Monthly Archives: December 2013

Timing is everything!

Dr. Charles ffrench-Constant is a professor at the University of Edinburgh, director of the MRC Centre for Regenerative Medicine, and a pioneer in the fields of nervous system tissue repair and myelin biology. We were fortunate to have Dr. ffrench-Constant with us at the endMS conference to talk about a very active and expanding area of research in MS – remyelination. Remyelination, a term which refers to the repair of the protective myelin sheathe surrounding nerve cells, is the key to slowing disease progression and rebuilding the central nervous system in MS. Remyelination allows the nerve cells to recover from injury, and avoid further damage. With many currently available and emerging therapies treating inflammation, the research community’s attention is now turning to remyelination with the aim of enhancing this process to reduce disability and restore neurological function.

Through highly advanced imaging experiments, Dr. ffrench-Constant and his research team demonstrated that the cells which are capable of producing myelin, called oligodendrocytes, have a very brief window of time to generate new myelin following inflammatory damage. Once that moment has passed, the cells do not produce new myelin again. Determining when, and exactly how long, this restricted time frame for remyelination remains critically important in understanding the process of repair in MS.

Image: The image above shows an oligodendrocyte in contact with cells of the central nervous system, called neurons. The oligodendrocyte produces the protective myelin sheathe that covers the cord-like structures of the neurons, called axons.
Photo credit: MSAlliance

An introduction to poster sessions

Many of us are familiar with posters. We hang them up in our rooms, around the house, in our office spaces, etc. But what many people are not as familiar with are scientific posters. Scientific posters are a fundamental component of any scientific conference, as they provide a snapshot of the breadth of research that is happening in Canada and around the world.

When I attend a research conference, I very much look forward to seeing the posters that are on display. These posters are created by researchers and clinicians, who present their research methods and data on a poster for all to see.

Sometimes you will find a researcher standing next to their poster, which is always ideal as you can chat with them about their work and learn from what they have done and observed in their study. If they are not at the poster, that is fine as well. In those instances I simply observe the poster, and come back another time to see if the researcher is around to ask questions or have a discussion.

Posters are a great way to visually display the details of a research study. When viewing a scientific poster, you might see things like images of the lab or experiment set-up, charts and tables containing data, and other images that assist the researcher in explaining their work to their audience. You may also see text describing the study further, and details on the researcher’s academic institution and collaborators.

Here are some images from the poster session at this year’s endMS Conference:

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Managing symptoms of MS – new approaches in research and clinical care

Symptom management and rehabilitation are two areas of research that are breaking new ground in multiple sclerosis. This was reflected at the endMS Conference when, for the first time ever, a separate session was created to include presentations focused on these areas. As one would expect, as research in symptom management and rehabilitation advances in MS, so to would treatments that manage the physical aspects of MS versus the underlying disease which is the main goal of disease-modifying therapies. Symptom management and rehabilitation strategies offer a holistic, comprehensive approach to MS care, and they involve collaboration between a diverse, interdisciplinary team of health professionals.

World leading MS expert and neurologist Professor Alan Thompson from the University College London discussed the importance of symptom management research for mobility, vision, and cognition – all functions which are dramatically impaired in MS. He emphasized the value in determining the right ‘outcome measure’ for use in MS clinical trials to effectively measure the benefits of a particular treatment. Outcome measures can include changes in: walking, learning and memory, disability, quality of life, etc. Identifying and validating the right outcome measures will allow future studies to assess the benefits of symptoms management treatments which can then be used in the clinic. Many studies also include ‘patient-related outcome measures’ which are treatment benefits that are reported by the study participants through questionnaires.

Prof Thompson talked about the benefits of exercise in MS, particularly resistance and endurance training. He listed several ongoing clinical trials observing the effectiveness of exercise, many of which show improvements in muscle strength, learning and memory and no serious adverse effects (click here to read about one recent pilot trial in Germany that demonstrated a positive effect of exercise in a small group of people with progressive MS). Prof Thompson also listed a number of candidate symptom management therapies (Fampiridine, cannabinoids, intrathecal baclofen, and several others) which are currently being evaluated for their ability to manage symptoms such as spasticity, bladder dysfunction, motor disturbances, and cognitive impairment.

Prof Thompson said something very important during his talk that I wanted to share on the blog. He stated that symptom management and treatments for progressive MS are the two top priorities for individuals affected by MS. His hope is that the research we heard about at the conference involving basic science, a term which refers to research conducted in the lab to determine the biological nature of MS, will translate into effective treatments today. This message resonated with me, and made me think back to the Research Priorities Discussions. During the discussions we heard from many people impacted by MS, who said that accelerating the pace of research to enable the development of treatments and a cure for people living with MS is of critical importance and where they would like to see research efforts focused upon in the near future.

