MS disease – what happens beneath the surface?

There is an ongoing debate on whether inflammation causes nervous system damage in MS, or if the damage occurs first followed by inflammation. MS Society funded researcher and neurologist Dr. Amit Bar-Or from the Montreal Neurological Institute at McGill University provided an overview of the mechanisms of inflammation during ECTRIMS. He emphasized that, regardless of what comes first – inflammation or tissue damage – inflammation is occurring in MS. But why is inflammation occurring, and what is causing it? Research is ongoing to find definitive answers for such questions.

There are multiple mechanisms of inflammation, each one involving many different types of cells. Dr. Bar-Or noted that inflammation impacts MS disease differently in different parts of the brain and that the level of inflammation depends on a person’s state of disease. Future work on inflammation must take into consideration that inflammation may change over time and will involve different components of the immune system. The MS Society is currently funding several studies which delve deeper into the story of inflammation and the role of this complex process in MS.

The second part of the lecture focused on mechanisms of tissue damage in neurodegenerative disease. Dr. Kerchensteiner from Munich presented his lab’s work on developing novel, highly advanced imaging techniques that enable them to visualize the breakdown of brain cells in detail. He and his colleagues are particularly interested in looking at axons, which are components of nerve cells responsible for transmitting chemical impulses. In MS, damage to axons leads to diminished impulses, resulting in loss of physical functioning and disability. Dr. Kerchensteiner’s team aims to use their technique to visualize the breakdown of axons and determine the mechanisms causing the damage.

One mechanism that is being looked at involves the mitochondria, which is the part of the cell that provides energy. Mitochondria has been recently looked at in MS, as it is believed that transport of this important cell component is malfunctioned in nerve cells of people with MS, causing neurodegeneration. Dr. Kerchensteiner’s lab was able to determine that the neurodegeneration is likely caused by an influx of calcium along with the release of harmful reactive oxygen species.

This level of technology has the potential to help us understand how degeneration takes place in the brain of someone with MS, and can have implications in the clinic when evaluating people at different disease stages. The results thus far are preliminary, and so I look forward to future advancements in this area of research.

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