“In response to interest generated by an earlier post on hot microglia as a therapeutic target, we have invited Professor Laura Airas, who presented her much talked about work on this topic at the recent AAN, to do a guest post. She has agreed to answer questions on the topic so please feel free to ask. This innovation in imaging has particular implications for progressive MS trials.”
Laura Airas, MD, PhD. Positron emission tomography (PET) holds promise for better treatment of progressive MS. Turku University Hospital, Turku, Finland
While there is increasing number of efficient therapies available for relapsing-remitting MS (RRMS), secondary and primary progressive MS (SPMS and PPMS) still remain the under-treated and under-investigated forms of the disease, and treatment of the progressive patients represent today the greatest unmet need in the field of MS. Consequently, many sufferers of progressive MS end up wheelchair-bound or bed-ridden, which not only causes huge impact on the quality of life, but also leads to enormous societal costs due to inability to work and dependence on carers.
We have been working with positron emission tomography (PET) imaging to see whether PET could provide more information about the underlying neuropathology in patients with secondary progressive MS than conventional MRI imaging can do. With PET imaging we can use radioligands that bind to activated microglial cells. This is an inflammatory cell type within the CNS, which gets activated in association with chronic degenerative diseases. Our latest work which was just recently presented at the American Academy of Neurology meeting in Philadelphia, USA, demonstrates that PET imaging allows us to visualize microglial cell activation in and around the MS lesions, and in areas of normal-appearing white matter, i.e. in areas that look normal in MRI. In other words, PET can give us more detailed information of the ongoing disease process in progressive MS, than MRI.
|A patient in a PET scanner|
Our work indicates that PET holds promise as a research tool in understanding the central nervous system pathology of secondary progressive MS, and will also aid in recognizing new therapeutic targets. We have recently demonstrated using an animal model of progressive MS, that fingolimod-treatment led to reduced microglial activation, and this could be measured in vivo using PET. We believe that PET imaging could potentially be used as a biomarker in the development of novel treatments targeting progressive MS, and our findings will thus hopefully ultimately lead to better treatments for progressive MS.
Special interests of Dr. Airas include multiple sclerosis and pregnancy-related issues, mechanisms controlling lymphocyte homing into the CNS, development of novel drugs for MS, and advanced imaging techniques such as positron emission tomography (PET). She has been coordinating a Finnish nation-wide study looking at pregnancy-related alterations in MS immunopathology, and has numerous international collaborations in immunology and imaging fields. Dr. Airas also actively participates in clinical studies investigating new drugs to treat multiple sclerosis.
In addition to her scientific activities, she is responsible for neuroimmunological patients in the outpatient clinic of Turku University Hospital, and takes an active part in giving neuroimmunology-related education to fellow neurologists, other health care professionals, medical students and patients.