When describing the progress 迟丑补迟鈥檚 been made in multiple sclerosis (MS) treatment, Dr. Jack Antel, a clinician-scientist in The Neuro鈥檚 MS Clinic, tells a story about a patient who came into his office and asked why there seemed to be fewer patients in wheelchairs than before.听听
鈥淚t鈥檚 because we have drugs now that can prevent disability in a lot of patients,鈥� Dr. Antel says. 鈥淥ver the last generation, for the early phases of MS, the drugs that have come on the market are extraordinarily effective, to the point that they can virtually stop the relapsing forms of multiple sclerosis.鈥�听
Since joining The Neuro in 1986, Dr. Antel and his colleagues have helped improve the number and quality of treatments available to people with MS by studying the disease鈥檚 basic mechanisms. His group has studied why the immune system causes damage to oligodendrocytes, a type of cell responsible for producing a sheath over neurons called myelin. When this protective sheath is damaged, the neuron loses the ability to transmit signals, leading to physical and cognitive problems.听听
As a hospital and research institute, The Neuro has proven to be an excellent workplace to study MS. The MS Clinic is celebrating its 75th anniversary this year, having been founded in 1949 with a $10,000 donation from the Multiple Sclerosis Society of Canada, split evenly between research and clinical care.听
The best way to study any neurological disease is with living human samples of the cells in question. At The Neuro, patients with diseases such as epilepsy or brain cancer have surgeries to remove pieces of brain tissue, giving scientists access to human brain cells听 with their consent. To provide more consistent access to these cells, The Neuro鈥檚 Early Drug Discovery Unit was founded in 2015. The EDDU grows them from human-derived stem cells.听听
A team effort
As a research group, the MS team has approached the disease from multiple angles. Jo Anne Stratton, who joined The Neuro in 2019, studies how cells and their products circulating through the spinal fluid in cases of MS can access the brain tissue and cause injury.听听
Dr. Douglas Arnold has been a leader in neuroimaging, improving diagnosis and ability to monitor progression. He played a critical role in assessing ocrelizumab, the first effective drug for progressive MS. Dr. Arnold built on the work of the late Dr. William Feindel, The Neuro鈥檚 former director, who brought Canada鈥檚 first magnetic resonance imaging machine to the institute.听听
A new hire to the MS Clinic, Dr. Adil Harroud, is identifying genetic and environmental causes of MS, with the goal of developing therapies that prevent MS and delay or halt progression.听
A lot of work remains to be done to help people with MS. Dr. Antel says he would like to see treatments that prevent the initial immune response that causes myelin damage to block the progressive disease phase, and repair damage already done to the nervous system. Overall, however, he is proud of the progress he and his fellow researchers and clinicians have made in keeping听 MS patients healthier than they have ever been.听
鈥淭he first approved drugs came in the 1990s, and MRI diagnosis came roughly at the same time,鈥� he says. 鈥淭he therapy and diagnostics virtually overlapped. That was an exciting time, in terms of understanding the disease and the therapies we can offer. Now with new research technology, the ability to grow cells and analyse them at a molecular level, 飞别鈥檙别 set to take MS treatment even further.鈥澨�听
