Bay Biosciences provides high quality, clinical grade fresh frozen bio-specimens, cryogenically preserved sera (serum), plasma and peripheral blood mononuclear cells (PBMC) biofluid samples from patients diagnosed with Multiple sclerosis (MS).
The sera (serum), plasma and PBMC biofluid specimens are processed from multiple sclerosis (MS) disease patient’s peripheral whole-blood using customized collection and processing protocols.
Multiple sclerosis (MS) Overview
Multiple sclerosis (MS) is a chronic disease that affects the central nervous system, which is the brain, spinal cord, and optic nerves. This can lead to a wide range of symptoms throughout the body.
MS is an autoimmune disease in which the body’s immune system attacks its own central nervous system (the optic nerves, brain and spinal cord).
In MS, the immune system attacks and damages or destroys myelin, a substance that surrounds and insulates the nerves. The myelin destruction causes a distortion or interruption in nerve impulses traveling to and from the brain. This can result in a wide variety of symptoms.
When myelin or nerve fibers are damaged or destroyed in MS, messages within the CNS are altered or stopped completely. Damage to areas of the CNS may produce a variety of neurological symptoms that will vary among patients with MS in type and severity.
The damaged areas develop scar tissue which gives the disease its name, multiple areas of scarring or multiple sclerosis.
Multiple Sclerosis (MS) is the most common disabling neurological disease of young adults with symptom onset generally occurring between the ages of 20 to 40 years.
The estimated number of people with MS worldwide has increased to 2.8 million. Nearly 1 million patients are living with multiple sclerosis (MS) in the United States,
Exact cause of multiple sclerosis (MS) is not known, but it is believed to involve genetic susceptibility, abnormalities in the immune system and environmental factors that combine to trigger the disease.
Types and Stages of Multiple sclerosis (MS)
There are four main types of Multiple sclerosis (MS):
Clinically isolated syndrome (CIS): This is a single, first episode, with symptoms lasting at least 24 hours. If another episode occurs at a later date, a doctor might diagnose relapse-remitting MS.
Relapse-remitting MS (RRMS): This is the most common form of MS. About 85% of patients with MS are initially diagnosed with RRMS. This involves episodes of new or increasing symptoms, followed by periods of remission, during which symptoms go away partially or totally.
Primary progressive MS (PPMS): Symptoms worsen progressively, without early relapses or remissions. Some people may experience times of stability and periods when symptoms worsen and then get better. Around 15% of people with MS have PPMS.
Secondary progressive MS (SPMS): At first, people will experience episodes of relapse and remission, but then the disease will start to progress steadily.
Signs and Symptoms of Multiple sclerosis (MS)
Since MS affects the central nervous system (CNS), which controls all the actions of the body, MS symptoms can affect any part of the body.
Following are some of the most common signs and symptoms of multiple sclerosis (MS):
Muscle Weakness: MS patients may develop weak muscles due to lack of use or stimulation due to nerve damage.
Numbness and Tingling: A pins and needles-type sensation is one of the earliest symptoms of MS and can affect the face, body, or arms and legs.
Lhermitte’s Sign: MS patients may experience a sensation like an electric shock when they move their neck, known as Lhermitte’s sign.
Bladder Problems: MS patients may have difficulty emptying their bladder or need to urinate frequently or suddenly, known as urge incontinence. Loss of bladder control is an early sign of MS.
Bowel problems: Constipation can cause fecal impaction, which can lead to bowel incontinence.
Fatigue: This can undermine a person’s ability to function at work or at home, and is one of the most common symptoms of MS.
Dizziness and vertigo: These are common problems, along with balance and coordination issues.
Sexual Dysfunction: Both males and females may lose interest in sex.
Spasticity and muscle spasms: This is an early sign of MS. Damaged nerve fibers in the spinal cord and brain can cause painful muscle spasms, including in the legs.
Tremor: Some patients with MS may experience involuntary quivering movements.
Vision Problems: Some MS patients may experience double or blurred vision or a partial or total loss of vision. This usually affects one eye at a time. Inflammation of the optic nerve can result in pain when the eye moves. Vision problems are an early sign of MS.
