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Thursday, May 1, 2008
Sunday, April 27, 2008
April 28, 2008
1) We estimate the narrow sense heritability of Multiple Sclerosis to be a low number for a few reasons. First, an exact cause has not been identified for MS. Second, it is unknown how much of the progression of the disease is due to the environment, and how much is due to heredity. Given these two points, it would be impossible to calculate an exact number for narrow-sense heritability. However, one study from 1998 suggested genetic heritability is high and includes more genes than originally suggested. Therefore, we believe the h2 value will be somewhat higher, anywhere from 75-85%. This information was gathered from a Brain, A Journal of Neurology article entitled "The genetics of multiple sclerosis: principles, background and updated results of the United Kingdom systematic genome screen" by J Chataway.
Given the high h2 value we chose to use, selection would have a large influence on MS. Along with a high h2 value comes a high degree of genetic variation, thus selection will occur at a higher rate.
2) In order to answer the question, what effect will inbreeding have on multiple sclerosis, we must first know the method of how one comes to be affected by this disease. As of right now, this is unknown. However, studies have shown that women are more affected than men. Also, families that already have someone with the disease are more likely to see another individual with multiple sclerosis. Knowing this, it can be inferred there must be a genetic component to MS that contributes. Therefore, inbreeding can be assumed to have an increased effect upon the prevalence of multiple sclerosis.
As stated above, multiple sclerosis seems to affect women more so than men. This could be a result from the role of the maternal effects upon the egg. Also, women are able to have children before the effects of MS are noticeable so many offspring could be produced before it is known the mother has MS. This would increase the number of people that carry the potential alleles. If inbreeding were to happen these alleles would more frequently come into contact with each other, thus increasing the frequency of the multiple sclerosis phenotype.
Given the high h2 value we chose to use, selection would have a large influence on MS. Along with a high h2 value comes a high degree of genetic variation, thus selection will occur at a higher rate.
2) In order to answer the question, what effect will inbreeding have on multiple sclerosis, we must first know the method of how one comes to be affected by this disease. As of right now, this is unknown. However, studies have shown that women are more affected than men. Also, families that already have someone with the disease are more likely to see another individual with multiple sclerosis. Knowing this, it can be inferred there must be a genetic component to MS that contributes. Therefore, inbreeding can be assumed to have an increased effect upon the prevalence of multiple sclerosis.
As stated above, multiple sclerosis seems to affect women more so than men. This could be a result from the role of the maternal effects upon the egg. Also, women are able to have children before the effects of MS are noticeable so many offspring could be produced before it is known the mother has MS. This would increase the number of people that carry the potential alleles. If inbreeding were to happen these alleles would more frequently come into contact with each other, thus increasing the frequency of the multiple sclerosis phenotype.
Friday, April 11, 2008
Response to Questions, April 11 2008
Stephanie: This is a fairly complex paper, and after reading it three times, it was still impossible for me to fully comprehend. However, I did pick up pieces of information, unknown to me before. More importantly, from the parts that I did understand, the paper seemed to be disheartening and self-contradicting in the following points.
First of all, I found it interesting that the researchers were so quick to disown the possibility that MS may be, either wholely or partially, a result of viral influence, after careful analysis of only one disease-causing virus in mince: Theiler murine encephalomyelitis virus (TMEV). As a whole, research has still NOT proven the source of MS and cannot entirely rule out virul stimuli an option.
Secondly, I struggled with the researchers' course of study. Why did they choose to respond to a disease, such as MS, in which patients continually struggle with immunodepression, with a regimen, such as HSCT, that further suppresses the immune system? How did this treatment even present itself as an option? MS patients constantly face the serious threat of illness, or infection, due to their already-supressed (or pre-occupied) immune systems, so why would they want to risk suppressing it even further? Even a common cold or a cat-scratch poses the threat of an onset of exacerbations in an MS patient, so it was NOT surprising to me, that later in the article, the researchers were faced with these issues: worsened clinical flares of MS, unimproved, or extra, neurologic deterioration, lethal opportunistic infections, and treatment-related deaths.
Finally, the rationale behind HSCT treatment, as stated in the article, includes the goal to design regimens that are justified for the risk of the disease being treated. The facts that this research seems to have, largely, negative effects: a high percentage of treatment-related deaths, a possibly-lessened quality of life for the patient due to immunosupression, and its inability to treat a large portion of MS patients (those with progressive MS), leads me to believe that the HSCT regimen is NOT justified for the risk of the disease being treated.
These and other issues, presented in the paper, just didn't "flow" for me. As stated earlier, I learned some new information, but found the paper to be contradicting in many of its presented topics.
Sean: I guess what was new for me was how these researchers were going about looking for the multiple sclerosis cure. I have heard about the possibility of stem cell transplantation for multiple sclerosis, but have never seen it implemented until now. The controversy over what types of stem cells to use for genetic research seem to dominate the media which may push work like this to the background. I have heard of this being a somewhat effective treatment though. The book, The Transformed Cell: Unlocking the Mysteries of Cancer, presents a similar approach to cancer treatment. The doctor behind this book would take a patient’s own immune cells, culture them and bombard the tumor with the increased number of cells. Our paper took this approach to providing the new treatment for MS.