Photo credit: DOUGBERRY (iStockphoto)

Getting to know the MS trainees

The endMS conference is not only a platform for sharing scientific knowledge, but also a celebration of the dedication and effort that has been demonstrated by MS research trainees across the country. The term ‘trainee’ refers to a junior investigator or young researcher, and can include:

Graduate students who are pursuing masters or doctoral work in MS research and are under the supervision of a senior researcher
Postdoctoral research fellows who conduct research to address very advanced, specific questions about MS
• Researchers who recently assumed faculty positions at academic institutions

The endMS Research and Training Network, which was created and implemented by the MS Society and involves activities such as the endMS Conference, is truly a multi-faceted program through which trainees in any of the above capacities are given invaluable opportunities for research training, career development, collaboration and mentorship.

Throughout the last few days, I have been inspired by the level of talent, passion, and innovation that has been displayed by the trainees. Not only were they presenting high-level research alongside some of the most renowned MS experts in the world, but were actively engaged in the question and answer periods, and even got together during coffee breaks to exchange ideas and ask questions about each others’ experiments.

When the endMS Network was created in 2006, the vision was that it would give rise to the next generation of MS researchers, and at the end of today I felt confident that that goal was achieved.

I wish I could write down all the interesting work in MS that was presented by trainees throughout the conference, but that would require several additional blog posts. Instead, I’ll briefly introduce one MS research trainee who I met during lunch yesterday. His name is Brian Cheng.

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What comes first, the chicken or the egg? Science points to another perspective on how MS begins

At almost every MS research conference I’ve attended, one of the most actively discussed topics is immunology. It is clear that that the immune system is acting in an uncharacteristic way in MS, as evidenced by many elegant experiments showing a build-up of immune cells in the brain and spinal cord causing severe tissue damage. These studies encourage the belief that MS begins with the immune system.

But there are a group of scientists that are now wondering whether, in MS, the immune system misbehaves causing tissue damage, or if the break down of nerve tissue is actually taking place before the immune cells arrive and cause more harm.

This important example of ‘which came first, the chicken or the egg?’ has prompted new research that is moving away from the immune system and focusing efforts on trying to understand the mechanism of tissue breakdown in the nervous system, also known as ‘neurodegeneration’.

In 2011, the MS Society funded an extensive, multi centre research grant spearheaded by Dr. Peter Stys from the University of Calgary. Dr. Stys is interested in learning more about neurodegeneration and whether this is the first step in propagating MS. He presented data here at the endMS conference which challenges the conventional wisdom that MS is an autoimmune disease driven by white blood cells that enter the nervous system and break down tissue. Instead he proposes that perhaps the tissue is undergoing some process of degeneration first, followed by inflammation through mechanisms that may involve copper or other key molecules.

Research in this area is critical as it would not only provide clues about the cause of MS, but also insights on progressive MS which is characterized more so by tissue damage rather than inflammation.

This alternative view of the cause of MS was supported by data presented by MS Society funded researcher Dr. George Harauz from the University of Guelph. In his presentation Dr. Harauz provided very detailed descriptions of the structure and function of myelin – one of the most important substances in the brain and also a major target of harmful immune cells in MS. Dr. Harauz stated that it is possible that early alterations to myelin may, down the road, lead to development of MS. I had a chance to chat with Dr. Harauz, who has been studying myelin and MS at the University of Guelph for over 25 years.

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First presentations at the endMS conference shed light on cause of MS

Day 1 of the endMS Conference turned out to be a very busy, eventful one. We started bright and early at 8:00am with opening remarks, and jumped right into the first scientific presentations.

Dr. David Hafler, a neurologist and world-leading MS expert from Yale School of Medicine, opened with an insightful presentation on causes of MS. Recent advancements in science and technology and have enabled researchers like Dr. Hafler to pioneer ground breaking experiments that provide details about the gene-biology-environment interactions in MS.

Data from these experiments show that the genes associated with increased risk of MS are predominantly immune system-related genes. Interestingly, this group of genes is also implicated in other conditions like crohn’s & colitis (another autoimmune disease with features similar to MS). Dr. Hafler’s research also shows that genes undergo very small but important chemical changes that affect the activity of immune cells, specifically the Th1, Th17, Treg and B cells (all types of white blood cells of the immune system). These genetic modifications control how the blood cells behave in MS, which in turn significantly influences disease course.

Dr. Hafler reminded us that genes and changes to the immune system are not the only determinants of MS. Research is providing more interesting clues about how the environment is playing a role. His research team at Yale recently published data on the potential contribution of salt, which shows that giving salt to mice with an MS-like disease leads to worsening of symptoms.

Overall Dr. Hafler’s presentation reminded us of how far science has come in allowing the research community to pin down the exact cells, genes, and external factors that are involved in MS. It is apparent that the processes underlying MS are very complex. Thus, the more details we know, the closer we are to more targeted therapies that will slow down or stop the disease in its tracks.

Stay tuned for my next post, which will highlight an emerging, unconventional view of MS causation and progression, as well as some interesting techniques that are now being used to screen and track MS at the cellular level.

The 2013 MS Society of Canada endMS Conference begins today!

