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MSWA Bulletin Winter 2019

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RESEARCH RESEARCH ROUND UP SUE SHAPLAND RN, BN, MSCN MS NEWS TODAY DAILY DIGEST Quanterix Leads Research on Neurofilament Light Chain as Potential MS Biomarker Research presented at the American Academy of Neurology Annual Meeting, was validation of using the neurofilament light chain (NfL) as a potential biomarker for the diagnosis, prognosis, treatment and monitoring of patients with multiple sclerosis (MS) and other neurodegenerative diseases. Neurofilaments are nerve cellspecific components that can be measured in methods including a blood test. NfL appears to be a promising biomarker for MS patients; it is almost exclusively present in nerve cells, and is a sign of neuron degeneration/damage. This is such an exciting concept that there are currently 46 studies in the USA alone. These studies are evaluating the value of blood NfL levels as a reliable way to diagnose and monitor a range of neurodegenerative diseases, including MS, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), spinal muscular atrophy (SMA) and Huntington’s disease. Stress-induced Changes in Gut Bacteria May Increase Risk of Autoimmune Disorders, Mouse Study Suggests A study in mice suggests that stress-induced changes in gut bacteria, or gut microbiota, may play a significant part in the possible link between exposure to stress and the risk of autoimmwune disorders such as MS. It’s believed that autoimmune diseases arise from a complex interplay between genetic and environmental risk factors, some of which have already been linked to MS. Stressful life events are also thought to predispose people to these disorders — but the chain of events behind this link at the cell and molecular levels is still unclear. The team studied how gut microbiota changed in response to stress in mice with a genetic susceptibility to autoimmunity, specifically to optic neuritis. To address the impact of stress, researchers divided the mice into two groups: one was exposed to stress daily, while the other group wasn’t. After ten days, researchers found that the stressed mice had higher levels of certain types of bacteria in their gut, including those from the genus Bilophila and Dehalobacterium. These types of bacteria were reported to be highly abundant in the gut of MS patients, compared with healthy people. The findings suggested that stress can change the activity of the gut microbiota, which in turn enforces an immune response and the potential to trigger an attack against the body. That increases the risk for autoimmune diseases in susceptible individuals. Oestrogen Promotes Remyelination in Adult Brains of MS Mice A new study showed that giving oestrogen to two different adult MS mouse models, including the EAE model, promoted remyelination. Researchers also tried to boost remyelination by treating the adult mice with an oestrogen receptor beta compound, previously shown to have neuroprotective effects by stimulating natural myelination. They found that as myelin was repaired naturally, oligodendrocytes turned on genes promoting the production of cholesterol. Treatment with the oestrogen receptor beta also increased cholesterol production and enhanced remyelination in the cuprizone MS model. 8

HERE WE PROVIDE SUMMARIES OF RESEARCH SOURCED FROM WEBSITES IN AUSTRALIA AND AROUND THE WORLD. READ MORE AT: MSWA.ORG.AU/RESEARCHUPDATE Exposure to the hormone affected gene activity in oligodendrocytes, tricking them into producing myelin, the protective fatty substance that is destroyed in MS. This process appeared to mimic the in-utero development of the brain, when the foetus is exposed naturally to oestrogen in the mother’s blood. MS TRUST (UK) Microaggressions at Work – More than Just Hurt Feelings There is growing evidence that microaggressions are common in the workplace, but little is known about the experience of people with disabilities. In a first of its kind, US researchers investigated workplace microaggressions experienced by people with MS. Microaggressions are subtle and everyday discriminatory actions which can be difficult to identify as prejudice and can leave people unsure of what to do or how to react. 29 people with MS attended focus groups, answering questions to draw out episodes of microaggression, how this affected their working life and the strategies used to cope with difficulties. Participants categorised micro aggressions into three sub-types; / Microassaults: viewed as direct discrimination, often conscious statements or actions intended to hurt a person / Microinsults: often unconscious and remarks or actions that intentionally or unintentionally convey rudeness or insensitivity; eg “You look so well for someone with MS.” / Microinvalidations: typically unconscious and include comments and behaviours that discount, exclude, negate or contradict the thoughts, feelings or lived experience of a person (eg after explaining the impact of MS fatigue – “Oh I know, I get really tired too.” All participants reported experiencing microaggressions in the workplace, which they primarily attributed to others lack of knowledge or misperceptions about MS. The vast majority saw these as discriminatory and negative, increasing their level of stress, damaging working relationships and undermining their confidence in their performance and ability to contribute. The participants described struggling to make a decision about disclosing MS due to concerns about possible negative consequences, and feeling that it was a challenge to educate coworkers and supervisors about MS symptoms and discuss reasonable adjustments that they needed. Few described positive experiences following disclosure of their MS, although the researchers suggest this might have been due in part to the nature of the focus group questions. The results highlighted the negative impact workplace microaggressions can have on job satisfaction and security. People often doubt their reactions and are less likely to report incidents to managers, limiting the opportunities to change attitudes. The researchers make several recommendations including creating a more positive and inclusive workplace climate through organisational change and working directly with people with MS to help improve self-confidence and skills to communicate the impact of MS and negotiate reasonable adjustments. continued over page 9