Gait and Mobility Changes: MS can change the way people walk due to muscle weakness and problems with balance, dizziness, and fatigue.
Emotional Changes and Depression: Demyelination and nerve fiber damage in the brain can trigger emotional changes.
Learning and Memory Problems: These can make it difficult to concentrate, plan, learn, prioritize, and multitask.
Pain: Pain is a common symptom in MS. Neuropathic pain is directly due to MS. Other types of pain occur because of weakness or stiffness of muscles.
Less common symptoms include:
- Headache
- Hearing loss
- Itching
- Respiratory and breathing problems
- Seizures
- Speech disorders
- Swallowing problems
There is also a higher risk of urinary tract infections, reduced activity, and loss of mobility. These can impact a person’s work and social life.
In the later stages, MS patients may experience changes in perception and thinking, as well as sensitivity to heat.
MS affects individuals differently. For some, it starts with a subtle sensation, and their symptoms do not progress for months or years. Sometimes, symptoms worsen rapidly, within weeks or months.
A few MS patients will only have mild symptoms, and others will experience significant changes that lead to disability. However, most patients will experience times when symptoms worsen and then get better.
Causes and Risk Factors of Multiple sclerosis (MS)
Researchers don’t know the exact causes of MS, but following are the risk factors:
Age: Most people receive a diagnosis between the ages of 20 and 40 years.
Sex: Most forms of MS are twice as likely to affect women than men.
Genetic Factors: Susceptibility may pass down in the genes, but scientists believe an environmental trigger is also necessary for MS to develop, even in people with specific genetic features.
Smoking: People who smoke appear to be more likely to develop MS. They also tend to have more lesions and brain shrinkage than non-smokers.
Infections: Exposure to viruses, such as Epstein-Barr virus (EBV) or mononucleosis, may increase a person’s risk of developing MS, but research has not shown a definite link. Other viruses that may play a role include human herpes virus type 6 (HHV6) and mycoplasma pneumonia.
Vitamin D deficiency: MS is more common among people who have less exposure to bright sunlight, which is necessary for the body to create vitamin D. Some experts think that low levels of vitamin D may affect the way the immune system works.
Vitamin B12 deficiency: The body uses vitamin B when it produces myelin. A lack of this vitamin may increase the risk of neurological diseases such as MS.
Previous theories have included exposure to canine distemper, physical trauma, or aspartame, an artificial sweetener, but there is no evidence to support these There is probably no single trigger for MS, but multiple factors may contribute.
MS in Women
Multiple sclerosis (MS) is three times more common in women than in men. In addition, nearly all women afflicted with MS get the condition before menopause. This could mean that hormones play an important role in the disease’s development.
MS in Men
Usually, MS in men is more severe than it is in women. They typically get MS in their 30s and 40s, just as their testosterone levels begin to decline.
Although MS is more common in women than men overall, one form of the disease contradicts this pattern. People with primary progressive (PP) MS are about as likely to be male as female.
Multiple sclerosis (MS) and Smoking
People who smoke are more likely to develop MS, and to develop it more severely and with a faster progression.
MS is more prevalent among Caucasians than other ethnicities. MS is believed to have a genetic component as people with a first-degree relative with the disease have a higher incidence than the general population.
Diagnosis of Multiple sclerosis (MS)
A doctor will carry out a complete physical and neurological examination, ask about symptoms, and consider the patient’s medical history.
No single test can confirm a diagnosis of multiple sclerosis (MS), so a doctor will use several strategies when deciding whether a patient meets the criteria for a diagnosis.
These include:
- MRI scans of the brain and spinal cord, which may reveal lesions
- Spinal fluid analysis, which may identify antibodies that suggest a previous infection or proteins consistent with a diagnosis of MS
- An evoked potential test , which measures electrical activity in response to stimuli
Other conditions have symptoms that are similar to those of MS, so a doctor may suggest other tests to assess for other possible causes of the person’s symptoms.
If the doctor diagnoses MS, they will need to identify what type it is and whether it is active or not. The person may need more tests in the future to check for further changes.
