Another diverse and jam-packed day! The breadth of the sessions and topics, the sense of energy, as well as the sheer size of this conference, really demonstrates how no stone is being left unturned in the global effort to better understand, better treat and better manage MS.
Myelin Repair
Today I started with a fascinating talk on the factors that myelin-producing cells secrete that may help prepare the demyelinated axons in MS, the long fibres of nerve cells, to receive and a new myelin wrapping, which would lead to their repair. Moreover, another important talk on how microglial cells, a type of supporting immune cells in the brain can be manipulated to allow myelin repair. The two talks really demonstrate how repair in the MS brain will dependent on a range of crucial interacting cells and molecules.
Disease Course
Then on to a more clinical session covering the different courses of MS disease and how we might be able to predict progression better and predict how severe or mild the diagnosis of MS might turn out to be for an individual. Importantly, two researchers answered an along debated question of whether there is such a thing as benign MS. Both presented interesting data supporting the concept that a small group of patients do have a very mild disease course with very few relapses, little disability accumulation and no progressive disease. However, this remains a diagnosis that can only be made in hindsight. However, confirming the nature of this form of MS will open the door to study further to better predict right from the start who these patients might be to avoid costly and unnecessary treatments.
Gene and Environmental Risk Factors
Another highlight of the day was a session on the interaction between genetic and environmental risk factors. Dr Stridh presented clear evidence that the key MS risk gene, HLA, and a protective gene interact in an additive way and then these genetic factors, in turn, interact with the strong lifestyle risk factors of smoking, EBV infection and obesity, to strongly influence the risk of developing MS. These findings have important implications for family members of people with MS who are at higher than average risk of developing MS. Professor Ascherio, however, revealed that the low vitamin D and EBV infection act completely independently on MS risk, with no evidence for an interaction.
We also heard about intriguing new genes that may underlay primary progressive MS – a long-sought clue in the MS story. However, more work is needed to follow up on this exciting insight.
Increasing MS incidence
Dr Magyari was able to show that the incidence of MS in women in Denmark, as in many countries, has doubled over the last 60 years while remaining steady in men. However, their comprehensive data was not able to reveal any environmental or factors that could explain the change.
MS Health Economics
Completing that session was an important health economic study in which Dr Pugliatti and her colleagues had modelled the impact of smoking cessation and increasing vitamin D levels on both quality of life and the health care costs associated with MS. her findings show that promoting healthier lifestyles as well as instigating early, effective use of disease-modifying therapies in people with MS will have significant benefits for both individual quality of life and the economic impact of MS on society.
Once again Follow me on Twitter @lisameltonMSRA and check back into the website for more news from this amazing conference.

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Report from the world’s biggest MS conference – Day 3