Chat About Multiple Sclerosis
More than 300,000 Americans suffer from multiple sclerosis, a degenerative disease of the central nervous system that can paralyze and, occasionally, kill. Its cause is not yet known, but new research points to a possible trigger: Human Herpes Virus-6.
What does this new research, and other discoveries about MS, mean for treatment of the disease? Here to help put things in perspective is Dr. Lauren Krupp, a neurologist and co-director of the MS Comprehensive Care Center at State University of New York Stony Brook.
The following is a transcript of Dr. Krupp's live chat on ABCNEWS.com.
Jill Gleason from curb.com at 3:00pm ET
Is medical researching pointing to the fact that the Herpes virus is a cause, a contributing factor or just coincidence in MS patients and is it found in all types of MS?
Dr. Lauren Krupp at 3:06pm ET
For the past 2 years a number of research laboratories through-out the country have been investigating the relationship between HHV6 and MS. Studies have involved examining the brains of individuals who have died of MS, studies of the blood of people with MS and more recently lymph node biopsies. At present we still do not know whether this virus is present to a greater degree in individuals who have MS versus those who do not. It is probably not the case that HHV6 is the direct cause of MS. Unfortunately it is a much more complicated issue. One study which examined the role of anti-viral treatment in a group of 60 individuals with MS did not show a clear benefit over placebo.
steve smear from [184.108.40.206] at 3:07pm ET
What would be the harm in treating MS patients with the best anti-virals available for HHV6, even if it isn't definitely proven to be the cause at this time?
Dr. Lauren Krupp at 3:10pm ET
The disadvantage of treating individuals with MS using anti-viral agents at this time, is that while we do not know whether this is a form of therapy which is effective, we do know that there are available therapies which have been convincingly demonstrated to benefit people with MS. Further, there could be potential adverse effects for individuals with MS in combining anti-viral therapy with known effective MS treatments. The best way to answer the question of efficacy of anti-viral therapy is through controlled clinical studies.
Jeanne Farrell from [220.127.116.11], at 3:11pm ET
With this new research on MS and the HHV-6, why isn't the NMSS publicizing the new results and notifying doctors and patients of anti-viral medications available? Are there any clinical trials on the effects of anti-viral medications on slowing MS? There is alot of press on the A, B, C (Avonex, Betaserson & Copaxon)drugs but little about hitting the MS where it starts.
Dr. Lauren Krupp at 3:16pm ET
Most health care providers involved with individuals who have MS are
very reluctant to draw premature conclusions regarding treatment. Compared
to the numbers of individuals who have received either Avonex, Betaseron,
or Copaxone, the number of individuals treated with anti-viral agents is
very small. As I noted above, the published studies with anti-viral agents
in MS have been disappointing. The NMSS does
support numerous efforts designed to understand the causes of MS.
Craig Adams from [18.104.22.168], at 3:16pm ET
What do you think the chances of a vaccine are? So many viruses that have been identified still have no effective treatment...
Dr. Lauren Krupp at 3:19pm ET
The role of viruses and MS has been studied for many years. At the present time, there is no convincing data that any one particular virus including HHV6 is clearly responsible for MS. Therefore, it is not clear whether developing effective anti-viral vaccines is the best approach in preventing MS.
Kate from proxy.aol.com at 3:19pm ET
What do the new findings regarding Herpes Virus 6 mean for patients who have had MS for 20 + years? Any chance of reversing some symptoms?
Dr. Lauren Krupp at 3:23pm ET
The findings regarding HHV6 and MS are still very preliminary and contradictory. For example, other researchers have not demonstrated a link between HHV6 and MS. The implications for recent research on this virus and people at early and later stages of disease are very unclear. Fortunately, there is research directed at improving symptoms and the illness course even in individuals who have had MS for many years.
David from [22.214.171.124], at 3:23pm ET
A female friend in her late thirties is beginning to show signs of MS. Are there any preventative measures such as diet, drugs, herbs, etc, which she can take to retard the progress of MS?
