51 msfocusmagazine.org 4) Transplantation. The saved stem cells are given back to the person with MS via the bloodstream. 5) Immune Reconstitution. The stem cells differentiate into the new immune system, one that hopefully will not attack myelin. Several research groups globally are working on perfecting HSCT. It does appear that the procedure is more effective in RRMS with active relapses and/or new lesions on MRI. On a side note, some people with MS have been frustrated when they cannot get HSCT through one of the study sites. This has led some to pursue HSCT in Mexico, Russia, or other places. If you are considering this, do your homework. The procedure is expensive when done outside of research and there may be poor continuity of care back at home. Fingolimod may help with secondary progressive MS A research team led by scientists from Brigham and Women's Hospital found fingolimod interferes with signals sent by lipid receptors, and may reduce the disease- producing activities by cells in the nervous system. The findings suggest the treatment may hold promise for difficult-to-treat secondary progressive MS. Dr. Thrower: Progressive forms of MS (primaryandsecondary)havebeenasignificant challenge, both to those living with them and those trying to treat them. Primaryprogressive MS is in a category by itself. In contrast to RRMS, PPMS affects men and women equally and the attack seems to be more directed at the spinal cord than the brain. Secondary progressive MS is an extension of relapsing-remitting MS. It presents its own unique challenges and questions. Why does RRMS evolve into SPMS? How does one know when that evolution is occurring? Why do disease-modifying therapies seem less effective in SPMS than in RRMS? We don’t have the answers to these questions yet, but researchers have a renewed determination to get them. Stay tuned. Researchers say they have found MS blood biomarker A study by researchers at Macquarie University, in Sydney, Australia, claims to have found the first blood biomarker for MS. A test using the biomarker is said to be able to discriminate between the three subtypes of the disease with 85-90 percent accuracy and could be available within as little as two years. Dr. Thrower: MS treatment options become more numerous with each passing year. As these options grow, so will our need to customize treatment for the individual. Clearly, not every person with MS follows the same course or has the same response to a given medication. “Biomarker” is the term used to describe tests, usually referring to a blood test, that would let us predict many things about an individual’s MS, rather than making an educated guess. Future biomarkers might allow us to accurately classify what subtype of MS a person has, which is what the Australian researchers are working on. Biomarkers might also let us choose the best medication for an individual and monitor how well that therapy is working. As we understand more about the varied and complex nature of the human immune system and as MS treatments become more numerous, the need for customized treatment becomes more obvious.