Inflammation on the surface of brain drives grey matter disease in MS

Epub ahead of printHowell et al. Meningeal inflammation is widespread and linked to cortical pathology in multiple sclerosis. Brain. 2011 Aug 11. 

Background: Inflammation of the coverings layers of the brain and spinal cord, in the form of lymph node like structures, has been suggested to play an important role in the development of grey matter pathology in MS. The gray matter is where the neurons live and is found on the surface of the brain.

Aim: This study analysed the incidence and distribution of these lymph-node-like structures in MS’ers who had unfortunately died with secondary progressive MS (SPMS). 
Results: 123 MS’ers with SPMS were studied. Ectopic lymph-node-like structures were found 40% of MS’ers and were distributed throughout the brain. 
Cortical (surface of brain) grey matter demyelinated lesions were located both adjacent to, and some distance from lymph-node-like structures. 
The presence of lymph-node-like structures was associated with an increase in diffuse inflammation of the covering of the brain and correlated with the degree of activation of immune cells and grey matter cortical demyelination. 
The average age of disease onset, time to disease progression, time to wheelchair dependence and age at death all differed significantly in these cases when compared with those without these lymph-node-like structures. 
Conclusions: These findings suggest that meningeal inflammation may play a contributory role in the underlying grey matter pathology and accelerated clinical course in MS.
“This study supports previous work in this area demonstrating that inflammation on the surface of the brain may be responsible for gray matter pathology in MS. Another reason to target these structures as part of an MS therapy. Pity Biogen-Idec aborted their trial of baminercept (see link below).”

07 Jun 2011
We were very excited when Biogen-Idec annoucned they were going to do a trial in SPMS with an inhibitor of lymphotoxin called Baminercept. This drug is very clever indeed; it is a soluble form of the lymphotoxin receptor 

11 thoughts on “Inflammation on the surface of brain drives grey matter disease in MS”

  1. Anyone see the new RISE OF THE APES film? I found the whole plot concerning big pharma company’s greed for money and the neuro scientist’s pursuit to cure Alzheimer's disease really interesting. It was so true to the kind of things I’ve read on this blog about how curing diseases is less interesting to big pharmas than the desire to create drugs that merely relieve symptoms.

  2. Re: "I haven't read any such thing on this blog"Please search the blog using the term "grey matter" and read the posts on this. If this is not helpful I will review the issue next week or over the weekend.

  3. Re: "I’ve read on this blog about how curing diseases is less interesting to big pharmas than the desire to create drugs that merely relieve symptoms."I am not sure that this is correct. A good analogy is carcinoma of the cervix. We now know that it is a sexually transmitted disease due to various strains of a virus called HPV. Big Pharma were the ones to take the risk and develop effective vaccines against this virus that prevents the disease. They should be congratulated for doing this. If you have ever seen a woman die from cancer of the cervix you will know why this is such an important development. If we could pin down the cause of MS with certainty, for example EBV, I am sure Big pharma will be there to develop a vaccine or treatment to target EBV. Too many of you are sceptical about Big Pharma and think they are some kind of beast that is out to ruin the world. The are simply companies run by people like you and me; they and their families get ill, develop disabilities and die like us. I know a lot of industry people and on the whole they are decent, moral people. At a macro-economic level Big Pharma, and little Pharma, are an important part of the economy we mustn't forget that. In the UK the Pharma Industry punches way above it size in terms of its contribution to GDP. In fact we should champion the industry rather than continually bashing it. Most people with a private pension are relying on the dividends paid by Big Pharma to pay their pensions; all, or almost all, big pension schemes hold a substantial amount of pharma shares in their investment portfolios. Finally, Big Pharma is here to stay. It is impossible to develop new drugs for most diseases without them. It is simply too expensive and complex to do it without them. We need Big Pharma!

  4. Re: "I haven't read any such thing on this blog" – I was actually responding to the previous comment! ("…the kind of things I’ve read on this blog about how curing diseases is less interesting to big pharmas …")

  5. Re: NY Times article from last month:"Useless Studies, Real Harm"I agree; these are typically phase 4 or post-marketing studies that are designed purely for marketing purposes. They are pretty easy to spot and we tend to avoid getting involved in them. In the UK, most neurologists work for the NHS and therefore don't get any personal compensation for enrolling patients into clinical trials; the NHS gets paid the money. This is very different to other countries where private neurologists get paid for participating in clinical trials. The bottom line; unless there is a real scientific question being addressed in a clinical trial it is unethical to enroll patients in trials. Each study is an experiment and needs a carefully thought out hypothesis and study design to address the question being asked. Ethics committee and the peer-review process is meant to weed out poorly designed and unethical trials. Obviously this does not always work.

  6. Your point about the UK is well made. I think the issue in the NYT article is a good illustration of where the 'morals' of the pharma industry stray to, given half the chance.

  7. Re: "Moral Prof G?"Yep, it is! Vaccination really works by herd immunity; i.e. you need to get as many people as possible vaccinated to drive the prevalence of the infection to very low levels. To do this you need vaccinate as many people as possible in the population. This is why the UK is considering extending the vaccination programme to boys as well as girls. This is a good thing as the same virus that causes cervical cancer also causes cancer of the penis and anus. Vaccinating boys will dramatically impact on these cancers down the road. It is a pity the US has made lobbying such an integral part of their political system, it comes across so badly. But it is here to stay; lobbying is integral to how you do business and almost everything else at a federal or even state level in the US. Forget the politics, the world is much better place for having the HPV vaccine. As it would be if we had a vaccine that prevented MS.

  8. Many parents believe their child's MS was triggered by a vaccination and have decided to avoid the HPV vaccine.Should kids & teens with MS get all the usual vaccines?

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