Thursday, 22 December 2011

December:Unrelated Blogger Comments

Sometimes You want to post a comment that is Unrelated to the thread.


Therefore I have Created this Spot for You
I'll move it so that it is Visible &
Start a New One
Every So Often

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9 comments:

  1. I have a question about the idea of personalized medicine and the types of MS. I know no one knows the answer to this, but what do you think underlies the different types of MS and causes the differences?

    Do you think the underlying types of MS are related to the four commonly-cited types: RRMS, SPMS, PPMS and PRMS? I ask this because I don't seem to fit comfortably in any of those boxes (which sometimes leads me to wonder if I really have MS) and also they are apparently based on expert consensus (so it's not clear to me how clearly they're mapped to the underlying biology)

    Do you think MS is one disease or many?

    Do you think there are any promising biomarkers related to MS that are likely to be validated and available anytime soon? There are a lot of articles and press releases, but they all seem to be so much vaporware.

    I know this is a lot of questions, but thank you for any thoughts.

    ReplyDelete
  2. Dear Anon 12 19th

    There was a post on personalised Medicine by Prof G
    http://shift.ms/magazine/2011/12/podcast-personalised-medicine-where-are-we-at/

    What underlies the causes of MS, is a million dollar question. It depends on who you talk to.

    Some ideas will be presented at our Research day in January..

    The differences-Perhaps genetics, environment, lesion location and time etc. You can have identical twins with different diseases courses so its not an easy answer. Time of disease onset, sex are associated with differences in chances of developing RRMS vs PPMS.

    The types of MS are just a way to pigen hole disease but there is variety. Most people with RRMS develop SPMS, but in terms of treatment it seems that RRMS and probably RPMS respond to immunomodulation, progressive MS (PPMS v SPMS does not and will need a different treatment). So whether you are gadolinium enhancing or not maybe more relevant than a name.

    Do I think they are different diseases..No just a spectrum of different paths that can develop. In animal models where we know the cause you can get very different spectrum of clinical courses, which are dependent on genetics and the target of the response.

    If you are not happy with diagnosis you can always ask for a second opinion. Although I am not a clinician

    Is MS just one disease... this changes with time, not long ago Devics MS was considered a form of MS, like Marburg MS and Balos MS. Now Devics disease is called NMO (neuromyelitis optica) and is thought by most to be a different disease to MS, it responds differently to therapy.

    If you understand the mechanisms of disease and treat these you can have an impact.

    Is there going to be a MS biomarker I am not sure about this, I doubt there is going to be one easy biomarker for diagnosis and so we'll need neuros, but MRI has been helpful in diagnosis. I do believe that some biomarkers that indicate disease processes are around and will be developed further.

    Prof G may give you an alternative opinion.

    ReplyDelete
  3. What underlies the causes of MS is worth a heck of a lot more than a million dollars Doc.

    RE "If you want a one-one with a Neuro, Private Consultation is the Best Place For This."

    Really? Is the NHS that inept at doing its job?

    I must say that MS care on the NHS is the worst in Europe. I now live in Amsterdam and it's so much better here. (I didn't move here for the dope, more because of a girl.)

    ReplyDelete
  4. Has anyone on Team G seen this news item?

    "MS not disease of immune system":
    http://medicalxpress.com/news/2011-12-contends-multiple-sclerosis-disease-immune.html

    IMO, her lipid theory seems far-fetched to me. Do forensic anthropologists have any expertise in MS? I fear a repeat of the past two years (sigh).

    ReplyDelete
  5. www.nytimes.com/2011/12/26/science/robert-ader-who-linked-stress-and-illness-dies-at-79.xml

    Is there a link between stress and getting MS and MS progression?

    ReplyDelete
  6. Re: "Is there a link between stress and getting MS and MS progression?"

    Not that I am aware of. There is a weak link between stressful events and relapses, so theoretically there could be a link between stress and disease progression.

    ReplyDelete
  7. Re: "I must say that MS care on the NHS is the worst in Europe."

    Not sure about this; I agree that the quality of MS care can be highly variable depending on where you live, but there are centres of excellence in the UK that are amongst the best.

    ReplyDelete
  8. Re: ""MS not disease of immune system":
    http://medicalxpress.com/news/2011-12-contends-multiple-sclerosis-disease-immune.html

    IMO, her lipid theory seems far-fetched to me. Do forensic anthropologists have any expertise in MS? I fear a repeat of the past two years (sigh)."

    Unfortunately, I can't access the article to review so it is difficult to comment. However, with all new theories on causation the proponent needs to apply Bradford-Hills' criteria for causation. I await the publication with interest and will comment fully on it when it is available.

    ReplyDelete
  9. The lipid theory article is up at http://www.overcomingmultiplesclerosis.org/html/blob.php?attach=true&documentCode=7055&elementId=20084&ei=dUUDT63bJcKjiALNs7yjCg&usg=AFQjCNFstRLToCnpuWQmQDcGfKPQIvoEqw&sig2=KDF8iEpAmRKRDKPT6MhijQ or http://goo.gl/hYwBN

    ReplyDelete

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