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MSWA Bulletin Magazine Spring 2020

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RESEARCH FROM THE MS SOCIETY OF CANADA Read more at: New health conditions identified as part of the MS prodrome Neurodegenerative diseases such as Alzheimer’s and Parkinson’s, can start years before clinical diagnosis and are often preceded by a range of health issues. Individuals with Parkinson’s may experience depression and constipation years before the classic symptoms, such as motor deficiencies, are detected. These early symptoms are collectively known as the ‘prodrome’. Recent evidence suggests the existence of an MS prodrome, as reported by Dr Helen Tremlett’s research team at the University of British Columbia. They found that in the five years leading to the onset of MS-related symptoms, people diagnosed with MS were up to four times more likely to visit a physician or hospital for conditions related to nervous system disorders. Higher rates of other health issues, including musculoskeletal pain, mood or anxiety disorders, and migraine headaches, were also observed among MS cases. Recognising the earliest signs of MS years before the development of classic symptoms could be important for early disease detection and intervention. Thus, additional research is needed. The study reviewed clinical data from British Columbia and records of nearly 8,000 individuals with MS and more than 35,000 without MS (controls). The most prevalent conditions among MS cases in the preceding five-year period before onset of classic symptoms (eg, first demyelinating event) was pain, followed by sleep disorders, anaemia, and fatigue. The odds of having a sleep disorder were up to 161% higher in MS cases compared to controls, and the odds of experiencing pain were up to 115% higher. FROM THE MS TRUST UK Read more at: Myelin Repair Research Repairing the damage to nerves caused by MS is possible, according to new research. A study of the cancer drug bexarotene in Cambridge and Edinburgh showed it led to regrowth of myelin in people with RRMS. However, the dose needed to produce this effect led to serious side effects including thyroid disease and potentially damaging levels of blood fats. Whilst the fact it is possible to encourage the regrowth of myelin in humans is a breakthrough and will lead to further research, the side effects mean that bexarotene will not become a treatment for MS. The Cambridge team are planning another remyelination study using metformin (a diabetes drug) in combination with clemastine (a treatment for hay fever and allergies). FROM MULTIPLE SCLEROSIS NEWS TODAY Read more at: Pathway and Its Proteins Found to Control Myelin Repair, Renewal. Researchers have identified a pathway controlled by three proteins — Daam2, Nedd4, and VHL — as a key regulator of myelin production during central nervous system development and regeneration after injury. Myelin, the protective fatty layer that covers nerve fibers and helps to speed transmission of signals between nerve cells, is damaged and lost in MS. Iron Deficiency May Be Linked to Depression and Poorer Life Quality. A small Polish study reported that low blood levels of ferritin — the main form of iron stored in cells — are significantly associated with more severe depressive symptoms and poorer quality of life in MS patients. Data showed no link between the levels of other measures of iron metabolism and fatigue severity. .5M NATION-WIDE COMMITMENT TO MS RESEARCH Each year MSWA is able to continue our commitment to neurological research locally, across Australia and worldwide. By funding a variety of projects through different institutions, we hope to continue to make real differences for real people living with a neurological condition in WA. As part of last year’s financial allocation, we contributed .1m to MS Research Australia (MSRA) to form part of their .5m national boost towards multiple sclerosis research. MSWA is proud to support MSRA’s movements towards finding ground-breaking research results. “This record figure, formed nationally, shows Australia’s commitment to finding new treatments for MS. Funding efforts will significantly enhance research outcomes in Australia as well as fast forward the process for identifying effective MS treatments.” – Marcus Stafford, CEO. For more information, visit MSRA’s website: 10

RESEARCH RESEARCH IN FOCUS Here, we provide an insight into the research projects we are funding in Western Australia. DEMYSTIFYING DEMYELINATING DISEASES MSWA is proud to continue funding the Perron Institute’s Demyelinating Diseases Research group, led by group Director and Clinical Professor Allan Kermode. Since our last update the group has been active across many areas in 2020, despite the disruptions caused by COVID-19, with members working both independently and collaboratively towards shared targets. In the first seven months of 2020, the group published 12 peerreviewed papers and a further 12 have been submitted or accepted for publication. Dr Marzena Fabis-Pedrini, a key member of the group, is an MSWA Research Fellow at the Perron Institute. She is leading research into biomarkers, including neurofilament light chain, to personalise treatment options for people living with multiple sclerosis. Dr Fabis-Pedrini is also leading studies into the use of quantitative MRI assessment in the management of MS, and the interrelated effects of environment and immunogenetics. Collaborations have been established with Sun Yat-sen University PRC, the Chinese University of Hong Kong, and University of California, San Francisco USA to leverage these findings. Clinical Professor Allan Kermode – Consultant Neurologist and Head of the Demyelinating Diseases Research at the Perron Institute. Also with funding from MSWA, Dr Stephanie Trend, an MSWA Research Fellow with the Perron Institute based at the Telethon Kids Institute (TKI), has continued work with the group on a longterm collaborative project led by Professor Kermode and Professor Prue Hart (TKI). The research has been evaluating the effects of UVB phototherapy as a potential new intervention for people diagnosed with clinically isolated syndrome (single episode) in early MS. Gathering pivotal pilot data generated with MSWA support by Professor Hart’s team, has enabled chief investigator Dr Trend and her team to be awarded a nationally competitive MSRA project grant, which is investigating the role of antibodies and B-cells in MS. This recent work has benefitted from a new collaboration with Professors Björn Frendéus and Ingrid Teige and their colleagues at BioInvent in Sweden. Dr Xiaonan Zhong, neurologist and University of Western Australia PhD scholarship recipient, has also been busy studying T-cell immune targets in immediate post-mortem MS lesions in a collaboration with Murdoch University, the Erasmus Medical Centre Netherlands, and Vanderbilt University USA. The results will be pivotal in determining the key drivers for the development of the MS lesion. While the work being conducted by each researcher is diverse, it is all scientifically related, with topics strategically designed to interlink. For more information about MSWA funded research, head to our website: 11