Also, the research was slightly disheartening for anyone beyond the initial stages of MS. Throughout most of the report it was reiterated that those afflicted with chronic or late stage MS had basically no hope. However, it is exciting that treatments are still developing and new strategies are being adapted to the eventual cure of multiple sclerosis.
Ben: What I learned most from the assigned paper was that the differet stages of Multiple Sclerosis make it exceedingly difficult to treat. While inthe earlier stagess of the disease doctors have found a way to treat patients, the later, more degenerative stages are proving to be very complicated to tend to. I also learned that Experimental Autoimmune Encephalomyelitis is the autologous disease that is being researched in mice to help find cures for MS. Furthering this research is exciting for both the science and medical worlds as far as perfecting the stem cell treatments that are currently available to patients and finding new ways to treat them as well.
A doctor needs to know about evolution for a number of reasons. The obvious reason is that diseases and bacteria are always evolving. This evolution will make them resistant to existing treatments overtime, thus making it necessary for doctors to be constantly researching new treatments. It also helps to know about evolution because being aware of analogous genes between different species of animals allows researchers to test their products on other animals before having to try them on humans. This helps in avoiding many lawsuits for mistreatment of a patient.
First of all, I found it interesting that the researchers were so quick to disown the possibility that MS may be, either wholely or partially, a result of viral influence, after careful analysis of only one disease-causing virus in mince: Theiler murine encephalomyelitis virus (TMEV). As a whole, research has still NOT proven the source of MS and cannot entirely rule out virul stimuli an option.
Secondly, I struggled with the researchers' course of study. Why did they choose to respond to a disease, such as MS, in which patients continually struggle with immunodepression, with a regimen, such as HSCT, that further suppresses the immune system? How did this treatment even present itself as an option? MS patients constantly face the serious threat of illness, or infection, due to their already-supressed (or pre-occupied) immune systems, so why would they want to risk suppressing it even further? Even a common cold or a cat-scratch poses the threat of an onset of exacerbations in an MS patient, so it was NOT surprising to me, that later in the article, the researchers were faced with these issues: worsened clinical flares of MS, unimproved, or extra, neurologic deterioration, lethal opportunistic infections, and treatment-related deaths.
Finally, the rationale behind HSCT treatment, as stated in the article, includes the goal to design regimens that are justified for the risk of the disease being treated. The facts that this research seems to have, largely, negative effects: a high percentage of treatment-related deaths, a possibly-lessened quality of life for the patient due to immunosupression, and its inability to treat a large portion of MS patients (those with progressive MS), leads me to believe that the HSCT regimen is NOT justified for the risk of the disease being treated.
These and other issues, presented in the paper, just didn't "flow" for me. As stated earlier, I learned some new information, but found the paper to be contradicting in many of its presented topics.
Sean: I guess what was new for me was how these researchers were going about looking for the multiple sclerosis cure. I have heard about the possibility of stem cell transplantation for multiple sclerosis, but have never seen it implemented until now. The controversy over what types of stem cells to use for genetic research seem to dominate the media which may push work like this to the background. I have heard of this being a somewhat effective treatment though. The book, The Transformed Cell: Unlocking the Mysteries of Cancer, presents a similar approach to cancer treatment. The doctor behind this book would take a patient’s own immune cells, culture them and bombard the tumor with the increased number of cells. Our paper took this approach to providing the new treatment for MS.
Also, the research was slightly disheartening for anyone beyond the initial stages of MS. Throughout most of the report it was reiterated that those afflicted with chronic or late stage MS had basically no hope. However, it is exciting that treatments are still developing and new strategies are being adapted to the eventual cure of multiple sclerosis.
Ben: What I learned most from the assigned paper was that the differet stages of Multiple Sclerosis make it exceedingly difficult to treat. While inthe earlier stagess of the disease doctors have found a way to treat patients, the later, more degenerative stages are proving to be very complicated to tend to. I also learned that Experimental Autoimmune Encephalomyelitis is the autologous disease that is being researched in mice to help find cures for MS. Furthering this research is exciting for both the science and medical worlds as far as perfecting the stem cell treatments that are currently available to patients and finding new ways to treat them as well.
A doctor needs to know about evolution for a number of reasons. The obvious reason is that diseases and bacteria are always evolving. This evolution will make them resistant to existing treatments overtime, thus making it necessary for doctors to be constantly researching new treatments. It also helps to know about evolution because being aware of analogous genes between different species of animals allows researchers to test their products on other animals before having to try them on humans. This helps in avoiding many lawsuits for mistreatment of a patient.
