World MS Day on May 30 is meant to raise awareness about Multiple Sclerosis, educate the general public and consolidate international research in the effort to improve the lives of those diagnosed with the condition.
According to data published by the Atlas of MS organization, 2.8 million people around the world have multiple sclerosis. But only 0.1-0.2 percent of the population is at risk of developing multiple sclerosis.
What is Multiple Sclerosis, exactly?
Multiple sclerosis is one of the most common diseases of the central nervous system, which is found in the brain and spinal cord. The Multiple Sclerosis International Federation (MSIF) explains the condition is caused by the immune system attacking and causing damage to myelin, which is a fatty material that insulates nerves, acting much like the covering on an electric wire.
Under Magnetic resonance imaging (MRI), the damage to the myelin shows up as as scars, which is how multiple sclerosis, which means “many scars,” gets its name.
So, what does that actually mean? Think about when you go to pick up a cup. Your brain creates a message telling your hand to pick up the cup. That message is conducted from your brain through the nerves in your spinal cord to your muscles, until eventually you pick up the cup.
When a person has MS, damage to the myelin sheath makes it difficult for the brain’s message to travel to the appropriate muscles. Think of a TV with an electrical wire where the plastic covering has worn away. Will it turn on? Maybe, sometimes, if you jiggle it just right.
Obviously, people living with MS are not electrical appliances. So how do these myelin-damaged nerves express themselves in people?
According to the MSIF, MS symptoms vary widely. Most often, they can appear as blurred vision, weak limbs or limb paralysis, tingling sensations, unsteadiness and fatigue.
Is Multiple Sclerosis preventable?
According to Dr Victoria Mifsud, staff physician in the Neurological Institute at Cleveland Clinic Abu Dhabi, there is still no conclusive data that explains why people get the condition, which makes it impossible to prevent. On the other hand, she says that “more than 200 genes have been found to be associated with MS.”
That number might be too big to be useful right now, but it’s a great step toward a future where doctors can determine who might develop MS.
Though multiple sclerosis can’t be prevented, it can’t be spread or passed on, either. “No specific gene is directly responsible for MS and there is no specific pattern of inheritance,” said Dr. Mifsud.
Prevention may not be possible currently, but like every other condition, maintaining a healthy lifestyle can decrease the progression and greatly improve your quality of life with MS.
How to live healthy with MS
With the right treatment and care, you can still live a healthy and fulfilling life with a multiple sclerosis diagnosis. In a webinar for World MS Day 2021, doctors and staff from the Multiple Sclerosis and Autoimmune Neurology Center at Cleveland Clinic Abu Dhabi shared what you should do to stay healthy if you have MS.
First off, what’s good for the heart is good for the brain, which means managing controllable risk factors like diabetes, blood pressure, cholesterol and weight through regular physical activity, a balanced diet and not smoking. Also, make sure you maintain vitamin D levels, manage stress levels and get enough sleep – all things we should be doing anyway.
Treating MS
In the past 10 years there has been a lot of development in MS disease modifying treatments (DMTs), to make living with MS that much easier. Dr Anu Jacob, director of the Multiple Sclerosis and Autoimmune Neurology Center at Cleveland Clinic, explained how MS medications and treatments are broken down into three categories: moderately effective, more effective and highly effective.
MS medications vary. There are capsules like Tecfidera, injectables like Tysabri, or infusions like Ocrevus.
Each treatment has its own list of benefits and drawbacks and it’s okay to change medications because of side effects or lifestyle. If you have MS, talk to your neurologist about which may be the best treatment plan for you.
The future of MS — a cure?
MS treatment has come a long way and the new research is cause for excitement. Dr Jacob gave a preview of the new drugs in clinical trials that will change how MS is treated in the future.
Evobrutinib is a BTK protein inhibitor, currently in the second phase of clinical trials in the US and Canada. By blocking BTK protein, researchers hope to reduce nerve cell damage seen in MS patients and prevent relapses.
The second drug in clinical trials is Ibudilast. In those trials, Ibudilast demonstrated slower rates of disability due to nerve fiber damage, reduced brain volume loss and a lower relative risk of new inflammatory lesions converting to persistent black holes, which are associated with relapses.
Lastly, Dr Jacob was excited to share the news that stem cell transplants for MS patients are in clinical trials and have been shown to repair damaged nervous systems. But he warned against private clinics popping up offering stem cell transplant treatments for MS. The treatment is still in clinical trials and has not been approved for wider use.
The last development is an mRNA vaccine – yes, just like the PfizerBioNTech Covid-19 vaccine.
The multiple sclerosis mRNA vaccine would prevent people from developing multiple sclerosis. It’s amazing to think about how far MS research has come in just 25 years.
MS & Covid-19
Going back to the other mRNA vaccine on our minds, should people diagnosed with MS be receiving the Covid-19 vaccine?
Dr. Beatrice Benedetti, staff neurologist at Cleveland Clinic Abu Dhabi, gives an emphatic yes. “In general, the risks of Covid-19 outweigh the potential risks from the vaccine. The vaccines available in the UAE do not have live cultures of the virus and can be given to people with multiple sclerosis.”
She also stated people with MS should not stop their treatments, even if they are immunosuppressant, but simply stay active and take extra precautions to avoid Covid-19.
How is the UAE supporting MS research?
In 2015, the Salama bin Hamdan Al Nahyan Foundation partnered with Cleveland Clinic Abu Dhabi to create the Multiple Sclerosis and Autoimmune Neurology Center with a mission to help those diagnosed with MS access appropriate care, educate the wider public on multiple sclerosis, and create a supportive space those living with MS to share stories and information.
On World MS Day 2021 the Salama bin Hamdan Al Nahyan Foundation and Cleveland Clinic Abu Dhabi’s Multiple Sclerosis and Autoimmune Neurology Center launched a new MS-specific website, which shares information and resources about MS in English and Arabic.
