2018 Multiple Sclerosis Charcot Lecture

You know you are getting old when you start getting invited to give named lectures. 

2018 Multiple Sclerosis Charcot Lecture

Made possible by the patronage of Jackie Havener and the Anne Lee Sahm Memorial

Monday, June 11, 2018 | 6:30 PM

THE NATIONAL PRESS CLUB, 529 14TH Street, NW – 13th floor, Washington, DC 20045

What can the convergence of the epidemiology and biology of multiple sclerosis tell us about its cause? How soon can we start MS prevention trials?

Presented by: Gavin Giovannoni, MBBCh, PhD

Professor of Neurology, Barts & The London School of Medicine and Dentistry, Queen Mary University London

This particular lecture is a daunting one, particularly in view of the previous speakers. However, I am very passionate about the topic and have a renewed sense of purpose. #PreventingMS is what I am planning to spend most of the latter part of my career working on. Some of you may, or may not, know that I have taken on a new role as co-director of the Preventive Neurology Unit within the Wolfson Institute of Preventive Medicine. Our lead diseases are MS, Parkinson’s disease and all-cause dementia. 

Preparing this lecture is making me think very hard about what we can realistically achieve within a 5-10 year timeline in relation to MS. One thing I am sure of is that I will have to leave it up to my colleagues to find out if our prevention strategies work; it is a 20+ year experiment. However, we owe it to the next generation of MSers to try and prevent them getting MS in the first place. 

The latest review by Alfredsson & Olsson summarises what is currently know about MS from the environmental perspective and highlights several modifiable factors. 

Alfredsson & Olsson. Lifestyle and Environmental Factors in Multiple Sclerosis. Cold Spring Harb Perspect Med. 2018 May 7. pii: a028944.

Lifestyle and environmental factors potently influence the risk of multiple sclerosis (MS), because genetic predisposition only explains a fraction of the risk increase. There is strong evidence for associations of Epstein-Barr virus (EBV) infection, smoking, sun exposure/vitamin D, and adolescent obesity to risk of MS. There is also circumstantial evidence on organic solvents and shift work, all associate with greater risk, although certain factors like nicotine, alcohol, and a high coffee consumption associate with a reduced risk. Certain factors, smoking, EBV infection, and obesity interact with human leukocyte antigen (HLA) risk genes, arguing for a pathogenic pathway involving adaptive immunity. There is a potential for prevention, in particular for people at greater risk such as relatives of individuals with MS. All of the described factors for MS may influence adaptive and/or innate immunity, as has been argued for MS risk gene variants.

Do you believe MS is a preventable disease? To add a little extra to the lecture I would appreciate it if you could complete the following survey. I plan to present the results as part of the lecture. Thank you. 

ProfG    
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