Multiple sclerosis is a devastating disease that induces the body's own immune system to eat away at the central nervous system, slowly robbing patients of their physical mobility. It is also mysterious. Despite years of research, the cause remains elusive, and treatments are few and far between.
Progress is slow, but measurable. The study of clusters of cases in Canada is starting to reveal the complicated interactions between genetics, geography and a common viral infection that may lie behind the disease (see page S4). And new treatments, many based on existing drugs, are starting to show promise for the more debilitating progressive form of the disease, which has until recently been largely ignored and forgotten (S7). Leaders in the field are calling on researchers to take more risks and develop new kinds of clinical trial to test different combinations of drugs to treat progressive multiple sclerosis (S10).
A drastic form of treatment that eliminates a patient's immune system and replaces it with fresh stem cells (S11) is offering hope. But many doctors worry that it is too dangerous for widespread use, and it is already attracting unethical and unlicensed imitators.
Until a blockbuster drug treatment is found, patients have to manage their disease. A variety of diets have been developed, aimed at helping to control the symptoms, and they are now finally getting the scientific scrutiny they deserve, despite the difficulties of applying rigorous clinical-trial standards to eating habits (S13). With perseverance, imagination and a bit of luck, progress on treating and curing multiple sclerosis could soon move faster than ever.
This Outlook has been supported by a grant from F. Hoffmann-La Roche Ltd, which has had no control over the editorial content of this activity.