Tuesday, March 25, 2008
Questions regarding Multiple Sclerosis
Below are the questions that were asked to our group regarding Multiple Sclerosis. The questions are bolded with responses to each given immediately after each. Sources that were supplemental to the required article are listed at the end of the questions.
According to your interview and other data, MS appears to be more common in females. It has recently been found that women who take birth control pills may be less likely to develop MS while they're on the pill; and women are nearly three times more likely to develop the first symptoms of MS in the first six months after pregnancy than at other times (nationalmssociety.org; webmd). What does this tell you about the role of hormones in this autoimmune disease?
The findings in this question suggest that hormones that are present in high levels during pregnancy or high levels due to the pill are actually capable of preventing Multiple Sclerosis. The hormone that each is referring to is estrogen. The pill is an exogenous source of synthetic estrogen that prevents ovulation in woman. Estrogen levels naturally rise during pregnancy, and then fall in the proceeding months. It appears that when estrogen is low women are more likely to become afflicted with MS. Some studies have shown that estrogen mixed with white blood cells in a test tube actually make the WBC’s more active, producing immune substances called cytokines (www.abc.net.au). These cytokines act to keep MS away. Other studies have shown that estrogen leads to the survival and activation of autoreactive B cells (Peeva 2005). These findings are playing a significant role in furthering the research to treating MS. One article went so far as to say that the best treatment for Multiple Sclerosis is pregnancy (http://www.news-medical.net/).
In an evolutionary sense, why is it informative to study MS and its implications in mice?
Due to the orthologous nature of the developmental genes in mice and human genomes, we can study new therapies or treatments for Multiple Sclerosis in mice. Results from these studies enable researchers to interpret how effective a treatment can be. This strategy has been very successful in the past. Mouse Experimental Autoimmune Encephalomyelitis (EAE) is said to be equivalent to human Multiple Sclerosis. Thus, studying EAE in mice will allow us to learn more about MS in humans and allow us to get around some of the ethical issues surrounding experimental procedures in humans such (for example: is it ethical to try a new medication on humans? It would be more-so if it worked in a mouse that had a disease that parallels MS in humans). Many treatments for Multiple Sclerosis in humans originated from EAE research in mice, including glutamate receptor antagonists such as Riluzole (Gilgun-Sherki et al, 2003).
The paper (page 861) asserts that “[t]he rationale for autologous HSCT of MS is to regenerate an antigen-naïve immune system from the patient’s own HSCs.” Why, then, would assessing protein folding and misfolding be important to the process of HSCT of MS?
Researchers want an antigen-naïve immune system so they can start from a healthy base. The antigen-naïve immune system can defend against the effects of Multiple Sclerosis more effectively. Inflammation of the Central Nervous System decreases in this environment. This helps in studying the actual progress of the brain, more so the myelin sheath, damage because there is less tissue in the way.
Protein folding would be the next step of the process. By removing inflammation of the surrounding tissues the effects of protein folding/misfolding can be more closely scrutinized. HSCT provides this anti-inflammatory environment. Reasons or explanations for protein misfolding can be discovered and eventually remedied.
Why would this treatment regimen not be effective for patients who are suffering from the progressive, degenerative stages of MS?
As stated in the article, Hematopoietic stem cells can be acquired from euthanized animals of a different animal strain (allogeneic HSCT), from one of the same highly inbred strains (syngeneic HSCT), or from a syngeneic animal with the same stage of disease (pseudo-autologous HSCT). Any of these sources are capable of inducing remission and preventing relapse when performed during the early phases of Multiple Sclerosis. The article goes on to say, however, that hematopoietic stem cell transfer is ineffective therapy for late-stage or chronic progressive EAE. As stated in earlier questions, EAE is the mouse equivalent to MS in humans. Thus, the regimen would work better during the early stages of MS. The article even says that HSCT should be performed in the relapsing phase of MS while it is still an immune-mediated inflammatory process, rather than in it chronic progressive phase.
What would be the consequences of a regulatory gene mutation in a HSC?
As we learned in class, a mutation in any sort of gene will result in either an altered function, or a total loss of function. The book calls this change “re-purposing” or “co-opting” genes. The book goes on to say that “evolutionary change occurs when genes involved in regulatory cascades are expressed at new times or in new amounts (728). The cells being used for this new research are stem cells, meaning all subsequent cells stem from these original cells. Therefore, if the founding stem cells have a regulatory gene mutation every cell that is produced through mitosis will have the same mutation. If the mutation is on a regulatory gene then whatever that cell was originally designed for will not be accomplished. For instance, if the mutation is for the formation of a cell receptor that receptor may not develop correctly. Due to its incorrect formation, the cell would not function appropriately. In the case of this study a mutation to a regulatory gene of a hematopoietic stem cell would most likely result in failure to produce an antigen-naïve immune system. Failure to produce this type of system would render the treatment regimen suggested in this study inoperative. These cells would be basically useless in this treatment, and thus selected against all due to the mutation. The cascade of events holds true due to the one mutation in a regulatory gene.
