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For the first time in the world, Israeli neurologists have identified early genetic markers of multiple sclerosis that appear up to nine years before healthy young adults develop symptoms of the disease.
The research led by Prof. Anat Achiron of Sheba Medical Center and Tel Aviv University’s Sackler School of Medicine involved taking blood samples from soldiers and has just appeared in the journal Neurobiology of Disease.
MS is an autoimmune inflammatory disease in which the immune system’s T cells mistakenly regard the myelin coating that insulates neurons as “foreign” and attack it. This causes neurons to “short circuit” and can produce a wide variety of symptoms, which vary from patient to patient and can attack rarely or frequently. MS is more common in people of northern European descent and individuals from colder climates, while women are more than twice as likely to develop MS than men.
It usually affects people between the ages of 20 and 50, and the average age of onset is in one’s mid-20s to mid-30s. There are about 4,000 MS patients in Israel.
Myelin is a protein that allows the nerves to transmit information to and from the brain in a fraction of a second. If the myelin is disrupted in any way, the transmitted information is not only delayed, but it may also be misinterpreted by the brain. The destruction of the myelin sheath leads to areas of plaque in the brain and spinal cord that disrupt the transmission of information and lead to MS symptoms.
Among these are vision, motor and sensory symptoms. Some people have a first attack that never repeats itself, while others get accumulated disabilities as neurological deficits accumulate. Many of the drugs that shorten the attacks and alleviate their power, such as Copaxone and interferon beta, were developed in Israel.
Achiron told The Jerusalem Post
that her team took blood samples from healthy young IDF soldiers at an average age of 19 and followed up on them for nine years. Nine of them developed MS, while a control group remained free of MS. Their blood was compared with 31 people during the first clinical episode of MS. The researchers identified genetic markers shared by those who later developed MS and those who were already showing their first clinical symptoms.
Although the number who showed the early markers could be considered a
small group, Achiron noted that it is not, considering that in this age
group, an average of only 30 people out of 100,000 develop MS. The
research, conducted with Drs. Itamar Grotto, Ran Balicer, David
Magalashvili, Anna Feldman and Michael Gurevich, suggests that the
potentially devastating disease could eventually be identified and
screened years before it manifests itself. This would open the way
toward interventions that could lead to early prevention of the disease.
The Sheba neurologist said the disease does not pass from one
generation to another, but it is more common in a sibling of someone
with the disease.
But finding biomarkers is significant, she added. Of 2,500 MS patients
given early diagnosis to rehabilitation by a multidisciplinary team at
Sheba, there are only four or five families that have more than one
case, she said.
“We are not yet able to treat people with MS biomarkers early to
prevent onset. But knowledge is power. We are working further in this
direction,” said Achiron, who is researching the gene expression of
specific biological pathways mainly associated with inflammation and
cell death and neuroprotective pathways associated with different
disease stages. This work has the potential to discover the mechanistic
processes associated with the pathogenic process involved in MS and –
it is hoped – would lead to new MS treatments.