Are series A C considered as an early stage

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(Vienna, 09-02-2015) The Center for Brain Research at MedUni Vienna is a world leader in research into the mechanisms of multiple sclerosis (MS). Now an international team of researchers from Edinburgh, Cleveland and Vienna under the direction of Hans Lassmann, Head of the Department of Neuroimmunology at MedUni Vienna, has for the first time summarized the pathological course of the disease from the early to the late stages in the top magazine Lancet Neurology and has also shown that inflammatory and neurodegenerative processes play a role at the same time. That could open up new therapy options.

So far, there have been two approaches to categorizing the disease: the first regards MS as an inflammatory disease of the nervous system in all stages, whereby the inflammation is also responsible for the following neurodegenerative damage. The second approach postulates that the disease eventually changes from inflammatory to neurodegenerative. In the current paper, however, the research team shows for the first time that multiple sclerosis consists of both factors - namely that the inflammatory process acts as a "driving force" from the beginning and until the end and that neurodegenerative processes are added in the so-called progressive, later phase, that damage the brain.

Lassmann: “The inflammatory process, which can be treated well in the early stages, becomes less and less with age, but the neurodegenerative damage increases. This also explains why the drugs that initially work well lose their effectiveness later. "

In the later stage of the disease, “amplification mechanisms” are set in motion: The damage is multiplied (amplified) - as a cycle “within itself” that goes on and on. The neurodegenerative damage in the brain activates microglial cells, which also promote the disease as well as the formation of oxygen radicals that destroy lipids and proteins in the brain. At the same time, mitochondria, the power plants and energy donors of the cells in the brain are damaged. This - and the normal aging of the brain and the associated iron deposition - also lead to further damage.

According to the researchers, new therapeutic approaches could now be based on the new findings from all of these mechanisms. “There are two ways of doing this,” says Lassmann, “on the one hand, by developing drugs that also have an anti-inflammatory effect in the brain and not only attenuating the defense reaction in the blood and lymphatic organs, on the other hand, by developing neuroprotective therapies that preventively block the amplification mechanisms and damage to the mitochondria and thereby prevent the consequential damage. "

On the basis of the data now presented, clinical studies are already running with some potentially usable drugs, but the results will not be available in five years at the earliest, explains Lassmann: “But I firmly expect that it will be in the foreseeable future, i.e. in the next five to ten years , will succeed in doing something against the amplification mechanisms and thus further delaying the progressive phase. "

This amplification cycle in the brain also occurs in other neurodegenerative diseases such as Alzheimer's or Parkinson's, but also in normal brain aging. Therefore, these new therapies from MS research could also be helpful here.

2.5 million people worldwide affected
Around 8,000 Austrians suffer from multiple sclerosis. Around 2.5 million people are affected worldwide. MS is a chronic inflammatory disease of the central nervous system in which the insulating layers of the nerve fibers are destroyed. The mechanisms of inflammation in the nervous system have largely been elucidated. On the basis of these findings, effective therapies are available that can delay the course. However, these therapies have only a very limited effect on those affected with advanced disease. The exact cause of MS is not yet known. It is possible that it is an autoimmune disease. The excessive immune response could also be directed against an infectious pathogen that has not yet been discovered.

Service: Lancet Neurology
"Pathological mechanisms in progressive multiple sclerosis." Don H. Mahad, Bruce D. Trapp, Hans Lassmann. Lancet Neurol. 2015; 14: 183-93.

Five research clusters at MedUni Vienna
A total of five research clusters have been established at MedUni Vienna. There, the MedUni Vienna is increasingly focusing on basic and clinical research. The research clusters include medical imaging, cancer research / oncology, cardiovascular medicine, medical neuroscience, and immunology. The content of the present work falls within the subject area of ​​the cluster for medical neurosciences. Its official spokesman is Hans Lassmann.