Beta-1a What is Multiple Sclerosis? Most commonly defined as an autoimmune disease that affects the CNS Characterized by the loss and/or damage of the myelin sheath Loss of myelin sheath results in the inability of neurons to transmit neural signals properly, causing the many symptoms of MS Unpredictable and no known cures Anatomy of the Neuron Four Major Varieties of MS Relapsing/remitting (RRMS) Characterized by periods of flare-ups and remission Accounts for 85% of MS patients Primary Progressive (PPMS) Slow continuous worsening of disease from onset Only about 10% Four Major Varieties of MS (cont.) Secondary Progressive (SPMS) Initial period of relapsing-remitting, then steady worsening of disease 50% of patients diagnosed with RRMS develop into this variety within 10 yrs without drug treatment Progressive Relapsing (PRMS) Steady worsening with acute relapses Different from RRMS in that disease progresses during relapses What Causes MS? Not exactly known Several theories Most commonmyelin damage results from abnormal response in the immune system T cells (type of white blood cell) attack myelin Though to be triggered by environmental and/or genetic factors Many other theories MS is pathogen-mediated Research suggests Chlamydia Pneumoniae and other pathogens may trigger MS Genetics Identical twin studies-> one has MS, other has 30% chance No specific gene/s found yet Most likely involves a combination MS Geography Typical onset between ages 20-50 Reduces life expectancy by about 10-15 yrs About patients survive 30+ yrs from onset Affects 2-3 times as many women than men Research suggests that genetic factors play a role More common among people of European descent About 400,000 Americans have MS Symptoms of MS Wide variety due to nature of disease Different classifications of symptoms Visual Motor Sensory Cognitive Coordination/Balance Bowel, Bladder, and Sexual Others Diagnosis of MS No single test for diagnosing MS Usually diagnosed when all other possibilities ruled out Many tests Medical history Nervous system functioning MRI, Evoked potential tests, spinal tap Basic Rule for Diagnosis Est. by committee sponsored by NMSS in 1965 Must have BOTH of the following: Evidence of myelin loss in at least 2 areas occurring in different places at different times Any other diseases that could account for the above have been ruled out Revised in 1983 by Poser to take into account advances in MRI technology Treatments for MS No known cure Treatments involve relieving the symptoms or slowing the progression of the disease These are mostly drug treatments Also CAMs- Complementary and Alternative Medicine CAMs Used with or instead of conventional drug treatments Some include Acupuncture Herbal medicine Yoga Relaxation techniques Hypnosis Conventional Drug Treatments Disease-modifying drugs* ABC Treatments Chemotherapeutic Agents Corticosteroids & ACTH Drugs that help with symptoms Wide variety from anti-depressants (depression) to laxatives (bowel dysfunction) to anti-convulsants (pain/altered sensations) ABC Treatments Most popular drug treatments for modifying course of disease Work by regulating aspects of the immune system ABC refers to the 3 major brand names of this category of drugs: Avonex, Betaseron/Betaferon, and Copaxone Also now added Rebif and Novantrone ABC Treatments Cont. Interferon beta-1a Avonex, Rebif Interferon beta-1b Betaseron/Betaferon Glatiramer acetate Copaxone Mitoxantrone Novantrone What are Interferons? Occur naturally in human body Proteins that prevent viral multiplication by stimulating the production of antiviral proteins in normal cells Interferon-alpha, Interferon-beta, and Intereron-gamma Avonex Interferon-beta-1a Used for RRMS and SPMS w/relapses Produced by recombinant DNA technology using genetically engineered Chinese Hamster Ovary cells into which the human interferon beta gene has been introduced The resulting amino acid sequence is identical to human interferon beta Avonex Mechanisms by which it exerts it effects not fully understood Pharmacokinetics in MS patients not evaluated Recommended dosage of 30 mcg to be injected intramuscularly one weekly Not recommended subcutaneously- adverse reactions mainly at site of injection* No known interactions with other drugs Safet of doses abo e 60 mcg has not Current Avonex Research Avonex fairly new Lots of research being done, few consistent findings yet Most research with Avonex focuses on: Comparison with other drugs of its type Testing properties of the drug by altering dosages,etc. Seeing how well drug modifies disease course in placebo studies Future Research on MS Finding the cause Stopping/slowing progress of disease Repairing damage already done Remyelination Better ways of treating symptoms Focusing on the social implications Recommended Websites to Learn More http://www.avonex.com http://www.nationalmssociety.org
Characterization of Methicillin-Resistant Staphylococcus Aureus Isolated From Public Surfaces On A University Campus, Student Homes and Local Community