Multiple Sclerosis: The Nervous System

The nervous system is the most important system in the body. It transmits impulses to and from the brain. Disruption of the nerve cells and fibers that transmit the messages severely impairs the body's ability to carry out complex function. Once a disruption occurs, one may never recover and neurological function will steadily degrade. Multiple Sclerosis is a disease that disrupts this network. Multiple Sclerosis (MS) is the most common disabling neurological disease in young adults between 20 and 40 years of age. It is an autoimmune disease, meaning that it results from the body's immune system attacking its own cells. In this case, the immune system attacks myelin, the substance that coats nerve fibres, causing inflammation and damage to
the axons. The damaged cells form scar tissue, called sclerosis or plaques. The nerve impulses travelling to and from the brain and spinal cord are interrupted, causing symptoms. The cortex also shrinks as the disease progresses. The disease causes disability but those with MS maintain a normal life expectancy. Scientists are unsure of the cause of MS.
It is confirmed that the symptoms are caused by the immune system damaging myelin, nerve fibres, and neurons in the brain and spinal cord, but the reason for the attack is unknown. The common theory is that the immune system mistakenly identified the brain cells as foreign (National Institute of Neurological Disorders and Stroke, 2015). MS is hard to diagnose prior to the appearance of symptoms. Those with MS first undergo Clinically Isolated Syndrome (CIS) which is the first neurological event that suggests MS. It lasts for at least 24 hours, with symptoms indicating the number and severity of lesions. Physicians then perform MRI scans. Once plaques are found, the patient is diagnosed with one of the four forms of MS. Most patients are initially diagnosed with Relapsing-Remitting MS where there are temporary relapses of symptoms. Most with RRMS transition into Secondary Progressive MS where symptoms worsen steadily over time, with or without relapses. A small number may be diagnosed with Primary-Progressive MS is a form where symptoms continuously slowly worsen without relapses. Progressive-Relapsing MS is the most rare form. Symptoms worsen from the start, but there are acute
relapses. Symptoms in general depend on the severity of immune system reaction and the location and extent of plaques. Early symptoms of MS include vision problems, weak and stiff muscles with spasms, numbness in the body, loss of balance, dizziness, and bladder control problems. As the disease progressives, the patient may experience mental or physical fatigue, mood changes, inability to concentrate, and difficulty making decisions. Inflammation in the spinal cord may cause the loss of spinal cord function. Research has determined that a mix of genetic and environmental factors correlate with MS.
Current research suggests dozens of genes and hundreds of variations that increase the risk of MS, but genes are not the sole factor: identical twins only have a 1 in 3 chance of both having MS (National Institute of Neurological Disorders and Stroke, 2015). Smoking leads to a greater risk of MS. The immune response to certain viruses such as Epstein Barr Virus increases inclination for MS (National Institute of Neurological Disorders and Stroke, 2015). Statistics have also shown that those near the equator have a lower risk for MS. Scientifically, this is because Vitamin D from the sun helps regulate the immune
system. There is no cure to MS, but treatments can improve symptoms and reduce disease progression. Early treatment is critical: MS does more damage in the first year than in later years. The initial method is to inject high doses of a steroid drug like methylprednisolone intravenously over 3 to 5 days, quickly suppressing the immune system, reducing the inflammation and hastens recovery (National Institute of Neurological Disorders and Stroke, 2015). For relapsing forms of MS, physicians may also utilize plasma exchange. Blood taken out of the body is removed of components thought to be harmful. Along with replacement plasma, the blood is then transfused back into the body (National Institute of Neurological Disorders and Stroke, 2015). As the disease progresses, more potent drugs are used. Current therapies focus on modulating or suppressing inflammatory reactions and different forms of MS utilize different drugs. Drugs used include beta interferon, glatiramer acetate, teriflunomide, and dimethyl. As one drug loses effectiveness due to antibody development, alternate drugs are taken. Drugs such as mitoxantrone and Natalizumab are used as last resorts as they are linked to fatal diseases such as blood cancer and viral infection of the brain (National Institute of Neurological Disorders and Stroke, 2015). The downfall of the drugs is that they produce side effects and may be expensive. Researchers have turned to vitamin D as a potential treatment as it is affordable, safe, and has shown correlation with lower risk. They have found that not only does it lower the risk of MS, but also reduces inflammation and delays progression of the disease in patients. In a JAMA Neurology study, it has been found that a high level of vitamin D reduces amount of new lesions, lowers relapse rate, and reduces the risk of RRMS patients shifting into SPMS (Rosick, 2016). Research into MS is ongoing. A new Tel Aviv University study found a possible trigger of the disease in the membrane's physical structure. Myelin is made up of mainly lipids, thus, the shape of lipids have a critical impact on the resulting membrane. If the lipids are in cone-like shapes instead of the preferred straight shape, the membrane forms closed round cylinders which produce holes in the surface, creating a structural instability that helps the immune system enter and attack neurons (Neural membrane's structural instability may trigger multiple sclerosis, 2016). Researchers at the University of Maryland are combining immunology and nanotechnology to reprogram the function of lymph nodes so that they generate regulatory immune cells to control the attack on myelin instead or producing the inflammatory cells that attack it (Science Daily, 2016 Sep. 15). The team has experimented on two rodent models of MS (Science Daily, 2016 Sep. 15). The results were promising: a single particle treatment permanently reversed paralysis (Science Daily, 2016 Sep. 15). Although currently there is no cure, recent research has opened up new approaches to therapies and diagnostics, creating hope for the possibility of a cure. Until then, readers can only live healthier lifestyles and avoid triggers of the disease to live a MS free life.