Dr. Lauren Krupp at 3:27pm ET
There are more treatment options for individuals with early signs of MS than ever. Your friend should consult with her physician and review the appropriateness of any of the three current FDA approved medications for decreasing the frequency of attacks of MS. In general, a healthy lifestyle and effective stress management can be helpful.
michael bliss from [126.96.36.199], at 3:28pm ET
Could you please give a brief summary of the general advances made in understanding MS in the past few years, and what this means in practical terms for people with MS?
Dr. Lauren Krupp at 3:36pm ET
There have been many exciting advances. For instance, studies of immunology have revealed that there are a variety of different cell types that are important in understanding how the disease affects an individual. We have also learned that the nerve itself (axons) are affected early in the disease course and therefore early intervention is important. Recent advances in the ability to image the brain and spinal cord have shown us that MS can be active even when an individual is experiencing few symptoms. With respect to therapy, there have been many developments in the past five years. Three drugs are now available in the United States. There are many clinical trials planned or underway to test other treatments. Also there is a steady improvement in treatment of the symptoms of MS. For more information and continued research updates, contact the NMSS.
Amanda from [188.8.131.52] at 3:36pm ET
In your opinion, do any "alternative" treatments for MS have any efficacy (besides the traditional drug treatments)?
Dr. Lauren Krupp at 3:46pm ET
Many individuals find alternative therapies helpful. However, no alternative therapeutic approach has yet been demonstrated scientifically to improve MS or its symptoms. Bee venom which is of current interest was not found to be helpful in an animal model of MS. However, a controlled study of bee venom in humans with MS is underway. While I do not recommend alternative therapies to replace the current recommended treatments, they can at times complement management of the disease either through reducing sress and empowering the individual. However, I always caution my patients to be careful of false claims and spending their money on treatments that have not been proven to be helpful.
Angelee Dion from sc.scruznet.com at 3:46pm ET
Is there any research being done using stem cells to regrow myelin in MSers?
Dr. Lauren Krupp at 3:53pm ET
There has been some preliminary research on bone marrow transplantation, a very aggressive form of treatment in MS, but so far the evidence does not demonstrate that this is an effective treatment. A variety of research approaches are being taken to try to restore the myelin (the covering of the nerves that is damaged by MS). One method involves the use of growth factors to help the cells which make myelin. Another approach involves transplantation of early myelin producing cells into areas of the central nervous system in which the myelin has been damaged. These studies are for the most part still being done in animals or in the laboratory but are extremely important.
Dee Dee from dc.alz.org at 3:53pm ET
I heard recently that a new drug for treating MS, Rebif, is close to FDA approval. Are there any other treatments out there pending approval or being done in clinical trials?
Dr. Lauren Krupp at 3:57pm ET
Rebif is a form of interferon beta-1a It is structurally similar to Avonex. However, it is adminstered subcutaneously (under the skin), which may be an advantage to Avonex which is injected into the muscle. It has also been studied at a variety of doses. This agent has been studied in Europe and has been shown to be very effective in reducing MS attacks and altering the disease course.
Chris from [184.108.40.206], at 3:58pm ET
I am presently in the drug trial using Valtrex to fight the HHV6 virus. You seem to discount this theory. Why are there still trials going on if this is not showing some positive results?
Dr. Lauren Krupp at 4:02pm ET
I did not intend to discount the importance of recent findings regarding HHV6. Again, I only hope to prevent individuals from reaching premature conclusions without adequate study. Particpating in clinical trials is an excellent way to help both yourself and tdhe MS community. Clinical trials are our only way to determine whether a treatment for MS is truly effective. There are more clinical trials either being planned or underway than ever before and I anticipate many advances in both our understanding and treatment of MS.
Moderator at 4:03pm ET
That's all the time we have today. Sorry we couldn't get to everyone's
questions. But thanks for joining us, and thanks to Dr. Krupp for being
here to take questions.