Ottawa doctors behind breakthrough multiple sclerosis study


OTTAWA -. A team of doctors Ottawa is preparing the publication of a full report on its progress study management of multiple sclerosis that has eliminated so far the disease in patients treated

The experimental study began about 13 years ago as a last resort for patients who do not improve with drug therapy and who suffer severe symptoms of MS. Fragments of the results have been published “here and there”, said Dr. Mark Freedman neurologist, one of the show’s Hospital in Ottawa, but has never been published in full.

No date has been set for its release, but team results are far from secret. MS not return in any of the 24 participants, success stories of patients appear in the media across the country. Since completion of the original study, another dozen patients have been treated with all showing the same results.

Removal of MS completely and observing patients improve so surprised Freedman and Dr. Harold Atkins, an expert in bone marrow transplantation, the study began. The two were originally established to monitor the development of the disease and find a way to treat it. His theory was as follows :. Clean the entire immune system, reboot the system with a bone marrow transplant patient and wait for it to regenerate MS

“We thought we might be able to intercept a signal that initiates the disease and that would then give us a clue about how to treat it,” Freedman said. He jokes that he “had, in fact, not because the disease never returned. No one expected to see zero activity of the disease after transplantation.”

Patients Vancouver to Newfoundland, who had given up hope, became part of the original 24, including medical students third year Alex Normandin of Montreal.

The doctor noted that aspire alarming symptoms of fatigue, numbness and impaired balance and coordination. Researchers at the Montreal Neurological Institute confirmed that it has a particularly aggressive form of multiple sclerosis, an unpredictable and degenerative disease that affects the central nervous system.

Most patients do not become severely disabled because the disease moves slowly. But in the case of Normandin, the destruction was so fast that doctors hoped would need a wheelchair within months.

Normandin, however, learned cutting-edge treatment directed by Freedman and Atkins. He became the patient number 19 in the experiment and had his transplant in Ottawa in December 2008.

The procedure has its risks. One patient died at an earlier stage of the process. It was in 2001 or 2002, Freedman recalled, saying that death was due to the pill form of the drug busulfan. It is used from the beginning of the experiment, the drug attacks the liver twice, both when it enters the body and again when you leave. But within a year, the team had discovered that a new version of the drug intravenously greatly improved patient safety.

Freedman had the task of trying to scare patients telling them the risks.

“My job was to talk to everyone outside it,” he said. “It really is the hardest thing you have to do in their lives. It’s a bit of a gamble, but with the fantastic team we have in Ottawa, which is less of a gamble.”

All participants showed a dramatic improvement, and none reported relapses, according to a study on the Freedman-Atkins treatment by a team of researchers from MS in the Neuro and the University of Montreal.

In addition, nuclear magnetic resonance (NMR) showed no damage to the brain, “no new MS activity”, according to findings published in the latest issue of the journal Annals of Neurology.

To Normandin, who is now a family physician in private practice in the west of the island and no longer takes medication for the disease. Their problems of fatigue and balance continue to decline daily.

But despite such dramatic results, none of MS researchers in this study is called the procedure a cure.


On the one hand, it is not known if treatment is good to stop other types of MS, the neurologist explains Amit Bar-Or, Montreal Neurological Institute and McGill University and principal investigator of the study.

In addition, transplants of bone marrow stem cells for the treatment of MS are not approved outside clinical trials because while the disease itself is not fatal, the procedure is fatal in up to five percent the patients.

But Freedman questioned the risk rate. It is said that the figure of five percent was from data collected in the 1990s as the team prepared for the experiment. That number has dropped since the one percent, he said.

In addition to medical advances, by comparing immune responses in patients before and after treatment, researchers discovered a key to new therapies that might be able to provide similar benefits without the risks associated biological target to knock out someone’s immune system to facilitate bone marrow transplantation.

Several studies have already indicated that in patients with MS, the body’s immune system attacks its own cells. The Hyperactive T (a type of white blood cells called lymphocytes) cells – which are responsible for defending the body against bacteria, viruses and other parasites – can also damage myelin, the protective insulation that covers nerve

.

The concept is simple, said Bar-Or. To combat infection, different types of T cells and other T quickly ratchet back that answer fast response cells then are mounted, he said. However, in autoimmune conditions, including multiple sclerosis, this regulation is twisted and the body attacks itself.

Researchers have zeroed in on a particular subset of T cells, called Th17 cells, which have a substantially diminished function after experimental transplantation. The discovery could help researchers point to a treatment in MS patients in general.

“We are cautious not claim we realized all the cells responsible for all relapses in patients with MS,” Bar-Or said. “Note that these patients have very aggressive MS, so maybe TH17 are especially important in these patients.”

emerging treatments, however, are already trying to address the TH17 cells, but the story is even more complicated, Bar-Or said.

“We do not know everything about them (Th17 cells), even in terms of basic immunology. It is likely that within the TH17 subset may be some bad guys … It would be good to know that, because we need to have these cells part of the time. Get rid of all of them all the time may not be completely safe. “

Both the clinical study of the Research Unit in Multiple Sclerosis Ottawa Hospital in Montreal and biological study was funded by the Research Foundation of the Multiple Sclerosis Society of Canada.

Canada has one of the highest rates of MS in the world -. It affects about 55,000 to 75,000 people

Normandin says his illness has been a blessing in disguise, giving it a unique perspective that is not in the textbooks of medicine.

“my whole outlook on life was changed. It definitely affects how I see patients. I am more sensitive in how to talk to them and more empathetic treatment with chronic diseases.”

He was once a race track where care work focused, but now “life balance” is everything and he is grateful for the treatment regained her life around and allowed him to work in a clinic where you can spend all the time necessary to talk to patients.

“Life is great,” he said. “I love to say it.”


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