Because there is both an environmental (page 863) and genetic component (traced to a gene cluster on Chromosome 6), is MS a qualitative or quantitative trait?
With the understanding that a quantitative trait is a “you either have it or you don’t” trait and a qualitative trait is trait that has varying degrees of severity, we believe MS to be a qualitative trait. We reached this conclusion for a couple of different reasons. First, because Multiple Sclerosis is a progressive disorder, meaning that the myelin sheaths can be more degenerated in some cases than others. Second, there are multiple types of Multiple Sclerosis that a person can be diagnosed with. They are: Benign Multiple Sclerosis, Relapsing-remitting Multiple Sclerosis, Secondary-progressive Multiple Sclerosis, Primary-progressive Multiple Sclerosis, and Malignant Multiple Sclerosis. Each of these types of the disease has different symptoms, as well as varying degrees of similar symptoms. For example, malignant multiple sclerosis is designated by a swift and relentless decline to disability which may result in death within the first few months, whereas a person afflicted with benign multiple sclerosis may show little or no effects of the disease for many years. With this in mind, it is hard to see how a person could get by with just saying, “I have multiple sclerosis,” with the intent of having the other person with whom they are talking to understand exactly what they are talking about.
Sources:
Freeman, Scott; Herron, Jon C. Evolutionary Analysis, Fourth Ed. Pearson Education, Inc.; Upper Saddle River, NJ, 2007. P. 728.
Gilgun-Sherki, Yossi; Melamed, Eldad; Offen, Daniel; Panet, Hana. Riluzole suppresses experimental autoimmune encephalomyelitis: implications for the treatment of multiple sclerosis. Laboratory of Neurosciences, Felsenstein Medical Research Center and Department of Neurology, 17 July 2003.
Peeva, Elena; Zouali, Moncef. Spotlight on the role of hormonal factors in the emergence of autoreactive B-lymphocytes. Albert Einstein College of Medicine, Department of Medicine, Microbiology and Immunology, 5 July 2005.
http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s62050.htm
http://www.news-medical.net/?id=4375
According to your interview and other data, MS appears to be more common in females. It has recently been found that women who take birth control pills may be less likely to develop MS while they're on the pill; and women are nearly three times more likely to develop the first symptoms of MS in the first six months after pregnancy than at other times (nationalmssociety.org; webmd). What does this tell you about the role of hormones in this autoimmune disease?
The findings in this question suggest that hormones that are present in high levels during pregnancy or high levels due to the pill are actually capable of preventing Multiple Sclerosis. The hormone that each is referring to is estrogen. The pill is an exogenous source of synthetic estrogen that prevents ovulation in woman. Estrogen levels naturally rise during pregnancy, and then fall in the proceeding months. It appears that when estrogen is low women are more likely to become afflicted with MS. Some studies have shown that estrogen mixed with white blood cells in a test tube actually make the WBC’s more active, producing immune substances called cytokines (www.abc.net.au). These cytokines act to keep MS away. Other studies have shown that estrogen leads to the survival and activation of autoreactive B cells (Peeva 2005). These findings are playing a significant role in furthering the research to treating MS. One article went so far as to say that the best treatment for Multiple Sclerosis is pregnancy (http://www.news-medical.net/).
In an evolutionary sense, why is it informative to study MS and its implications in mice?
Due to the orthologous nature of the developmental genes in mice and human genomes, we can study new therapies or treatments for Multiple Sclerosis in mice. Results from these studies enable researchers to interpret how effective a treatment can be. This strategy has been very successful in the past. Mouse Experimental Autoimmune Encephalomyelitis (EAE) is said to be equivalent to human Multiple Sclerosis. Thus, studying EAE in mice will allow us to learn more about MS in humans and allow us to get around some of the ethical issues surrounding experimental procedures in humans such (for example: is it ethical to try a new medication on humans? It would be more-so if it worked in a mouse that had a disease that parallels MS in humans). Many treatments for Multiple Sclerosis in humans originated from EAE research in mice, including glutamate receptor antagonists such as Riluzole (Gilgun-Sherki et al, 2003).
The paper (page 861) asserts that “[t]he rationale for autologous HSCT of MS is to regenerate an antigen-naïve immune system from the patient’s own HSCs.” Why, then, would assessing protein folding and misfolding be important to the process of HSCT of MS?
Researchers want an antigen-naïve immune system so they can start from a healthy base. The antigen-naïve immune system can defend against the effects of Multiple Sclerosis more effectively. Inflammation of the Central Nervous System decreases in this environment. This helps in studying the actual progress of the brain, more so the myelin sheath, damage because there is less tissue in the way.
Protein folding would be the next step of the process. By removing inflammation of the surrounding tissues the effects of protein folding/misfolding can be more closely scrutinized. HSCT provides this anti-inflammatory environment. Reasons or explanations for protein misfolding can be discovered and eventually remedied.
Why would this treatment regimen not be effective for patients who are suffering from the progressive, degenerative stages of MS?
