b"BMIs above 30, those older than age 60, Black In this study, both physical therapy and Pilatespeople and those with more disability. Some improved walking speed.studies have suggested that people on B-cell Study improves understanding of gut,therapies (Ocrevus, Rituxan, Truxima, and immune system, CNS linksKesimpta) might be at higher risk for more In a new study, researchers at Brighamsevere COVID-19 symptoms. On a personal andWomen'sHospital,HarvardMedicalnote,ourMSInstituteworkswithabout3,000 individuals with MS and we have had School, identied a subset of astrocytes thatabout 65 cases of COVID-19. Two of those express LAMP1+TRAIL+. Astrocytes are cellswere hospitalized. None died. Its important in the central nervous system and when theyfor people in the MS community to stay in are disrupted by inammation there can betouch with their healthcare team to discuss consequences to neurological functions. Ifany concerns or issues they have as it relates disruption occurs then T cells will modulateto their MS and COVID-19. astrocyte responses. In mice studies, theStudy: Pilates improved walking speed researchers looked at four main components:A study consisting of a 12-week Pilates (1) the most abundant marker in spinal cordexercise training program on gait and balance astrocytes called lysosomal-assorted membranewas conducted by researchers at the Multiple protein 1 (LAMP1); (2) TRAIL ligand that controlSclerosis Center, Sheba Medical Center, in Israel. cell death; (3) IFNy signaling; and (4) NK cells,They recruited 50 participants with relapsing- which are the most abundant IFNy producingremitting MS, 45 of whom completed the study. cells.TheresearchersfoundthatLAMP1+The participants were majority female with an TRAIL+ limit CNS inammation by causingaverage age of 43.2, EESS score of 4.3, and Tcelldeathandoodingthemicrobiomedisease duration for 11.8 years. The participants with IFNY+NK cells to regulate inammationwere randomly assigned to either a Pilates- in the CNS. This may provide a target forbased core stability training or standardized therapy modalities of astrocytes in MS.physical therapy. After 12 weeks of 30-minute Dr. ThrowerIts been said that the quickestone-on-one training sessions and daily 15- way to a mans heart is through his stomach.minute personalized at-home training exercises Maybe the quickest way to the human brainthere was an indication of improved static is also through our gut. The normal bacteria thatbalance control. However, overall, there was not live in our GI tract are called our microbiome.a signicant dierence in outcomes between Prior research has shown the gut microbiomethe Pilates and physical therapy groups. The is altered in people with MS and may return tostudy was published in the journal Clinical a more normal state with disease-modifyingRehabilitation.therapies. Our gut is also a very importantDr. ThrowerWeve come a long way in our site for immune regulation. ability to change the course of MS. In contrast Thisnewresearchhelpsusfurtherto 1992 when we had no approved disease- understandthelinkbetweenthegutmodifying therapies, we now have many. As microbiome, the immune system, and thewe look to the future, we see the potential for central nervous system. Showing how theseneural repair and the reversal of disability.Lets not forget, however, that we have tools three systems might communicate and regulateright nowexercise and rehabilitationto inammation may get us one step closer toimprove function for people living with MS. truly understanding and stopping MS.55 msfocusmagazine.org"