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from donors. They are processed in the lab to 
minimize the risk that the recipient’s body 
might attack them or vice versa. The advantage 
of allogeneic T-cells is they are more easily  
obtained and can be used across all patients. 
Autologous CAR-T cells are derived from the 
patient themselves. Because they are your 
cells, there is no potential for rejection. This 
type of treatment is custom made for each 
person. However, this does make it more 
labor intensive and expensive. The treatment 
of the first human with MS with allogeneic 
CAR-T calls at the University of Nebraska 
marks a major milestone in this promising 
new therapy. 
Retina thinning potential disease 
damage biomarker  
Researchers from Austria explored whether 
thinning of the retina, which is measured with 
a painless eye scan called optical coherence 
tomography, is linked to disease progression 
in people with relapsing MS occurring without 
new relapses or visible MRI activity. Researchers 
followed 210 patients for more than two years 
after starting treatment. They found that patients 
who experienced this silent progression, called 
PIRMA, showed faster loss of retinal nerve 
layers than those who did not. This suggests 
retinal thinning reflects damage to nerve cells 
in the brain and spinal cord, even without 
inflammation. The findings support using OCT 
as a simple, noninvasive way to track nerve 
degeneration and disease progression in MS, 
though larger studies are needed to confirm 
this. The findings were published in the journal 
Neurology. 
Thrower - A major area of research focus in 
MS has been on how MS disability may 
progress in the absence of relapse activity 
and the absence of both relapse activity and 
new lesions on brain MRI. PIRA and PIRMA 
are felt to be driven by several factors including 
smoldering inflammation and loss of neural 
reserve. Progression of disability is the clinical 
manifestation of PIRA/PIRMA, but are there 
other biomarkers we can use? The MRI correlates 
of PIRA/PIRMA are not new lesions on MRI. 
Rather, we may see slowly enlarging lesions 
and/or paramagnetic enhancing rim lesions. 
An additional biomarker for PIRA/PIRMA is 
optical coherence tomography. OCT is a quick, 
painless and inexpensive test that uses light 
waves to measure the thickness of the retinal 
nerve fiber layer. The RNFL thickness is correlated 
to brain volume. OCT is also commonly used 
by ophthalmologists to measure retinal health 
in conditions such as glaucoma. 
Menopause not linked to worsening MS    
This study, conducted by researchers in 
Australia, explored whether menopause affects 
disability progression in women with MS. 
Researchers analyzed data from 987 women with 
relapse-onset MS, comparing premenopausal and 
postmenopausal groups. The median age at 
menopause among participants was 48.5 years. 
They found that menopause was not linked 
to an increased risk of confirmed disability 
progression or secondary progressive MS. 
Factors such as age, disease duration, and 
exposure to high-efficacy disease-modifying 
therapies were more influential in disability 
progression. The study also examined changes 
in disability before and after menopause 
but found no significant inflection point in 
progression. While menopause may contribute 
to aging effects, it is not the primary driver of MS 
progression. The findings provide reassurance 
to women with MS and highlight the importance 
of managing overall health and aging factors. 
The study was published in the journal JAMA 
Neurology. 
Thrower - Women represent the majority of 
people living with MS. It has long been noted 
that pregnancy and its associated hormonal 

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