Treatment of Multiple sclerosis (MS)
There is no cure for MS, but there are treatments available to slow the progression of the disease, reduce the number and severity of relapses, and relieve symptoms.
Some MS patients also use complementary and alternative therapies, but research does not always confirm the usefulness of these.
Multiple sclerosis (MS) treatment options include the following:
Medications to Slow Progression of Multiple sclerosis (MS)
Several disease-modifying treatments (DMT’s) have Food and Drug Administration (FDA) approval for treating the relapsing forms of MS. These work by changing the way the immune system functions.
A doctor may give some of these by mouth, by injection, or as an infusion. How often the person needs to take them and whether they can do this at home will depend on the drug.
The following DMT’s are used for the treatment of multiple sclerosis (MS) disease:
Injectable Medications
- Interferon beta 1-a (Avonex and Rebif)
- Interferon beta-1b (Betaseron and Extavia)
- Glatiramer acetate: (Copaxone and Glatopa)
- Peginterferon beta-1a) (Plegridy)
Oral Medications
- Teriflunomide (Aubagio)
- Fingolimod (Gilenya)
- Dimethyl fumarate (Tecfidera)
- Mavenclad (cladribine)
- Mayzent (siponimod)
Infused Medications
- Alemtuzumab (Lemtrada)
- Mitoxantrone (Novantrone)
- Ocrelizumab (Ocrevus)
- Natalizumab (Tysabri)
Current guidelines recommend a person begin using these drugs when in the early stages of MS, as there is a good chance that they can slow the progression of MS, especially if the person takes them when symptoms are not yet severe.
Some drugs are more useful at specific stages. For example, a doctor may prescribe mitoxantrone at a later, more severe stage of MS.
A doctor will monitor how well a drug is working, as there may be adverse effects and the same drugs do not suit everyone. New drug options coming onto the market are proving to be safer and more effective than some existing ones.
Adverse effects of immunosuppressant drugs include a higher risk of infections. Some medications may also harm the liver.
Current guidelines recommend the patient begin using these drugs when in the early stages of MS, as there is a good chance that they can slow the progression of MS, especially if the patient takes them when symptoms are not yet severe.
Some drugs are more useful at specific stages. For example, a doctor may prescribe mitoxantrone at a later, more severe stage of MS.
Relieving Symptoms During a Flare-up
Other drugs are useful when the patient experiences a worsening of symptoms during a flare-up. They will not need these drugs all the time.
These medications include corticosteroids, which reduce inflammation and suppress the immune system. They can treat an acute flare-up of symptoms in certain types of MS. Examples include Solu-Medrol (methylprednisolone) and Deltasone (prednisone). Steroids can have adverse effects if the patient uses them too often, and they are not likely to provide any long-term benefit.
Other medications and approaches can treat specific symptoms of multiple sclerosis (MS), which include the following:
Behavioral Changes: If the patient has vision problems, a doctor may recommend they rest their eyes from time to time or limit screen time. MS patients may need to learn to rest when fatigue sets in and to pace themselves so they can complete activities.
Problems with Mobility and Balance: The drug dalfampridine (Ampyra) may also prove useful. Physical therapy and walking devices, such as a cane, may help
Tremor: A patient may use assistive devices or attach weights to their limbs to reduce shaking. Medications may also help with tremors.
Fatigue: Getting enough rest and avoiding heat can help. Physical and occupational therapy can help teach patients more comfortable ways to do things. Assistive devices, such as a mobility scooter, can help conserve energy. Medication or counseling may help boost energy by improving sleep.
Pain: A doctor may prescribe anticonvulsant or antispasmodic drugs or alcohol injections to relieve trigeminal neuralgia, a sharp pain that affects the face. Pain relief medication, such as gabapentin, may help with body pain. There are also medications to relieve muscle pain and cramping in MS.
Bladder and Bowel Problems: Some medications and dietary changes can help resolve these issues.
Depression: A doctor may prescribe a selective serotonin reuptake inhibitor (SSRI) or other antidepressant drugs.
Cognitive changes: Donepezil, a drug for Alzheimer’s, may help some MS patients.
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