Recent evidence suggests that in addition to acute damage caused by lesions (spots of active inflammation in the brain and spinal cord), many people living with MS also display chronic inflammation around long-standing lesions (called slow-burning inflammation). Mr Klistorner and his team have shown that slow-burning inflammation (measured by MRI as an expansion of chronic lesions) is the most significant contributor to disease progression in people living with MS who are treated. Â
Their recent study has revealed that this process of lesion expansion is initiated by the loss of myelin around chronic lesions. They have also demonstrated that the degree of lesion expansion depends on the distance from the ventricles, a structure in the middle of the brain filled with cerebral-spinal fluid, and is strongly associated with the size of the network of small vessels inside the ventricles (choroid plexus), which is likely to play a very important role in sustaining chronic inflammation in MS. Â
The team are now investigating the relationship between plexus enlargement and inflammation around chronic lesions by examining people at the earliest stage of MS. In addition, they also plan to investigate potential effects of myelin repair therapies in preventing damage of brain tissue around chronic lesions. If confirmed, this will suggest that people living with MS displaying a significant degree of activity at the rim of chronic lesions may benefit from therapies that repair myelin. Based on the outcomes, the team will then develop an artificial intelligence (AI)-based model to assist in modelling lesion activity in a fast and semi-automated manner.Â
The key discovery of Mr Klistorner’s research has been about chronic lesion expansion, which is the slow-burning inflammation that occurs around long-standing lesions. This is now understood to vary greatly between individuals and to progress over a long time. This insight could revolutionise how we assess and treat chronic lesion expansion, possibly leading to more personalised treatment strategies and becoming a focus for future clinical trials.Â
In this project, chronic lesion expansion was also found to be closely linked to increased brain volume loss (atrophy), underscoring the importance of early and targeted treatment.Â
Updated 31 March 2024Â
$105,000
2022
3 years
Current project