May 21, 2003
The 7:30 Report
KERRY O'BRIEN: Australian researchers are about to launch a landmark study that may unlock one of the many mysteries surrounding the auto-immune disease multiple sclerosis.
The study will examine a phenomenon of MS called the latitude gradient, which simply means that the disease occurs more frequently the further you move away from the equator.
The latitude gradient is a world-wide phenomenon, but it's strongest in Australia, where people in Tasmania are seven times more likely to develop MS, than people in north Queensland.
Natasha Johnson reports.
CAROLYNN SALZMANN, MS SUFFERER: The hardest thing about MS is the uncertainty that goes along with it.
You really can't go to anyone and say what's going to happen to me in the next five years or what's going to happen to me in the next 10 years.
HELEN GESAPINI, MS SUFFERER: It is very hard to live with it when you just don't know what's going to happen tomorrow.
You get up one day and you may feel a lot worse than you did the day before or you might wake up and feel a lot better, but there's no way you're ever going to be back to normal.
NATASHA JOHNSON: Helen Gesapini and Carolynn Salzmann are among the estimated 15,000 Australians who have multiple sclerosis.
They're at the opposite ends of the MS spectrum.
Helen has been living with MS for more than 30 years, Carolynn for just one year, but both share the frustration of suffering a disease with no known cause, no cure and no predictable path of progression.
ASSISTANT PROFESSOR TREVOR KILPATRICK, NEUROLOGIST, ROYAL MELBOURNE HOSPITAL: Typically it comes in remissions and relapses.
So people would typically get a presentation affecting their eye or their spinal cord for a few weeks before it spontaneously remits only to recur in that area or another area of the central nervous system months or years afterwards.
And unfortunately for a percentage of people, ultimately it leads to chronic and evolving and progressive disability.
NATASHA JOHNSON: MS is believed to be an auto-immune disease in which the immune cells attack the myelin, or casing around nerve cells in the brain and spinal cord, causing varying degrees of symptoms in different people which can ultimately result in blindness and paralysis.
CAROLYNN SALZMANN: It started off with optic neuritis in my left eye, which was blurriness, and then I developed tingling in the bottom of my feet, and that also came up my legs a little bit.
But, after my symptoms had cleared up, it really hasn't been a major impact for me at all.
HELEN GESAPINI: I find it difficult to walk and my arms -- and I have not a lot of strength in my hands and arms.
I've actually gone into a wheelchair when I'm out with the family now because otherwise I slow them down too much.
NATASHA JOHNSON: It's most common amongst women of Caucasian, particularly Anglo-Celtic, background, and, curiously, the prevalence of MS increases the further you move away from the equator.
PROFESSOR TONY McMICHAEL, CENTRE FOR EPIDEMIOLOGY & POPULATION HEALTH: Epidemiologists have known for a number of decades that in various places around the world, but particularly in Australia, as you move from low to high latitude, the rates of multiple sclerosis increase.
It's evident in Europe, it's somewhat evident on the west coast of the United States, but it's particularly evident in Australia.
NATASHA JOHNSON: In fact, Australia has the strongest latitude gradient in the world -- meaning that the number of MS cases per 100,000 people increases 7-fold as you move from northern Queensland to Tasmania.
Just why no-one knows.
But researchers from the National Centre for Epidemiology and Population Health and the Royal Melbourne Hospital hope to find out.
In conjunction with colleagues in Hobart, Newcastle and Brisbane, they're about to start counting and studying new cases of MS occurring along the east coast over the next five years.
ASSISTANT PROFESSOR TREVOR KILPATRICK: If we do identify that there are differences in the susceptibility to the disease in different regions in Australia, that would indicate to us that there are very likely to be environmental factors in addition to genetic factors which predispose to this condition.
NATASHA JOHNSON: But just what environmental triggers are they looking for?
Life-time history of infectious diseases, particularly glandular fever, diet, temperature and the amount of exposure to sunlight are among the key factors to be explored as researchers try to explain the dramatic variance of MS between warmer and cooler parts of the country.
ASSISTANT PROFESSOR TREVOR KILPATRICK: There's a very seasonal climate in Tasmania and in northern Queensland a subtropical environment.
So, therefore, the exposure to winter-based infections, coughs, colds, et cetera, is going to be much greater in Tasmania, and so that could be a relevant factor.
One possibility is that sun exposure leads to an increase in vitamin D levels, and there are some experiments, particularly in animals, which suggest that the level of vitamin D might affect the functioning of the immune cells.
And it's possible that that could in turn alter the susceptibility to a disease like multiple sclerosis.
NATASHA JOHNSON: With so little medical certainty, people living with MS explore all sorts of exercise, diet and alternative therapies to combat their disease.
If this new study can pinpoint environmental causes, it could lead to strategies to prevent the disease, new treatments or even a cure.
And that's of world-wide interest, which is why the research is being funded by the American MS Society to the tune of $1 million.
In addition, what's learnt about MS promises to solve some of the mystery surrounding other auto-immune diseases.
PROFESSOR TONY McMICHAEL: In Australia, another disease that shows quite a strong latitude gradient in the same direction is childhood, or type 1, diabetes, rheumatoid arthritis, atopic dermatitis.
The findings from the study will actually have meaning for all of these immune disorders.
NATASHA JOHNSON: As Carolynn Salzmann and Helen Gesapini continue to live with the uncertainty of MS, they feel confident that there will soon be more answers to their questions.
HELEN GESAPINI: The research is pretty exciting because things are getting much closer to a cure.
CAROLYNN SALZMANN: I'm lucky I'm 25, I'm in the earliest stages of the disease.
And people have said to me, "Within your lifetime there should be a cure for it."
That's what I hope for really.
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