As stated in the article, Hematopoietic stem cells can be acquired from euthanized animals of a different animal strain (allogeneic HSCT), from one of the same highly inbred strains (syngeneic HSCT), or from a syngeneic animal with the same stage of disease (pseudo-autologous HSCT). Any of these sources are capable of inducing remission and preventing relapse when performed during the early phases of Multiple Sclerosis. The article goes on to say, however, that hematopoietic stem cell transfer is ineffective therapy for late-stage or chronic progressive EAE. As stated in earlier questions, EAE is the mouse equivalent to MS in humans. Thus, the regimen would work better during the early stages of MS. The article even says that HSCT should be performed in the relapsing phase of MS while it is still an immune-mediated inflammatory process, rather than in it chronic progressive phase.
What would be the consequences of a regulatory gene mutation in a HSC?
As we learned in class, a mutation in any sort of gene will result in either an altered function, or a total loss of function. The book calls this change “re-purposing” or “co-opting” genes. The book goes on to say that “evolutionary change occurs when genes involved in regulatory cascades are expressed at new times or in new amounts (728). The cells being used for this new research are stem cells, meaning all subsequent cells stem from these original cells. Therefore, if the founding stem cells have a regulatory gene mutation every cell that is produced through mitosis will have the same mutation. If the mutation is on a regulatory gene then whatever that cell was originally designed for will not be accomplished. For instance, if the mutation is for the formation of a cell receptor that receptor may not develop correctly. Due to its incorrect formation, the cell would not function appropriately. In the case of this study a mutation to a regulatory gene of a hematopoietic stem cell would most likely result in failure to produce an antigen-naïve immune system. Failure to produce this type of system would render the treatment regimen suggested in this study inoperative. These cells would be basically useless in this treatment, and thus selected against all due to the mutation. The cascade of events holds true due to the one mutation in a regulatory gene.
Because there is both an environmental (page 863) and genetic component (traced to a gene cluster on Chromosome 6), is MS a qualitative or quantitative trait?
With the understanding that a quantitative trait is a “you either have it or you don’t” trait and a qualitative trait is trait that has varying degrees of severity, we believe MS to be a qualitative trait. We reached this conclusion for a couple of different reasons. First, because Multiple Sclerosis is a progressive disorder, meaning that the myelin sheaths can be more degenerated in some cases than others. Second, there are multiple types of Multiple Sclerosis that a person can be diagnosed with. They are: Benign Multiple Sclerosis, Relapsing-remitting Multiple Sclerosis, Secondary-progressive Multiple Sclerosis, Primary-progressive Multiple Sclerosis, and Malignant Multiple Sclerosis. Each of these types of the disease has different symptoms, as well as varying degrees of similar symptoms. For example, malignant multiple sclerosis is designated by a swift and relentless decline to disability which may result in death within the first few months, whereas a person afflicted with benign multiple sclerosis may show little or no effects of the disease for many years. With this in mind, it is hard to see how a person could get by with just saying, “I have multiple sclerosis,” with the intent of having the other person with whom they are talking to understand exactly what they are talking about.
Sources:
Freeman, Scott; Herron, Jon C. Evolutionary Analysis, Fourth Ed. Pearson Education, Inc.; Upper Saddle River, NJ, 2007. P. 728.
Gilgun-Sherki, Yossi; Melamed, Eldad; Offen, Daniel; Panet, Hana. Riluzole suppresses experimental autoimmune encephalomyelitis: implications for the treatment of multiple sclerosis. Laboratory of Neurosciences, Felsenstein Medical Research Center and Department of Neurology, 17 July 2003.
Peeva, Elena; Zouali, Moncef. Spotlight on the role of hormonal factors in the emergence of autoreactive B-lymphocytes. Albert Einstein College of Medicine, Department of Medicine, Microbiology and Immunology, 5 July 2005.
http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s62050.htm
http://www.news-medical.net/?id=4375
Monday, February 25, 2008
Interview with Laura Bryon
Multiple Sclerosis, also commonly referred to as MS, is a debilitating disease that attacks the central nervous system of an affected individual. To any person not aware of this relentless disease, it will attack the myelin sheaths surrounding the axons of a seemingly healthy person. When these sheaths are destroyed, the communication between the brain and the rest of the body becomes increasingly hampered and, eventually, impossible. In an effort to further understand this disease and what efforts are being done to eradicate it from the world our team of Stephanie, Ben, and Sean sat down with a representative of the local National Multiple Sclerosis Society, Laura Bryon. The answers reported below are not exact quotes, but paraphrased answers to our questions. The date of the interview was Wednesday, February 20, 2008.
Q: Thank you for meeting with us today. To get started with, we are wondering why you have become involved with the MS Society?
A: I received a degree from Rockhurst University in Non-Profit Managing. I did not necessarily seek out the MS Society as my first choice for employment, but it fit what I wanted to do with my degree.
Q: How long have you been working with the MS Society and what do you do at the society?
