The idea that there was a real possibility of making a meaningful contribution to the lives of people with MS during my scientific career. In other words: to be involved in solving a challenging but solvable problem that, if cracked, would unequivocally be of benefit to a significant number of people.

Undoubtedly, the advent of immunomodulatory therapies that unequivocally benefit people with relapsing remitting disease. We now need to extend those advances to make sure that people with progressive MS also benefit.

This project revolves around detection, measurement, and treatment of subtle progression of MS, especially among patients who are at the highest risk of silent deterioration of their disease. It will first develop and validate a set of markers (clinical assessments, specialised investigations, and biological markers) that will be sensitive enough to detect subtle changes in people with seemingly well-controlled MS. Second, it will develop a new method for monitoring the activity of immune system within the brain. This method (PET or positron emission tomography using a special marker for subset of the immune system) will be first validated in animals and then translated to use in humans. Third, the program will develop a promising treatment for progressive MS: PEGylated-GAS6. This molecule modifies the behaviour of immune system within the brain.

Progression of MS can at times be insidious and is often initially missed by doctors and patients alike. It is not uncommon that while MS may seem to be appropriately controlled, the condition is deteriorating quietly in the background. Once this silent deterioration manifests as an overt worsening of disability, it is typically too late to reverse the loss of capacity. The completed research will set the scene for translation of this treatment into a research program offered to people living with MS - a first-in-human randomised clinical trial of PEGylated-GAS6.

The most enjoyable feature is the thrill of discovery and developing the vision of how that discovery might be translated into something of meaningful benefit. The biggest challenge remains the battle to acquire the funding to maintain that pipeline of discovery and to be able to continue to support the career development of the next generation of scientists. That is why the continuing support of MS Australia is so important, not only to my laboratory but to the field in general.