The predominant theory behind the cause of MS is the basis for the three recently developed treatment plans discussed hereafter. The theory holds that a specific type of immune cell, known as the cytotoxic T-cell, is incorrectly stimulated to find and destroy Schwann cells. These Schwann cells make up the myelin sheath protecting the neuron’s axons. (Appendix 2) Once the Schwann cells are located, the T-cells release antibodies which lock onto the specific antigens of the Schwann cells. While locked together, the T-cell’s antibodies bombard the Schwann cells with cytokine poisons, which theoretically cause the inflammation of the myelin sheath. This sequence of events is diagrammatically explained in Appendix Three. All this is theory and has not yet been proven, yet is commonly accepted in the scientific world.
Autologous stem cell transplantation is one of the most promising recently developed treatment systems for MS sufferers. The treatment plan has been implemented in less than one hundred people worldwide and so results, although positively indicative, are not conclusive. The process involves first obtaining a sample of the patient’s stem cells from the bone marrow in the spine. Next; high doses of chemotherapy are used to destroy the patient’s immune system cells. Chemotherapy is able to kill all cells which grow and divide rapidly. This includes “cancer cells, hair and intestinal cells and white blood cells of the immune system.”() While the sufferer’s immune system is suppressed, antibiotics and other fungal and viral protective agents are administered for protection against infection. The sample of patient stem cells taken earlier is then purged of immune system cells by dosing them with low level radiation, effectively resetting them. These cleansed stem cells are then infused back into the patient’s spine. The patient must take Neupogen, an oral drug which promotes multiplication of stem cells. As in foetal development, the stem cells differentiate into the cells needed by the body. Since the full grown MS sufferer has no need for other body cells aside from the immune system cells these are the only ones produced. Thus the stem cell will eventually make brand new immune cells, devoid of all prior knowledge of disease. (Appendix 3) This means patients have the immune system of a child and are thus equally vulnerable. Due to the effectual resetting of the immune system, the patient must avoid infection for as long as possible whilst their immune system learns anew. This treatment option is involved, expensive and experimental. Although results indicate that the treatments is able to stop the progression of multiple sclerosis, the radiation and chemotherapy are harsh on the patient and the whole process takes years to complete. For these reasons doctors do not recommend even experimental trial of this procedure unless the disease is life threatening or extremely progressed.
Another recently developed treatment option for MS sufferers is T-cell vaccination. This treatment is also based on the accepted theory that MS is caused by an “inappropriate attack on the myelin sheath by the immune system.”() In accordance with this theory T-cell vaccination aims to stop the T-cells completing their task by having the body kill them. This system is much like any other vaccine, with the pathogen being isolated, inactivated and injected into patients. A sample of the patient’s blood is taken, purified and the T-cells isolated. This purification process is achieved by separating the blood into density layers using centrifuge techniques. T-cells are so rare in the body that the sample obtained is insufficient and must be allowed to replicate before further processing. The T-cells are then inactivated through exposure to radiation. This radiation works in much the same way as the chemotherapy in autologous. This radiation ultimately makes the cells harmless and no longer able to attack the myelin sheath. Once this process is completed the inactive T-cells are injected as a vaccine back into the patient. When identified as a pathogen, the body’s immune system eliminates the vaccine from the body. The body now having recognised the vaccine as harmful, seeks out and destroys all other cells of a similar nature. This action will ultimately kill off all T-cells and thus stop their attacks on the myelin sheath. A disadvantage of this treatment is the increased susceptibility to infection resulting from a lack of T-cells, a vital constituent of the immune system. Although this treatment does not cure already demyelinated axons, it can slow down and ultimately stop the progression of MS.
The third recently developed treatment option is plasmapheresis (plasma exchange). As mentioned earlier, one of the predominant theories behind the cause of MS is an inappropriate attack from the immune system on the neurons in the central nervous system. Plasmapheresis is a process which, based on this theory, aims to remove the dangerous T-cells from the blood of sufferers. This treatment involves removing some of the patient’s blood from around the degenerative zone and putting it through a centrifuge. This separates the blood into layers (Appendix 5) and allows the patient’s plasma to be removed from the sample and the red and white blood cells returned to the body. For any change to be apparent large amounts of blood must be As appendix 6 shows, plasma contains, among other things, T-cells and the antibodies they produce. By periodically cleansing the blood of plasma these harmful agents are removed and the progression of the disease reduced. Plasmapheresis is not a cure, it is a palliative treatment which slows the progression of the disease rather than stopping it. Although based on theory, this treatment system has yielded positive results and is close to becoming a commercialised form of preventative treatment for multiple sclerosis.
In conclusion, these three types of treatment all target a specific part of the Multiple Sclerosis degeneration. At present no treatment is able to cure the disease, however, scientists hope that in slowing the deterioration of myelin sheath the patient’s quality of life can be preserved until actual cures are found. Autologous stem cell transplantation and T-cell vaccination are at present experimental treatments; with pleasing preliminary results. Plasmapheresis is a treatment plan that must span a sufferer’s entire life to be effective and for this reason is only administered to those at serious health risk. At this stage, research is focused on understanding the disease and its causes. Potential treatments are being explored, and hopefully the future will yield a complete cure to this dehabilitating disease.
