS. 

In MS, the immune system attacks myelin, leaving nerves unable to efficiently send and receive messages.  

Cambridge University scientists gave rodents the blood sugar-lowering medication metformin for three months.

They then stripped myelin from some of the nerves in the animals’ brain. Results described as ‘spectacular’ showed the rats’ damaged myelin made an almost complete recovery after three weeks on metformin. 

Another key milestone has been the discovery of treatments which may to protect nerves from damage.

This includes the use of cholesterol-lowering drugs known as statins. They are currently being tested in the biggest ever trial for secondary progressive MS.

WHAT IS MULTIPLE SCLEROSIS?

Multiple sclerosis (known as MS) is a condition in which the immune system attacks the body and causes nerve damage to the brain and spinal cord.

It is an incurable, lifelong condition. Symptoms can be mild in some, and in others more extreme causing severe disability.

MS affects 2.3 million people worldwide – including around 400,000 in the US, and 100,000 in the UK.

It is more than twice as common in women as it is in men. A person is usually diagnosed in their 20s and 30s.

The condition is more commonly diagnosed in people of European ancestry. 

The cause isn’t clear. There may be genes associated with it, but it is not directly hereditary. Smoking and low vitamin D levels are also linked to MS. 

Symptoms include fatigue, difficulty walking, vision problems, bladder problems, numbness or tingling, muscle stiffness and spasms, problems with balance and co-ordination, and problems with thinking, learning and planning.

The majority of sufferers will have episodes of symptoms which go away and come back, while some have ones which get gradually worse over time.

Symptoms can be managed with medication and therapy.

The condition shortens the average life expectancy by around five to 10 years.

The £6million project, which will be funded by the NHS National Institute for Health Research and the MS Society, offers hope of the first effective treatment for patients with secondary progressive MS – an advanced stage of the illness.

In the early stages, patients normally experience ‘relapsing-remitting MS’, where their condition gets worse and then stabilises in fits and starts.

Around half of those patients develop secondary progressive MS within 15 to 20 years.

At this stage there is no let-up in their decline and they progressively lose muscular function and become more disabled. 

Scientists hoping to cure the disorder within the decade have joined a Stop MS appeal by the MS Society, which needs to raise £100 million over a ten year period to accelerate new research.  

Professor Anna Williams, an expert in regenerative neurology at the MS Society Centre for MS Research at the University of Edinburgh, said the 10-year commitment was ‘not to be taken lightly’.

She added: ‘MS is a serious condition that can affect every aspect of your life, and the Stop MS Appeal will bring immense hope to millions of people affected.

‘For a national charity and professionals like myself to come out and say we believe it can be stopped, we must be able to deliver on that promise.’

The Stop MS Appeal launches publicly this week with a major advertising campaign.

The money raised will pay for new research and MS clinical trials network, which is currently being developed by leading clinicians and scientists bought together by the MS Society.

This trial will allow researchers to test many potential drugs simultaneously, saving time and money.   

Nick Moberly, chief executive at the MS Society, said: ‘Research has got us to a critical point, and we can see a future where nobody needs to worry about MS getting worse.

‘That means not living in fear you’ll be reliant on a wheelchair, or one day lose your independence entirely.

‘The worldwide MS community is coming together to help us achieve our ambitious goal to stop MS. But we need to act now, because people with MS can’t wait.’ 

‘I WATCHED MY MOTHER SLOWLY DIE TO MS… AND NOW I HAVE IT’

Nikki Jamieson, 52, from Warwickshire, has been living with relapsing MS since 2015 and is a former British Karate team competitor.

Her mother also had MS and passed away in a care home aged 59. 

When Mrs Jamieson was 14 she came home early from school to find her mum surrounded by pain killers considering killing herself. 

Her mother, Jean Watkinss had never told her how much pain she was in.

Nikki Jamieson (left as a teen), 52, from Warwickshire, has been living with relapsing MS since 2015. She watched her mother (right) lose the ability to perform basic functions while suffering with MS

Mrs Jamieson said: ‘When I was told I had MS it felt like my life had ended, and I think the reason was my mum.

‘I just thought, that’s what’s in store for me. For years I’d just seen her gradually get worse and worse and worse. 

‘She used to be a painter and eventually she couldn’t even write her name. Mum deteriorated every year until she had a huge heart attack brought on through lack of exercise. 

‘Apparently MS had shut her body down, so at 56 she had to move into a care home away from my Dad, the love of her life. 

‘She was heartbroken, and three years later she died. My Dad carried on another four years before he also died, aged 64, also of a broken heart.

‘It was 15 years after mum died that I lost all sight in my right eye – just like that. 

Mrs Jamieson (with husband Niall) experienced no symptoms of the disorder until Christmas 2014 when she went blind in her right eye

‘No warning, just gone. Less than two months later it was confirmed I had relapsing MS. 

‘Just recently my daughter asked me if she was going to get it too. And in the same way as I think my mum would’ve been devastated if she’d been alive when I diagnosed, it sort of brought me up short.’

