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.