A: I have been with them since I graduated, so it will be about a year in May. My job description is the volunteer coordinator. What I do is find people interested in making a difference concerning the defeat of MS and try to mobilize this group of people. We fundraise, have awareness meetings, and organize support groups for those with MS.
Q: What are some of the symptoms associated with the disease and what group of people are most affected?
A: To start with, caucasian people are most often affected by the disease and the majority of these people are women. Approximately two-thirds of all cases involve women. Symptoms in these cases vary greatly depending on the type of MS, which can range from moderate to severe. Some of the more common symptoms involve loss of bladder control, a tingling in the extremities, decreased cognitive ability, sexual problems, and an awkward gait. When these symptoms are active they are known as attacks, exacerbations, or relapses. When symptoms are suppressed they are referred to as remissions.
Q: Are there different types of Multiple Sclerosis?
A: Yes, there are four: Relapsing - remitting, primary - progressive, secondary - progressive, progressive - relapsing.
Q: What types of treatments are currently available for people with MS?
A: There are six medications currently approved by the FDA. Avonex, Betaseron, Copaxone, and Rebif are all injections that can be received. Tysabri is an infusion drug. The other option is Novantrone, which has proven to slow down the progression of MS.
Q: What are some of the common misconceptions about this disease?
A: The most common misconceptions simply stem from the fact that people do not understand the disease very well. They do not know the debilitating effects MS can have on a person's cognitive effects and never become educated about them. I also hear of people mistaking MS with MD (Muscular Dystrophy). I actually heard a guy at a conference once refer to it as Muscular Sclerosis.
Q: Take your best shot at why a doctor/researcher who studies this disease should know about evolution.
A: This one is kind of a tricky question. The big thing I would say is probably that they need to understand how the disease is progressive and thus research medications that can deal with these changing conditions.
Q: How important is the search for a cure and why?
A: Extremely important! There are 400,000 people nationwide that are afflicted with this disease, 3300 of which are located in the Kansas City area. There is a whole society that is aimed at better understanding this disease, as well as finding a cure. More than 300 research grants and fellowships are funded by the National MS Society each year.
Q: What is the responsiveness of the general public to multiple sclerosis?
A: The biggest thing with the general public is that they are not very educated in the area of Multiple Sclerosis. They don't realize the importance of funding the research and are not as willing to donate as they maybe could be.
Q: What can the average person do to improve research and funding for this disease, both locally and on the national level?
A: There are actually several things that people can do to help fund this research. They can support legislation for advances in research (i.e. stem cells), they can participate in MS awareness week which is March 10 - 17, they can donate/participate in events all across the country, they can restrict the money they donate to just be used for research...there are lots of ways people can get involved.
Q: What is one thing you would like people to know about MS and those affected by this condition?
A: I would have them know that this disease is not exclusive, and as far as anyone knows, it could affect anyone in anyway at anytime.
Q: Alright I think that about wraps it up. Thanks for taking the time to meet with us today!
A: Oh sure, no problem.
Q: Thank you for meeting with us today. To get started with, we are wondering why you have become involved with the MS Society?
A: I received a degree from Rockhurst University in Non-Profit Managing. I did not necessarily seek out the MS Society as my first choice for employment, but it fit what I wanted to do with my degree.
Q: How long have you been working with the MS Society and what do you do at the society?
A: I have been with them since I graduated, so it will be about a year in May. My job description is the volunteer coordinator. What I do is find people interested in making a difference concerning the defeat of MS and try to mobilize this group of people. We fundraise, have awareness meetings, and organize support groups for those with MS.
Q: What are some of the symptoms associated with the disease and what group of people are most affected?
A: To start with, caucasian people are most often affected by the disease and the majority of these people are women. Approximately two-thirds of all cases involve women. Symptoms in these cases vary greatly depending on the type of MS, which can range from moderate to severe. Some of the more common symptoms involve loss of bladder control, a tingling in the extremities, decreased cognitive ability, sexual problems, and an awkward gait. When these symptoms are active they are known as attacks, exacerbations, or relapses. When symptoms are suppressed they are referred to as remissions.
Q: Are there different types of Multiple Sclerosis?
A: Yes, there are four: Relapsing - remitting, primary - progressive, secondary - progressive, progressive - relapsing.
Q: What types of treatments are currently available for people with MS?
A: There are six medications currently approved by the FDA. Avonex, Betaseron, Copaxone, and Rebif are all injections that can be received. Tysabri is an infusion drug. The other option is Novantrone, which has proven to slow down the progression of MS.
Q: What are some of the common misconceptions about this disease?
A: The most common misconceptions simply stem from the fact that people do not understand the disease very well. They do not know the debilitating effects MS can have on a person's cognitive effects and never become educated about them. I also hear of people mistaking MS with MD (Muscular Dystrophy). I actually heard a guy at a conference once refer to it as Muscular Sclerosis.
