Evidence of Epstein-Barr Virus Found in MS Patients
Using postmortem brain tissue from 21 individuals who had multiple sclerosis (MS), researchers in Italy found evidence of Epstein-Barr virus (EBV) infection in 20 of 21 samples. No evidence of the virus was found in the brain tissue they tested from individuals with other inflammatory neurological diseases.
Evidence of EBV infection was discovered in a large portion of brain-infiltrating B cells (immune-system cells that cross the blood-brain barrier and cause damage to the brain) as well as plasma cells (antibody-producing cells). Certain areas were found to be major sites of EBV presence in the samples from individuals with secondary-progressive MS (SPMS).
While expression of inactive viral proteins was commonly seen in the MS brain tissue, viral reactivation appeared only in B-cell clustering in the meninges (covering of the brain) and acute MS lesions. Researchers do not know if EPV plays a role in the development of MS, or if it is a consequence of the disease process, but these findings suggest that EBV is involved in the damage caused by MS.
(Serafini B, et al, "Dysregulated Epstein-Barr virus infection in the multiple sclerosis brain," J Exp Med, 2007 Nov 26; 204(12): 2899-912.)
Botox Injections Improve Bladder Function and Quality of Life
Researchers in London collected data to demonstrate the effectiveness of botulinum neurotoxin type A (Botox ®) detrusor (bladder muscle) injections for the treatment of bladder dysfunction in MS patients. The researchers also wanted to measure the impact of this treatment on quality of life.
Forty-three MS patients who were experiencing severe urgency incontinence participated. Measurement of bladder function, diaries recording urination, quality-of-life questionnaires, and medication usage for bladder incontinence, were all collected before treatment and at four as well as 16 weeks after the injection was given. The same information was collected after repeated treatments.
Researchers found that the participants experienced "highly significant" improvements in: episodes of incontinence; urinary urgency; daytime frequency; and nocturia (the urge to urinate, or the leakage of urine, at night during sleep). While nearly all of the patients needed to perform self-catheterization following this treatment, all quality-of-life scores improved. The positive effects of the botulinum neurotoxin type A injection continued for a mean average of almost 10 months, and similar benefits were experienced with subsequent treatments.
The authors of this report conclude that the minimally invasive botulinum neurotoxin type A injections are exceptionally effective for treating bladder dysfunction in patients with MS.
(Kalsi V, et al, "Botulinum injections for the treatment of bladder symptoms of multiple sclerosis, " Ann Neurol, 2007 Nov;62(5):452-7.)
Mitoxantrone May Provide Delayed Benefit
Italian researchers conducted a five-year, open-label, prospective study to evaluate the effectiveness and safety of mitoxantrone (Novantrone ®) treatment. Fifty individuals with SPMS or rapidly worsening relapsing-remitting MS (RRMS) were given intravenous infusion treatments with mitoxantrone every two months for two years. Clinical assessments and magnetic resonance imaging (MRI) scans of the brain were performed prior to treatment, at the end of treatment, and then annually for the three-year follow-up period.
Approximately one-third of the participants experienced disease progression (as measured by the Expanded Disability Status Scale [EDSS]) during treatment, and only one-fifth of the participants experienced disease progression during the three-year follow-up. In addition, while approximately 35 percent of the participants had active MRI lesions prior to treatment, this dropped to 18 percent during treatment, and to zero (i.e., none of the participants had active lesions) at the end of the three-year follow-up period. These findings suggest a delayed beneficial effect after mitoxantrone treatment is completed.
(Buttinelli C, et al, "Mitoxantrone treatment in multiple sclerosis: a 5-year clinical and MRI follow-up, " Eur J Neurol, 2007 Nov;14(11):1281-7.)
— Summarized by Susan Wells Courtney; Reviewed by Dr. Jack Burks
|Last Updated on Friday, 14 September 2012 13:29|