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Paralysis inspires MS discovery | Paralysis inspires MS discovery |
(25 days later) | |
"I had a dead leg one Sunday morning and it progressed to full paralysis within two hours," says Dr Denise Fitzgerald, from Queen's University Belfast. | "I had a dead leg one Sunday morning and it progressed to full paralysis within two hours," says Dr Denise Fitzgerald, from Queen's University Belfast. |
She was only 21 at the time, but the event helped to inspire the fledgling scientist to crack how the brain is repaired. | She was only 21 at the time, but the event helped to inspire the fledgling scientist to crack how the brain is repaired. |
The discovery reported today could potentially help millions of people with multiple sclerosis who have a rogue immune system attacking part of the brain. | The discovery reported today could potentially help millions of people with multiple sclerosis who have a rogue immune system attacking part of the brain. |
Dr Fitzgerald's paralysis was caused by a similar condition to multiple sclerosis called transverse myelitis. | Dr Fitzgerald's paralysis was caused by a similar condition to multiple sclerosis called transverse myelitis. |
Part of her spinal cord had been stripped of a fatty substance called myelin - a protective coating that allows electrical signals to travel down nerves. | |
It serves a similar function to insulation on an electrical cable. Without myelin, her brain could no longer control her body. | |
'Repair process' | 'Repair process' |
The key difference between the two conditions is transverse myelitis is a one-off event, while multiple sclerosis is a life-long assault on myelin. | The key difference between the two conditions is transverse myelitis is a one-off event, while multiple sclerosis is a life-long assault on myelin. |
Dr Fitzgerald's myelin slowly regenerated and was growing at about the same pace as the hair on your head. | Dr Fitzgerald's myelin slowly regenerated and was growing at about the same pace as the hair on your head. |
"I asked the doctor 'can you speed this up?' and they said 'not until some bright spark like you comes up with something'." | "I asked the doctor 'can you speed this up?' and they said 'not until some bright spark like you comes up with something'." |
She was, eventually, able to make a "95% recovery" and even taught herself to walk again through intensive physiotherapy. | |
She told the BBC: "It shows how much regenerative capacity we have and on my mind was the repair process. | She told the BBC: "It shows how much regenerative capacity we have and on my mind was the repair process. |
"It was efficient and effective and that led me on to research on MS." | "It was efficient and effective and that led me on to research on MS." |
Disease and recovery | Disease and recovery |
In multiple sclerosis, the immune system mistakes myelin for a hostile invader and launches an assault. | In multiple sclerosis, the immune system mistakes myelin for a hostile invader and launches an assault. |
It can either just get worse, known as primary progressive MS, or come in waves of disease and recovery, known as relapsing remitting MS. | It can either just get worse, known as primary progressive MS, or come in waves of disease and recovery, known as relapsing remitting MS. |
"One of the reasons people have relapsing-remitting is because that natural repair process kicks in," Dr Fitzgerald told the BBC. | |
She is one part of a large research group made up of neuroscientists, immunologists and stem cell scientists that has cracked a key mechanism of how the myelin is regenerated. | |
They hope harnessing this process could lead to new therapies. | They hope harnessing this process could lead to new therapies. |
Their series of mouse experiments, published in Nature Neuroscience, has unpicked how the body restores myelin (it is a similar sequence of events that ultimately restored Dr Fitzgerald's movement). | |
It starts with a type of white blood cell (called a T-regulatory cell) that is attracted to the damaged myelin in the brain. | It starts with a type of white blood cell (called a T-regulatory cell) that is attracted to the damaged myelin in the brain. |
Once there it begins to co-ordinate the recovery like a foreman at a construction site. | Once there it begins to co-ordinate the recovery like a foreman at a construction site. |
But rather than bark verbal instructions, the white blood cells do it chemically by using a protein with the technical name of CCN3. | But rather than bark verbal instructions, the white blood cells do it chemically by using a protein with the technical name of CCN3. |
The protein then jolts nearby stem cells into activity. | The protein then jolts nearby stem cells into activity. |
Stem cells have the rare ability to morph into other cell types and CCN3 tells them to become myelin-manufacturing cells. | Stem cells have the rare ability to morph into other cell types and CCN3 tells them to become myelin-manufacturing cells. |
'Future treatments' | 'Future treatments' |
Dr Fitzgerald said: "From my perspective it is a fundamental step forward in understanding the biology of repair. | |
"Our goal is to eventually use this knowledge to develop drugs to drive the repair of myelin and potentially this could lead to patients regaining function. | "Our goal is to eventually use this knowledge to develop drugs to drive the repair of myelin and potentially this could lead to patients regaining function. |
"I love my career, but I'd happily be unemployed if the research field cures multiple sclerosis." | |
It is still early days and the next stage of the research will be to perform experiments using human rather than mouse tissues. | It is still early days and the next stage of the research will be to perform experiments using human rather than mouse tissues. |
"If only I had asked to saved some my T-cells from my blood samples back then, when I was recovering function," she said while musing on a missed opportunity for an experiment. | |
But even with treatments still on the horizon, the findings ask interesting questions about multiple sclerosis itself. | But even with treatments still on the horizon, the findings ask interesting questions about multiple sclerosis itself. |
Why does the repair process get worse with time? Does the disease become more severe and the repair process cannot keep up? Or does age make the repair less efficient? | Why does the repair process get worse with time? Does the disease become more severe and the repair process cannot keep up? Or does age make the repair less efficient? |
These will also be considered in the next stage of the research. | These will also be considered in the next stage of the research. |
Fellow researcher Dr Yvonne Dombrowski added: "This knowledge is essential to designing future treatments that tackle neurological diseases, such as MS, in a new way - repairing damage rather than only reducing attacks. | Fellow researcher Dr Yvonne Dombrowski added: "This knowledge is essential to designing future treatments that tackle neurological diseases, such as MS, in a new way - repairing damage rather than only reducing attacks. |
"In the future, combining these approaches will deliver better outcomes for patients." | "In the future, combining these approaches will deliver better outcomes for patients." |
Dr Sorrel Bickley, the head of biomedical research at the MS Society, said: "This exciting study gives us an important understanding of how myelin repair can be promoted, which could open up new areas for treatment development." | Dr Sorrel Bickley, the head of biomedical research at the MS Society, said: "This exciting study gives us an important understanding of how myelin repair can be promoted, which could open up new areas for treatment development." |
Follow James on Twitter. | Follow James on Twitter. |