A new study has reported that the molecular and immune profile of slowly expanding lesions (SEL) in progressive multiple sclerosis is distinct from that of active demyelinating lesions that occur in the relapsing phase of MS (Jackle et al. Brain 2020;143:2073-2088; free full text at https://academic.oup.com/brain/article-pdf/143/7/2073/33502654/awaa158.pdf). SELs are considered the pathological correlate of MS disease progression.
Recent reports on the immune response to SARS-CoV-2 infection have largely focussed on B cells, with particular emphasis placed on antibody testing. An antibody response can typically be detected within 15-30 days of the onset of COVID-19 symptoms but concerns have been raised about the persistence of antibodies. A U.K. study reported a rapid decline in antibody titres, with the level of neutralizing antibodies in some patients approaching baseline within two months of disease onset (Seow et al. medRxiv preprint; free download at www.medrxiv.org/content/10.1101/2020.07.09.20148429v1.full.pdf). This has raised concerns about whether a COVID-19 vaccine would confer long-lasting immunity.
The European Academy of Neurology (EAN) annual congress included new research on neurofilament-light (NfL), an indicator of neuroaxonal damage and one of the more promising biomarkers in multiple sclerosis and other neurodegenerative conditions. Several recent publications have also presented interesting findings that suggest a role for NfL in MS diagnosis, prognosis and treatment selection. Read More
In the past few years, considerable attention has focussed on the role of B cells in the pathophysiology of multiple sclerosis, in large part because of the success of anti-CD20 monoclonal antibodies (e.g. rituximab, ocrelizumab) in reducing clinical and radiological disease activity. A novel agent, ofatumumab, is expected soon and other agents (e.g. ublituximab) are in development. Read More
The following is a summary of some of the key studies on cognitive dysfunction in multiple sclerosis presented at this year’s European Academy of Neurology virtual congress.