Mrs Jamieson experienced no symptoms of the disorder until Christmas 2014.

She felt dizzy one morning and when she stood up in her kitchen she went completely blind in one eye.

‘We went through a bunch of tests, the eye specialists couldn’t work out what was wrong. Then doctors began testing for hole in my heart.

‘A brain scan finally revealed I had MS. I was absolutely devastated. I’ve managed to avoid the majority of symptoms – I can walk fine. 

‘But it’ll cause me to forget things I’m trying to say – words get stuck on the tip of my tongue.

‘It has been a horrible part of my life. I regularly get spasms in my right leg. If I have them they stop me from doing anything. 

‘When you think about what my mum used to have it’s not too bad. She had to suffer without medication. 

‘But I’m constantly Living in fear that symptoms are round the corner and you don’t know what they are.’

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Still at war with the tobacco epidemic, Indonesia must control e-cigarettes too

Several countries are banning e-cigarettes due to revelations of health risks to both users and bystanders.

But in Indonesia, the world’s second-largest cigarette market, the government has yet to put in place policies to prevent youths from taking up vaping.

More than 1,000 people were confirmed ill and at least 19 people died from a severe lung disease linked to vaping in the United States (US). The country has recently considered banning flavoured e-cigarettes in response to the deaths and illness associated with vaping.

Twenty countries in South America, the Middle East and Southeast Asia have banned the possession and sale of e-cigarette products.

There has been no research on the prevalence of vaping among youth in Indonesia, but the Indonesian government should be alarmed by the reports of illness and death due to vaping in the US.

The government should take immediate actions to prevent a youth vaping epidemic in Indonesia, especially since Juul, a leading US-based e-cigarette firm, entered the market in early July.

The sale of vaping devices in Indonesia might increase the number of young people who smoke, as vaping among non-smoking youth can be a gateway to tobacco smoking.

This will further burden Indonesia, which already has the highest rate of youth smokers in the region. A fifth of Indonesians between 13 and 15 years old smoke cigarettes.

Important measures

Here are some suggestions the government should adopt to control public health risks from e-cigarettes sales:

First, the government should control the safety and quality standards for e-cigarettes, including e-liquid ingredients and e-cigarette components.

Indonesia’s existing regulation on vaping is far from adequate.

Since 2017, Indonesia’s Trade Ministry has required e-cigarette products to be authorised by the country’s National Drug and Food Agency (BPOM) and Health Ministry before being marketed.

Currently, the vaping liquid (e-liquid) is taxed as high as 57%, higher than the average of excise tax for combustible cigarettes. However, this policy applies to e-liquid, not the prefilled pods found in Juul products. It is still unclear how Juul will be regulated in Indonesia based on the existing policy.

The Finance Ministry should periodically adjust the tax rate for inflation to keep vape products less affordable for kids. Also, there should be a single excise tax that encompasses all types of e-liquid, regardless of their cartridge model.

BPOM should also set the safety and quality standards for e-cigarettes and continuously monitor adverse effects of the products.

Second, limit access to e-cigarettes for youth and non-smokers.

The government can restrict access to e-cigarettes by limiting the type of selling outlets like kiosks and convenient stores, banning flavoured e-cigarettes, regulating e-cigarette promotion and advertising, and setting up a screening system to prevent non-smokers or young customers from buying the device.

Again, BPOM and the Health Ministry can apply such ban. The government should stop the distribution of misleading and scientifically unproven health claims that promote vaping. This includes messages like vaping helps smokers quit.

Ensuring the efficacy of this measure requires interministerial efforts, involving the Ministry of Communication & Information Technology, Trade Ministry and Health Ministry.

Third, ban vaping in smoke-free areas.

Secondhand vaping may harm the health of bystanders. The World Health Organization (WHO) recommends countries regulate vaping devices in public places.

Indonesian authorities at the regional level may extend current smoke-free laws that forbid smoking in public spaces to e-cigarette users.

Fourth, run a public education campaign about the harms of exposure to e-cigarettes.

The campaign may start in schools. Teachers can play an important role in educating students and parents about the risks of vaping.

The program should also involve health professionals or even youth communities, like in the US.

Again, the campaign should involve multisectoral authorities, like the Ministry of Education and Ministry of Communication & Information Technology.

Why Indonesia needs to control vaping

Vaping is dangerous for health, research has proven.

While it is true that vaping emits fewer chemicals than combustible cigarettes do, it produces other toxic substances. These substances include nicotine, a substance that is as addictive as heroin, and metals in the same or higher levels than combustible cigarettes. It means vaping is not necessarily less harmful than smoking.

E-cigarette’s aerosol can also expose users and bystanders to particulate matter and cancer-promoting substances such as formaldehyde.

Nicotine itself may increase the risk of cardiovascular diseases and harm brain development, which deteriorates attention, memory and learning.

