Interesting thoughts
I'm a little confused by the last paragraph. The authors state that treatments which reduce inflammation might also inhibit repair. And this is evidenced by the fact that we're seeing cases which have fewer relapses and less MRi activity, but continued progression of disability, although at a slower rate. What are they referencing here? Are they talking about ablation therapies, like Campath and Revimmune?
Yeah, Bob. we had a red hair and MC1R discussion a while back. I was glad to see it come back up.
Did you all see this?
Did you all see this?
White matter neurons also express a variety of vasoactive molecules, which supports their involvement in the regulation of vascular tone (Okhotin and Kalinichenko, 2003). Specifically, subsets of white matter neurons express nNOS, the enzyme that synthesizes the vasodilatory molecule nitric oxide (Fig. 1D), as well as the vasoconstrictors, NPY (Fig. 1E) and somatostatin (Fig. 1F
I think they are saying that the intensive treatments (like Campath or HiCy) may be more successful because they don't require ongoing immunosuppressive or immunomodulatory therapy.
"Although all of these more intensive immunosuppressive
or ablative treatments are deemed aggressive, they are
given as either pulsed or one-time treatments that require
no ongoing immunosuppressive or immunomodulatory
therapy; each study had patients who reported an
improvement in disability and had few new infl ammatory
events (relapses or MRI lesions). Could this quick but
defi nitive hit be enough to curb disease activity but
perhaps spare the disease repair mechanisms that underlie
the clinical improvements?"
But the trend out of Johns Hopkins seems to be toward following up with ongoing immune modulation. I believe HiCy patients are taking copaxone after ablation now, and there are reports that JH will be comparing copaxone vs tysabri after HiCy soon. I wonder how that will play out?
Of course the JH folks are a lot more knowledgeable than I am, so they must have their reasons, but I certainly recoiled a bit when I saw that they were following up with copaxone; and tysabri after ablation makes me very nervous.
I think Rush is watching Vit D levels closely after ablation. That makes more sense to me, but I know this is a big picture with a lot of intricacies I don't necessarily understand.
"Although all of these more intensive immunosuppressive
or ablative treatments are deemed aggressive, they are
given as either pulsed or one-time treatments that require
no ongoing immunosuppressive or immunomodulatory
therapy; each study had patients who reported an
improvement in disability and had few new infl ammatory
events (relapses or MRI lesions). Could this quick but
defi nitive hit be enough to curb disease activity but
perhaps spare the disease repair mechanisms that underlie
the clinical improvements?"
But the trend out of Johns Hopkins seems to be toward following up with ongoing immune modulation. I believe HiCy patients are taking copaxone after ablation now, and there are reports that JH will be comparing copaxone vs tysabri after HiCy soon. I wonder how that will play out?
Of course the JH folks are a lot more knowledgeable than I am, so they must have their reasons, but I certainly recoiled a bit when I saw that they were following up with copaxone; and tysabri after ablation makes me very nervous.
I think Rush is watching Vit D levels closely after ablation. That makes more sense to me, but I know this is a big picture with a lot of intricacies I don't necessarily understand.
That's where I'm a little confused. I guess they're saying the re-growth of these neurons is a good thing? And that the treatments that suppress inflammation might inhibit this re-growth? But they aren't clear on whether the one-time treatments like HiCy or Campath are bad for this.jimmylegs wrote:that's weird, it's like most of the ms brains lost a bunch of neurons that help control blood flow... but a few of the patients grew a bunch more new ones??
I don't know, but I tend to think the Tysabri after HiCy is mis-information. After the fiasco with combining Tysabri and Avonex how could they even be considering this? And how would they get it through their ethics committee?Axiom wrote: But the trend out of Johns Hopkins seems to be toward following up with ongoing immune modulation. I believe HiCy patients are taking copaxone after ablation now, and there are reports that JH will be comparing copaxone vs tysabri after HiCy soon. I wonder how that will play out?
Of course the JH folks are a lot more knowledgeable than I am, so they must have their reasons, but I certainly recoiled a bit when I saw that they were following up with copaxone; and tysabri after ablation makes me very nervous.
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