Worldwide, approximately 2.3 million people suffer from multiple sclerosis.

Having met a person with this disease on the street, you can hardly understand that he is sick.

In fact, he himself may not yet be aware of his illness.

Multiple sclerosis (MS) is a mysterious science, difficult for medicine and extremely dangerous disease that can quickly lead to disability.

No one currently knows exactly what causes multiple sclerosis.. The severity of the disease ranges from relatively benign cases to a rapidly progressive destructive process that results in partial or complete paralysis. In addition, many symptoms of multiple sclerosis are invisible.. MS is extremely difficult to diagnose, so many people are forced to live with their chronic illness until doctors calculate MS and prescribe adequate treatment..

According to the National Institutes of Health in the USA, 250-300 thousand people are diagnosed with multiple sclerosis in this country.. Since the Center for Disease Control and Prevention (CDC) does not require American doctors to report new cases of the disease, the number of cases of MS can be called only approximately.

At the beginning of March, the United States announced the National Multiple Sclerosis Awareness Week. In this article, well-known experts in the field of MS will talk about what makes this disease mysterious and difficult for modern medicine..

What is multiple sclerosis

Multiple sclerosis is an autoimmune disease in which the human immune system damages its own central nervous system - the brain and spinal cord, the optic nerve. At the moment, scientists do not know which substance is the target of the immune system, but it is known for sure that the myelin sheath of nerve cells is affected in this disease.

When multiple sclerosis begins, the immune system begins to gradually destroy myelin, which protects nerve fibers.. Together with it, the nerve cells themselves die. In this process, multiple foci of sclerosis are formed in the tissue, which are detected by a pathological study - hence the name Multiple Sclerosis (multiple sclerosis).

Damage to myelin and nerve fibers leads to impaired transmission of electrical signals inside the central nervous system, and various neurological disorders are associated with this. MS patients may have dozens of symptoms. The US National Multiple Sclerosis Society claims that there are no two MS patients with exactly the same symptoms, and the symptoms may change over time.

Such a variety of manifestations is explained by the fact that the central nervous system controls almost the entire body. Symptoms of MS may include gait disturbance, weakness, vision problems, pain, cognitive changes, bladder problems, etc..

Many of these problems are very common, some of them at first do not very much affect the lives of patients. Due to the presence of such “invisible symptoms”, a person with multiple sclerosis may seem healthier for a long time than it actually is.. Others notice these changes, but just do not go to the doctor.

Multiple sclerosis occurs in different ways.. There are four options for the development of the disease:.

• Relapsing-remitting MS. It accounts for about 85% of cases. It is characterized by pronounced exacerbations, followed by periods of remission. During remission, there is no progression of the disease.

• Secondary progressive MS. This form of the disease is characterized by secondary progression, with or without periods of remission..

• Primary progressive MS. It is believed that this form of the disease accounts for 10% of cases. In primary progressive multiple sclerosis, there is a continuous deterioration in neurological function over time.

• Progressive MS with exacerbations. This is the rarest variant of the disease, which is characterized by a stable deterioration of neurological functions with occasional severe exacerbations.

Good communication between patients and their doctors is vital. Symptoms, such as weakness, may occur as a result of other illnesses (such as obstructive sleep apnea). People with MS should tell their doctor about any changes in their health, and not just write off all problems at the expense of multiple sclerosis..

Reboot the immune system.

Diagnosing multiple sclerosis is a challenge. But with treatment everything is even sadder: modern medicine cannot defeat this disease.. Although, of course, some scientific work in this direction is underway.

In the UK, The Telegraph reported that stem cell therapy can cure multiple sclerosis.. In the American edition of JAMA, not so long ago, a message appeared that doctors learned how to use chemotherapy to destroy a malfunctioning immune system that attacks the myelin sheath of neurons, after which they “rebooted” the immune system using their own stem cells.

The article reported that patients with MS who were already moving in a wheelchair, after such a “reset” of the immune system, restored their ability to walk, and the blind became regained. This is a true dream for many patients.. However, the NHS is cautious about this..

Although during the experimental treatment, the researchers managed to restore the lost neurological functions by an average of 64%, only patients with relapsing-relapsing MS took part in this work.. In addition, the study did not have a control group. That is, this scientific work does not meet the "

“Preliminary results from an uncontrolled trial need to be replicated in a randomized controlled trial (RCT). It should also be noted that not every patient will be able to tolerate the aggressive chemotherapy that we use. This method is useless for people who have multiple sclerosis for more than 10 years or in a very serious form, ”the authors of the study admit..

This example illustrates that science still has a long way to go before an effective treatment for a serious illness is found.. The presence of four different variants of MS also suggests that for each of them you need to find your own, special approach.

Dr. Annette Langer-Gould, a researcher and neurologist at Kaiser Permanente in Pasadena, California, USA, talks about the situation with the treatment of multiple sclerosis in America: “We have highly effective immunomodulating therapy for relapsing.

For patients with primary progressive multiple sclerosis, American doctors suggest focusing on proactive symptom management to maximize function and quality of life. This requires more time and energy from the doctor and the patient.; a multidisciplinary approach is required with the participation of social workers, therapists, physiotherapists, urologists, etc..

Other problems.

Dr. Langer-Gould says that a new classification of multiple sclerosis is being discussed today, which should be different from the one we presented above.. According to the researcher, MS is a disease whose definition and classification are constantly changing as scientists discover new facts.. She believes that there are many more such changes ahead..

Here is one example.. Kaiser Permanente's research work covers more than 3.5 million Southern California residents. Her results showed that multiple sclerosis is more common among blacks than among white women. This is another surprise for scientists who previously believed that blacks are less susceptible to MS..

Results that do not agree with each other demonstrate a lack of a clear understanding of the nature of this disease.. Experts believe that environmental factors, infectious agents, and genetic factors influence the development of MS, but so far no one has been able to calculate the exact cause of the disease. Such uncertainty persists in the diagnosis of multiple sclerosis.. Due to the very large number and variability of symptoms, diagnosis takes a lot of time.

“The most important challenge today is to learn to identify patients at high risk of early disability in a timely manner and develop an optimal treatment plan for them.”. That's what modern neurologists need to handle, ”says Langer-Gould.

As new, fairly successful treatments for multiple sclerosis are created, the importance of quick and accurate diagnosis increases.. Previously, when aggressive MS could not be treated, and the diagnosis was just a sentence, quick identification of such patients was not as important as now, when the main thing is to intervene in time. Now, neurologists have received such effective drugs as natalizumab (natalizumab), fingolimod (fingolimod), rituximab (rituximab) and others, so timely diagnosis has become a critical barrier.

Unfortunately, this therapy is far from affordable for everyone even in the well-to-do United States. One of the main problems that sick Americans face is the astronomical cost of drugs, including those that may not be effective enough.. For many people, the surcharge for them is much more than they can afford.

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