Cedric Chan
Nathaniel Gensler
Zoe H
Shravani Gote
Imeloa Santosa
Jasra M.
Lexie Liu
Purvi Singhania
Alexandra Quezadaz
Emily Rodriguez
Cody Quoe
Introduction
Multiple sclerosis is an autoimmune disease, which can be caused by genetics (mutation in Immune system genes), or due to environmental factors, however a direct cause is unknown. Due to MS, the myelin sheaths that insulate the electrical impulses from nerves are damaged, and these electrical impulses that are used to communicate are either slowed significantly, or blocked completely. Multiple sclerosis symptoms differ greatly between each person, depending on the location of the nerve fibers that were affected. Symptoms usually affect movement, like numbness or weakness in limbs, electro-shock sensations that occur with certain neck movements like bending the neck forward, tremors, and lack of coordination. Vision problems can also occur, such as partial or complete loss of vision, double vision, or blurry vision. Other symptoms include slurred speech, fatigue, dizziness, tingling or pain in parts of the body, and problems with sexual, bladder, or bowel functions.
Diagnoses
There is no single test that can diagnose MS with certainty. Your healthcare provider will do a physical examination to discover the source of your symptoms. Blood tests and imaging tests, such as an MRI, may be carried out as well. An MRI scan examines the brain and spinal cord for lesions (damage zones) that could indicate multiple sclerosis. Five common diagnostic tools used to prove MS are:
-
A comprehensive patient medical history and neurological exam
-
Magnetic resonance imaging (MRI) of the neuraxis: can reveal lesions on the brain or spinal cord.
-
Evoked Potentials testing: records electrical signals that are produced from your nervous system in response to stimuli.
-
Analysis of the spinal tap (lumbar puncture): analysis of a small sample of cerebrospinal fluid collected from your spinal canal.
-
Blood tests: can check for specific biomarkers associated with MS.
Medical Treatments
There are injectable, oral and other infused medications approved by the FDA. Injectable medications include Avonex (interferon beta-1a) which is manufactured by a biotechnological process from a type of protein made up exactly the same as amino acids. Avonex is an anti-inflammatory medicine created to weaken the immune system’s response to certain stimuli. Individuals who took the medication had a reduced risk of disability progression, experienced less exacerbations and also showed a decline in number and size of active lesions in the brain.
An oral medication includes Aubagio (teriflunomide) which is a pyrimidine synthesis inhibitor which inhibits the function of specific immune cells that have been involved in MS. It inhibits key enzymes that are required by white blood cells also known as lymphocytes which then reduces the “proliferation of T and B immune cells that are active in MS and also inhibits the production of immune messenger chemicals by T cells” (Medications).
An induced medication includes Lemtrada (alemtuzumab) which is a humanized monoclonal antibody (an antibody which is produced by a single clone of cells with identical antibody molecules) directed at CD52 which is a protein on the surface of immune cells. After this treatment, the lymphocytes on the CD52 are then aimed for destruction.
Current Research
Research on Multiple Sclerosis has led to no findings of the cause, but there has been much progress in developing different treatments that prevent the worsening of multiple sclerosis as well as reducing disabilities associated with MS. The leading funder of research on the brain and nervous system including MS are the National Institute of Neurological DIsorders and Strokes (NINDS) and many different research projects conducted on MS by those from NINDS include topics on how the blood-brain barrier, circadian rhythms, genetics, diet, microbiome, and immune system affect the nervous system. For example, an experimental stem cell treatment known as autologous hematopoietic stem cell transplantation is being tested as a therapy for relapsing MS, where the patient's immune cells and their blood-forming stem cells are mixed to stop the immune system from attacking the central nervous system.
However, one of the problems of the current research is that the direct cause of MS has not been found. There is also not one test which can diagnose you with MS for certain. Multiple sclerosis is difficult to diagnose as there are a variety of different symptoms that it causes and how they are presented. Many conditions, such as migraines, mimic MS on MRI scans and patients can be misdiagnosed with MS.
Works Cited
Mayo Foundation for Medical Education and Research. (2020, June 12). Multiple sclerosis. Mayo Clinic. Retrieved October 9, 2021, from https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269.
Medications. National Multiple sclerosis Society. (n.d.). Retrieved October 9, 2021, from https://www.nationalmssociety.org/Treating-MS/Medications.
“Multiple sclerosis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 12 June 2020, https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/diagnosis-treatment/drc-20350274.
“Multiple sclerosis: Hope Through Research”, NINDS, Publication date August 2020. NIH Publication No. 20-NS-75 https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Multiple-Sclerosis-Hope-Through-Research.
Rolak L. A. (2003). Multiple sclerosis: it's not the disease you thought it was. Clinical medicine & research, 1(1), 57–60. https://doi.org/10.3121/cmr.1.1.57.