Q: Take your best shot at why a doctor/researcher who studies this disease should know about evolution.
A: This one is kind of a tricky question. The big thing I would say is probably that they need to understand how the disease is progressive and thus research medications that can deal with these changing conditions.
Q: How important is the search for a cure and why?
A: Extremely important! There are 400,000 people nationwide that are afflicted with this disease, 3300 of which are located in the Kansas City area. There is a whole society that is aimed at better understanding this disease, as well as finding a cure. More than 300 research grants and fellowships are funded by the National MS Society each year.
Q: What is the responsiveness of the general public to multiple sclerosis?
A: The biggest thing with the general public is that they are not very educated in the area of Multiple Sclerosis. They don't realize the importance of funding the research and are not as willing to donate as they maybe could be.
Q: What can the average person do to improve research and funding for this disease, both locally and on the national level?
A: There are actually several things that people can do to help fund this research. They can support legislation for advances in research (i.e. stem cells), they can participate in MS awareness week which is March 10 - 17, they can donate/participate in events all across the country, they can restrict the money they donate to just be used for research...there are lots of ways people can get involved.
Q: What is one thing you would like people to know about MS and those affected by this condition?
A: I would have them know that this disease is not exclusive, and as far as anyone knows, it could affect anyone in anyway at anytime.
Q: Alright I think that about wraps it up. Thanks for taking the time to meet with us today!
A: Oh sure, no problem.
Interview With Susan Schlosser (a.k.a. Stephanie's mom)
After our interview with Laura Bryon, I thought that it might be a good idea to have the patient's perspective on these issues and questions, concerning multiple sclerosis, for comparison. So, I called up my mother, who has been diagnosed with MS as of 7 years ago, and asked her the same questions, previously asked of Laura Bryon, of the MS society.
Multiple Sclerosis:
Q: What is multiple sclerosis?
A: The degeneration of the myelin sheath surrounding the nerves of the CNS.
Q: What are the typical symptoms of this disease? And what is the diagnostic accuracy pertaining to MS?
A: Some common symptoms are macular degeneration, bowel and bladder dysfunction, depression, loss of function in: speech, cognative function, fine motor skills, balance, stamina, immune suppression.
Diagnosis of MS is not very accurate. We need more research to identify the foundations for proper diagnosis, because the symptoms are too broad and could be a number of things other than MS. Even after a spinal tap, CT scan, and identification of lesions, I still wasn't officially diagnosed with MS. There is no "complete" method of diagnosis and a patient can go up to 15-20 years without official diagnosis and proper treatment of this disease.
Q: What treatments are available for MS patients? And which are most common?
A: First of all, they aren't really "treatments" for MS, but only aides in keeping symptoms at bay and boosting the immune system in order to prevention a full-blown exacerbation. They are not always effective.
The most commonly used treatments are injections, such as rebif or copaxone. There are a nuber of medications for the treatment of symptoms: providial for fatigue, neurotin for nerve pain, oxybutinin for bladder and bowel complications, and various anti-depressants. Other treatments include physical, occupational, and phsycological therapy.
Q: What is the average dollar amount spent, by an MS patient, for treatments each month/year?
A: For medications alone, at least $30,000 per year. Ex. Right now, it's about $1500 per month for copaxone and $1000 for other pills.
Q: What are some common misconceptions about this disease?
A: A lot of people think MS is muscular dystrophy (MD). MD is a more well-known disease and a larger number of people are educated on MD, in comparison with MS.
Also, people don't realize the extent and severity of the disease, because it isn't necessarily physically represented, unless you are in a wheel chair.
Q: Approximately how many people in the Mankato, MN area are diagnosed/ affected with MS?
A: (In a population 34,970 people:) There are approximately 300 diagnosed cases.
Q: Why should a doctor/researcher know about evolution?
A: It may potentially help people to understand how this disease has evolved in the past and, thus, how to treat it, both now and in the future.
Q: How important is the search for a cure? And why?
A: It is extremely important, because not only will it help a huge number of people in curing this disease, but would allow them and all of their families to lead normal lives. It would allow these people to become employed and lower the amount of disability being drawn and, thus, decrease taxes. Since MS is directly correlated with depression, like most diseases, suicide rates would decrease as well.
Q:What is your opinion on using grid computing for MS?
A: It seems like a positive development.
MS and the General Public:
Q:What is the responsiveness of the general public to multiple sclerosis?
A: There is a general misunderstanding due to the lack of knowledge of MS.
Q: Why should common society be concerned with this disease and with the support of MS research/ funding?
A: Because MS is turning into an epidemic. There is an increasing number of cases every year.
Q:What can the average person do to improve research and funding for this disease, both locally and on the national level?
A: They can learn about the disease and increase awareness. People can support the MS Society through financial donations, volunteering their time, or participating in MS events. Education is the biggest tool for improving, both, the research and funding for MS.
Q: How has support/funding for MS changed within the last decade?
A: More people have become involved due to the increasing number of cases and families affected, which has led to a larger amount of donations.
