Groundbreaking research carried out at NUI Galway is expected to pave the way for the first treatments for secondary progressive multiple sclerosis.
The research, driven by MS Ireland, the services, research and information society supporting those with the condition, shows that lesions formed in the grey matter of the brain might be associated with a signalling pathway called endoplasmic reticulum (ER ) stress.
MS is characterised by lesions, or a loss of myelin, in the central nervous system. This myelin speeds up nerve impulse production, and this is what gets damaged in the case of MS.
Higher levels of ER stress were discovered in lesioned areas in the grey matter of the brain in those with secondary progressive MS.
One of the most common neurological diseases in young adults, most people present with symptoms between 20 and 40 years. The condition is more common among young women than men, and for many, can be progressive.
The disease, which affects more than 6,000 people nationally, randomly attacks the nervous system in young adults. Its physical and emotional effects can last a lifetime. It affects the whole family system and can be managed if appropriate resources are made available, both social and medical, according to MS Ireland.
The research findings come from a team at the National Centre for Biomedical Engineering and Science at NUI Galway led by neuroscientist Dr Una FitzGerald and carried out by Dr Jill McMahon in collaboration with Dr Stephen McQuaid from Queen’s University Belfast.
The project, entitled “Endoplasmic reticulum (ER ) stress as a component of neurodegeneration in MS grey matter lesions”, is one of only two research projects in the world examining the role of ER stress in grey matter lesions in MS.
The research team first examined how lesions are formed in the grey matter of the brain. “When a person has MS, myelin disappears. When the myelin is gone we call it a lesion,” explains Dr Una FitzGerald.
She adds that grey matter lesions are believed to be the major cause of severe symptoms in secondary progressive MS. ER-stress is a signalling pathway which is associated with a variety of neurological disorders such as MS and Alzheimer’s disease.
The team found that ER-stress is expressed at raised levels in both white matter and grey matter demyelination. They developed the theory that molecules activated during ER-stress cause damage to the brain which many people with MS experience.
Dr Fitzgerald states that if a link is proven between the ER signaling pathway and lesion development, researchers can focus on creating drugs that can interfere with that pathway.
In 85 per cent of cases MS starts out as a relapsing-remitting form, with patients having symptoms followed by substantial or complete improvements. The periods of improvement are associated with the build up of myelin on the lesions again. However, over time the lesions remyelinate less, and people with MS can experience a gradual decline in neurological function.
Until now, MS research has mostly focused on how white matter lesions are formed because these are the easiest to see. However, it is now believed that grey matter lesions have a key impact on patient disability as MS progresses.
“Historically, MS has been considered to be predominantly a disease of the white matter of the brain. But there has been renewed interest in the grey matter of the brain as more scientists have realised that its occurrence there has been greatly underestimated,” says Dr FitzGerald.
The research project was supported by a research grant from MS Ireland. Its research programme offers Irish researchers an opportunity to contribute to the global research agenda through a dedicated research fund. Applications are accepted annually and reviewed by the MS Ireland Research Committee and a number of leading researchers in their field before funding is awarded.
Speaking about the breakthrough MS Ireland research committee chairperson Professor Michael Hutchinson, a consultant neurologist at St Vincent’s University Hospital, said it was delighted to have funded such an important piece of research.
“Understanding the mechanisms of grey matter lesions and the demyelination process is essential to find ways to treat, prevent or one day cure MS. Our research programmes contribute to the global research agenda and are always driven by the needs of the MS community and enthusiastic, professional researchers such as Dr FitzGerald and her team.
“MS research is central to an enhanced understanding of the disease, leading to new or better treatments, interventions, management and ultimately a cure for MS. Research is one of our five strategic goals, based on feedback from people affected by MS.”
He says each year MS Ireland receives an excellent standard of applications from around the country.
“We are delighted to support the important area of research inIreland.”
MS Ireland provides a range of services and resources to the whole MS community; those with MS, family members, employers and health professionals. Its aim is to provide “timely, sensitive and accurate information and support” to help address or minimise the impact MS may have.
The organisation provides services and resources at a local and national level. Locally, its team of 30 regional workers provide one-to-one and group support and its 41 voluntary branches provide opportunities to socialise, share experiences and avail of services.
For further details, log on to www.ms-society.ie or telephone the information line at 1850 233 233.