The e-cigarette has not yet been proven as an effective tool to stop smoking. Instead, vapers might be at risk of being dual users, smoking and vaping, or if they quit smoking, they could not give up vaping for a long term.

Tobacco-related diseases cost Indonesia almost Rp 4.2 trillion (US$295 billion) by 2019. By controlling e-cigarettes and their use, the government can save the young generation from becoming smokers as e-cigarettes tend to attract youth and may turn them into smokers.

E-cigarettes not a solution

The WHO has warned that e-cigarette firms, which are mostly tobacco companies, are trying to re-establish their image as part of the solution to the tobacco epidemic so they can influence governments’ tobacco control policies to increase their own profits.

Thus, the WHO Framework Convention on Tobacco Control (FCTC), the global public health treaty to address tobacco use, calls on FCTC countries to prohibit or restrict the production, distribution, sale and consumption of e-cigarettes.

In fact, Juul has been banned in Israel and Indonesia’s nearby countries, Singapore and Thailand.

Can Indonesia follow suit to protect its young generation?

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Doctors Say Sanders’s Heart Surgery Is Common for People His Age

The Democratic presidential candidate Bernie Sanders had a heart procedure for a blocked artery Tuesday night, and has put his campaign on hold while he recovers.

CNN reports that Sanders’s senior adviser, Jeff Weaver, delivered the news via conference call on Wednesday morning. According to Weaver, Sanders, who experienced chest discomfort during an event Tuesday evening, had “a blockage in one artery, and two stents were successfully inserted.” Weaver added that “Sanders is conversing and in good spirits. He will be resting up over the next few days.”

Tweeting from his hospital bed Wednesday, Sanders said that he was “feeling good,” and took the opportunity to highlight one of his key campaign promises: “None of us know when a medical emergency might affect us. And no one should fear going bankrupt if it occurs. Medicare for all!”

What Is an Arterial Blockage, and How Serious Is It?

An arterial blockage, such as the one affecting Sanders, can result from a condition known as atherosclerosis, where plaque builds up in the arteries and reduces blood flow, according to Texas Heart Institute. The condition can lead to heart attacks, stroke, and other forms of cardiovascular disease.

Although Sanders has no reported history of heart disease, doctors agree that his medical condition is typical for men his age.

“It’s certainly not unusual for a 78-year-old man to develop coronary disease and to require a coronary stent,” says William Fearon, MD, a professor of cardiovascular medicine at the Stanford University Medical Center in California. “It’s one of the most common conditions that we face as we get older.”

According to the Centers for Disease Control and Prevention, coronary heart disease (CHD) is the most common type of heart disease and kills more than 370,000 people annually.

“Unfortunately, these kinds of symptoms can emerge really out of the blue. And that’s why we tell people that if they’re experiencing chest pain, if they’re experiencing shortness of breath, the kind of symptoms that might be referable to your heart, it’s a good idea to check with your healthcare professional,” said Robert Harrington, MD, a cardiologist at Stanford University and the president of the American Heart Association (AHA), in a news statement.

Although Sanders’s campaign won’t say whether or not the senator had a heart attack, Sanders was in good health and had no history of cardiovascular disease, according to a 2016 letter from his doctor. The doctor did note, though, that his cholesterol numbers were high.

What Is a Stent?

According to the AHA, a stent is a small metallic mesh tube that supports the artery from the inside. It provides a framework to keep the artery structurally sound. Dr. Fearon describes it as “a scaffold to open up a narrowing and keep it open.”

The procedure used to insert the stent is known as angioplasty, and according to Fearon, it’s “minimally invasive.” Once correctly placed inside the artery, a balloon catheter is inflated inside the stent in order to expand it to the correct dimensions to keep the artery open and free of blockages. The balloon catheter is then removed, but the stent remains for support, he says, and eventually it becomes part of the arterial wall as the vessel grows back around it.

What’s Next for Sanders?

Fearon notes that the recovery from stenting is “fairly rapid” and that patients are often discharged on the same day in cases of stable coronary disease. The speed of recovery depends on a patient’s overall health and whether or not they had a heart attack. Fearon notes that a person’s age does not necessarily dictate how long the recovery process will take.

“If you have a very fit 78-year-old, that person should be able to recover quite well,” he says.

Fearon adds that a proactive approach to heart health will likely be necessary for Sanders from now on.

“In any patient who’s had an event like this, we want to be very aggressive with lifestyle and medical therapy,” he says. “Key things would be keeping cholesterol levels as low as possible, making sure blood pressure is well-controlled, and if a patient has diabetes, making sure their blood sugar levels are very well-controlled.”

Will Sanders Be Able to Continue Campaigning?

There has been plenty of speculation as to what this means for the senator’s presidential campaign. As Fearon notes, “It’s a difficult question to answer, and it’s something that he and his physicians will address at the appropriate time.”

As the Associated Press reported Thursday afternoon, a campaign spokeswoman, Sarah Ford, reassured supporters that the senator will still be participating in the next Democratic presidential debate on October 15 in Ohio.

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