Q:What issues/limitations do MS patients face regarding government programs/policies? (I.e. disability, NIH funding, etc.)
A: Disability is a big issue. It is extremely difficult for MS patients to receive disability because of the range in symptoms of MS and the, overall, lack of knowledge about the disease.
Q: Aside from a cure, in your opinion, what are two major areas pertaining to MS that deserve immediate attention? And what actions should be taken?
A: First, the issue of receiving disability. There needs to be more education and a broader understanding, concerning MS. There also needs to be a shift in the distribution of funds.
Secondly, amenities for handicapped people need to be improved. Too many of them do not meet code and make life difficult for people with MS and other debilitating diseases.
Q: What is the one thing you would like people to know about MS and those affected by this condition?
A: "That even if our brains aren’t working correctly, we are still here." People with MS are still "normal" human beings and deserve respect and patience.
Wednesday, February 13, 2008
About MS
It has occurred to the group that people may not have a complete understanding of Multiple Sclerosis at this point in their lives. So we decided to help anyone who was interested in learning more out. Here is a brief overvew of this complex disease.
MS is thought to be an autoimmune disease that affects the central nervous system (CNS). The CNS consists of the brain, spinal cord, and the optic nerves. Surrounding and protecting the nerve fibers of the CNS is a fatty tissue called myelin, which helps nerve fibers conduct electrical impulses.
In MS, myelin is lost in multiple areas, leaving scar tissue called sclerosis. These damaged areas are also known as plaques or lesions. Sometimes the nerve fiber itself is damaged or broken.
Myelin not only protects nerve fibers, but makes their job possible. When myelin or the nerve fiber is destroyed or damaged, the ability of the nerves to conduct electrical impulses to and from the brain is disrupted, and this produces the various symptoms of MS.
If you are interested in expanding your understanding of MS, feel free to visit the following link:
http://www.nationalmssociety.org/site/PageServer?pagename=HOM_ABOUT_what_is_ms
Another explanation of multiple sclerosis can be found at: http://www.montelms.org/AboutMS
Multiple Sclerosis (MS)
MS is thought to be an autoimmune disease that affects the central nervous system (CNS). The CNS consists of the brain, spinal cord, and the optic nerves. Surrounding and protecting the nerve fibers of the CNS is a fatty tissue called myelin, which helps nerve fibers conduct electrical impulses.
In MS, myelin is lost in multiple areas, leaving scar tissue called sclerosis. These damaged areas are also known as plaques or lesions. Sometimes the nerve fiber itself is damaged or broken.
Myelin not only protects nerve fibers, but makes their job possible. When myelin or the nerve fiber is destroyed or damaged, the ability of the nerves to conduct electrical impulses to and from the brain is disrupted, and this produces the various symptoms of MS.
If you are interested in expanding your understanding of MS, feel free to visit the following link:
http://www.nationalmssociety.org/site/PageServer?pagename=HOM_ABOUT_what_is_ms
Another explanation of multiple sclerosis can be found at: http://www.montelms.org/AboutMS
Multiple Sclerosis (MS)
is literaly a "disease of many scars."
The scars - or scleroses - form on nerve fibers in the brain, spinal cord, and optic nerves, which are the basic components of the central nervous system (CNS). Also known as plaques, these scars are the result of lesions that destroy the protective material that surrounds the nerve fibers. This material is called the myelin sheath.
Much like the insulation on an electrical wire, an intact myelin sheath keeps nerve impulses traveling rapidly and accurately along the nerve fiber. These impulses are essential to normal movement and sensation throughout the body.
MS lesions eat away at the myelin sheath, eventually healing into hardened scar tissue. This process is called demyelination.
The scar tissue "short circuits" or interferes with the proper transmission of nerve impulses to various systems in the body. The result is a broad array of motor and sensory disabilities.
If the sheath can regenerate itself - known as remyelination -- normal nerve function may return. If not, the nerve will eventually die, and the disability will be permanent.
As the extent of nerve damage increases, the level of disability can grow progressively worse over time.
Researchers believe the damaging lesions are caused by an autoimmune reaction, where the body's defense system mistakenly attacks its own tissue. What triggers this abnormal immune response is presently unknown, although viral infection and/or environmental factors are suspect. Genetics may also play a role in susceptibility to the disorder.
The immune system's assault causes inflammation of CNS tissues. The inflamed nerves then develop the destructive lesions that adversely affect a variety of functions, depending upon the location and extent of the lesion damage.
These functions include:
- Balance and Coordination
- Bladder/bowel control
- Pain
- Sensation
- Sexual function
- Speech
- Stamina
- Strength
- Thought process
- Vision
Monday, February 4, 2008
In the beginning...
Well, after much confusion, our group has finally downloaded grid-computing software. We found our project at the World Community Grid website. The topic we chose to volunteer for was the Multiple Sclerosis campaign. A few revisions may still have to be done, but everything is up and operational.
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