The MS Society research team and I have arrived at St. Sauveur, Québec for the 2013 endMS Conference. Manoir St. Sauveur, – the venue for the weeklong meeting – offers a beautiful view of the small but charming ski town, which is now a vision in white as snow begins to fall on the ground, trees, and shops.

I am truly excited for what is to come in the days to follow. Over 250 participants have registered for the conference, including researchers, trainees, neurologists, MS nurses, volunteers, staff, donors and industry representatives. This makes the endMS Conference the largest MS research and training conference in the country. We have all come together to exchange ideas and approaches in science, learn about the latest advancements in MS research, provide opportunities for junior investigators to learn from world renowned MS experts, and collaborate and network.

Although many of the conference attendees are from regions across Canada, I am delighted to note that there will be a number of international guests who will also be present. The endMS conference continues to be a multifaceted platform for collaboration in research, which is critical in advancing scientific discoveries and moving one step closer to developing effective treatments and a cure for MS.

The conference program, which commences tonight and runs until Friday, will involve a series of keynote presentations on various topics in MS research, workshops for trainees and poster presentations, during which researchers will display their data on posters and engage in interactive discussions with other conference participants.

I will be posting updates on the blog throughout the week, so please visit back shortly to see what is happening here at Manoir St. Sauveur. In the meantime here are some snapshots of the conference so far.

Roaming snowy St. Sauveur

Roaming snowy St. Sauveur

MS Society staff helping with set-up

MS Society staff helping with set-up

Conference programs are ready to go

Conference programs are ready to go

Putting up our poster highlighting the MS Society's Research Program

Putting up our poster highlighting the MS Society’s Research Program

Get involved on GivingTuesday!

Many of us are familiar with the stream of blockbuster deals and extreme markdowns associated with Black Friday and Cyber Monday. But has anyone out there heard of GivingTuesday? Last year in the USA, GivingTuesday was deemed a national day of “giving back” following Thanksgiving, Black Friday, and Cyber Monday. Individuals, families, and both corporate and non-profit organizations were encouraged to be generous in whatever ways mattered to them, whether that meant volunteering at a local charity or donating to a favourite cause.

To join in the spirit of giving, Canada has decided to take part in GivingTuesday. Today is a new Canadian day of giving and volunteering. We often get caught up in gift shopping and deals, but cannot forget that the Holidays are also about the community and thinking of others.

Today I encourage all of you to take part in GivingTuesday by rallying for a favourite cause, celebrating giving and volunteering, and encouraging energy and creativity to those around you to work together for a greater good.

Working for the MS Society for so many years, I realized just how generous and supportive people are when it comes to a cause they are passionate about. Our donors and volunteers, many of whom are people who are affected by MS, have committed a lot of time and resources to help steer the organization forward and are constantly advocating for better services, more research, and changes to government policy to improve the lives of people with MS.

MS Society of Canada will match every dollar donated on GivingTuesday

In celebration of GivingTuesday, today the MS Society launched a matching gift challenge. Any contribution, small or big, will help to bring us one step closer to ending MS. If you would like to take part and donate, you can do so through the MS Society website.

You can also learn more about GivingTuesday by visiting GivingTuesday.ca or by checking out the GivingTuesday Facebook page.

Mapping MS in Canada and around the world

Conferences like ECTRIMS are a great platform for scientists, academic institutions and health organizations to announce breakthrough discoveries and important medical and research news.

During this year’s ECTRIMS meeting in Copenhagen, the Multiple Sclerosis International Federation (MSIF) announced the release of a very important document called the Atlas of MS. Made possible by the work of many individuals in the health and government sectors, the Atlas of MS provides a detailed overview of the patterns of MS prevalence, diagnosis, and treatment around the world. Not only does it reveal the number of people with MS in different countries, but also highlights the distribution of resources and services for people with MS in these areas.

The objective of the atlas is to assist governments, policy makers, non-profit organizations, and private industry in making informed decisions around the treatment and support for people with MS. The Atlas also encourages researchers to engage in international collaboration and raises awareness about MS in various areas.

Ultimately, if MS communities around the world can identify gaps in research, healthcare, government polity and support programs, they will be able to develop the necessary tools and practices that will address these gaps and build a better future for people affected by MS. More information on the Atlas of MS and key findings can be read in detail on the MS Society website.

I felt a sense of pride when I learned that many Canadians contributed to the development of this critical resource, including staff at the MS Society and MS Society-funded researchers. I had an opportunity to speak with one of the researchers at ECTRIMS. Dr. Helen Tremlett (pictured below at ECTRIMS with neurologist Dr. Penelope Smyth from Calgary) is an associate professor in the Faculty of Medicine and epidemiologist at the University of British Columbia. Dr. Tremlett is interested in observing the effects of MS on people. Specifically, she looks at the relationship between MS and: pregnancy, family relationships, disability, other chronic health conditions and use of therapies.

Dr. Helen Tremlett is pictured here (left) with Dr. Penelope Smyth from Calgary, Alberta

Here are the some of the highlights from my interview.

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