IN DEPTH: Research On Progressive Multiple Sclerosis in 2012

_**As many of us know, the neurological disease Multiple Sclerosis (MS)  has multiple forms **_[1]:

* **_Relapsing-Remitting_  (RRMS)**:    Unpredictable attacks (relapses) followed by periods of relative remission with no new signs of disease activity
* **_Secondary Progressive (SPMS)_** :     Neurologic decline without acute relapses: A sign that one is evolving from RRMS to SPMS is that the baseline drugs[ CRABT]  work less well (Copaxone, Rebif, Avonex, Betaseron and Tysabri); Disability has progressed. _This group is fairly large : about 50 % of RRMS evolves into SPMS within age 40._
* **_Progressive Relapsing (PRMS)_** :     Steady neurologic decline and superimposed attacks.
* **_Primary Progressive  (PPMS)_** :    Decline from the beginning without attacks; problems walking, which gradually get worse; slowly worsening tremor; problems with balance.

_**This still could boil down to two overarching types: Relapsing Remitting and Progressive**_

Most Multiple Sclerosis (MS) new drugs, (See for example, our post on Alemtuzumab [2]), apply primarily  to the Relapsing Remitting Multiple Sclerosis form.

We have posted through the year on the Progressive forms of MS [4-8], and  checking on current research, we gathered the following.

First we bring you, through YouTube, a presentation by Dr Yaung Mao-Drayer, U. Of Michigan [3]. This is a good summary of the challenges of treating progressive MS.

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 The most important Chart of this presentation is below. Progressive MS according to Dr Mao-Draayer

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[](http://www.medinewsdigest.com/wp-content/uploads/2012/12/Progressive-MS-Dr-Mao-Drayer-UMHS.jpg)

Progressive MS, Dr Mao Draayer, UMHS

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Here you would have it, most , if not all the MS big guns address the inflammation phase of RRMS, as opposed to the Neuro-Degenerative phase of the progreesive types of MS.

_**Is it really that simple?**_

* Another study from Denmark [10],  shows that inflammation and neurodegeneration go and progress hand in hand :  "…emphasise a relationship between inflammation, axonal damage and demyelination…"
* From Austria [11]: "..**_.In progressive MS, as in relapsing-remitting MS, active tissue injury is associated with inflammation, but the inflammatory response in the progressive phase occurs at least partly behind the blood-brain barrier, which makes it more difficult to treat_**.  

We did publish about attempts to bring drugs to bear behind the Blood Brain Barrier [6]. intranasal delivery, is being studied for that purpose. Other methods use "…biodegradable polymeric nanoparticles…" [12]

_**Other research avenues against Progressive MS include:** A_ttacking the free radicals oxidation process [a nutraceutical favorite], by administration of oral treatments with Fumaric Esters [13]. Fumaric esters can be found in "…Fumaric acid is found in fumitory (Fumaria officinalis), bolete mushrooms (specifically Boletus fomentarius var. pseudo-igniarius), lichen, and Iceland moss…" (Wikipedia).

Problem Dimethyl fumarate is a potent irritant. Look before you jump…

Other methods we discussed in previous posts are

* Stem Cells:  Stem cells that can differentiate into a variety of cell types, including blood cells [4]
* Masitinib   [5]"… Masitinib, a selective oral tyrosine kinase inhibitor, effectively inhibits the survival, migration and activity of mast cells…"
* Statins: Usually for cholesterol concerns,  Zocor  (Simvastatin)   [7]

Discuss with your Doctor…

_**Sources:**_

1. [About.com ; Julie Stachowiak](http://ms.about.com/od/multiplesclerosis101/a/types_ms.htm)
2. [medinewsdigest](http://www.medinewsdigest.com/?p=5729) [;](http://www.medinewsdigest.com/) "Big Pharma's Slight Of Hand: Genzyme's Alemtuzumab Disappears as a Leukemia Drug, Only To Be Reborn as a Multiple Sclerosis Drug", Nov 2012
3. [medinewsdigest](http://www.medinewsdigest.com/?p=4549) ; IN BRIEF: Management of Secondary Progressive Multiple Sclerosis" ;April 2012
4. [medinewsdigest](http://www.medinewsdigest.com/?p=3861) ; "Progress in Stem Cell Treatment of Secondary Progressive Multiple Sclerosis" ; Feb 2012
5.  [medinewsdigest](http://www.medinewsdigest.com/?p=4744) ; "Possible New Treatment of Progressive Multiple Sclerosis: Masitinib" ; June 2012
6. [medinewsdigest](http://www.medinewsdigest.com/?p=5139) ; "IN DEPTH: Multiple Sclerosis Research And The Blood Brain Barrier" ; Aug 2012
7. [medinewsdigest](http://www.medinewsdigest.com/?p=5434) ; "IN BRIEF: Zocor Shown to Slow Disability in Secondary Progressive Multiple Sclerosis" ; Oct 2012
8. [medinewsdigest](http://www.medinewsdigest.com/?p=3249) ; "New Study shows Multiple Sclerosis caused primarily by inflammation, not neurodegeneration" , Dec 2011
9. youtube; "Progressive Multiple Sclerosis - 2012 Patient & Caregiver Conference"
10. [Multiple Sclerosis](http://www.ncbi.nlm.nih.gov/pubmed/23178691) ; " CSF inflammation and axonal damage are increased and correlate in progressive multiple sclerosis."; Nov 2012
11. [Nature Reviews Neurology](http://www.ncbi.nlm.nih.gov/pubmed/23007702)[ ; "Progressive multiple sclerosis: pathology and pathogenesis." ; Nov 2012 Multiple Sclerosis](http://www.ncbi.nlm.nih.gov/pubmed/17623736) ; "Intravenous immunoglobulin in primary and secondary chronic progressive multiple sclerosis: a randomized placebo controlled multicentre study." ; Nov 2007
12. [Journal of Controlled Release](http://www.ncbi.nlm.nih.gov/pubmed/21872624) ; "Transport of drugs across the blood-brain barrier by nanoparticles."; July 2012
13. [Int. Journal Of Molecular Science](http://www.ncbi.nlm.nih.gov/pubmed/23109883) ; "Mechanisms of Oxidative Damage in Multiple Sclerosis and Neurodegenerative Diseases: Therapeutic Modulation via Fumaric Acid Esters." ; 2012
14. [Alternative Holistic Health Answers](http://alternativendhealth.wordpress.com/2012/04/29/study-confirms-efficacy-of-oral-fumarate-in-multiple-sclerosis/) ; "Study Confirms Efficacy of Oral Fumarate in Multiple Sclerosis" ; Christopher Maloney, Naturopathic Doctor, April 2012
15. [uptodate.com](http://www.uptodate.com/contents/treatment-of-progressive-multiple-sclerosis-in-adults) ; "Treatment of progressive multiple sclerosis in adults" ; Oct 2012
16. [Multiple Sclerosis Journal](http://msj.sagepub.com/content/early/2012/08/22/1352458512458169.full) ; "Setting a research agenda for progressive multiple sclerosis: The International Collaborative on Progressive MS" ; 2012

URL: http://www.medinewsdigest.com/?p=5758