Recent studies on MS are highlighted, including a possible new avenue for future therapies.
Some studies suggest that MS patients have begun to live longer lives over the last 40 to 50 years. New research suggests that MS patients do not live as long as those in the general population, but controlling comorbidities may help improve their survival. On the positive side, MS patients may have lower rates of vascular comorbidities, including hypertension, diabetes, and hyperlipidemia, than the general population, according to another study. And new research on the sex differences in MS may lead to new MS therapies.
Survival of MS Patients. Most studies suggest that MS patients have shorter lives than an age- and sex-matched population without MS.These researchers hypothesized that survival is improving in the MS population over time.They compared survival in 5,797 MS patients with a matched cohort of 28,807 controls from the general population, and also evaluated the association of comorbidity with survival in both populations.
MS Patients’ Lives Shorter Than General Population's. Median survival for the MS population was shorter (75.9 years) compared to controls (83.4 years).MS was associated with a 2-fold increased risk of death (adjusted hazard ratio 2.40).The relative risk for death in the MS population was higher (3.65) in those under age 40 years than in those aged 40 to 59 years (2.88) or age 80 years and older (1.80).
Managing Comorbidities May Extend Lives of MS Patients. Several comorbidities were associated with increased hazard of death in both populations, including diabetes, ischemic heart disease, depression, anxiety, and chronic lung disease.The magnitude of the associations of these comorbidities was lower in the MS population than in the matched population.The most common causes of death in the MS patients were nervous system and circulatory system diseases.The researchers suggested that optimizing the management of comorbidity may be a means of improving survival in MS patients.Reference: Marie RA, et al. Effect of comorbidity on mortality in multiple sclerosis. Neurology. 2015;85:1-8. See abstract here.
Vascular Comorbidities in MS, Comorbidities in MS patients may contribute to disease progression, reduced quality of life, and unfavorable health outcomes.Vascular comorbidities, such as diabetes, hypertension, high cholesterol levels, and stroke have been shown to influence increasing cognitive decline and brain atrophy. In addition, they have been correlated with increased disability progression in MS.These researchers estimated the age-specific prevalence of vascular comorbidities in a community sample of MS patients and the general population.
Women with MS Have Lower Rates of Hypertension and Hyperlipidemia. A retrospective chart review of 200 MS patients, median age 45, with mean disease duration of 8 years found rates of vascular comorbidities in the MS patients were similar to those in the general population.Hypertension rates were lower in women with MS. In women aged 20 to 44 with MS, 4.1% had hypertension compared to 8.7% of the general population; in women aged 45 to 64, hypertension rates were 25% compared to 39.5% in the general population.A similar trend was seen for hyperlipidemia, with 23.5% of women with MS aged 45 to 64 with hyperlipidemia compared to 42.4% of the general population.
Vascular Comorbidities Lower in MS Patients than General Population.Among women, diabetes rates were higher for MS (4.1%) patients than the general population (1.7%).Among men, differences between rates of hypertension and hyperlipidemia in the MS patients were similar to the general population.Men with MS had lower rates of diabetes than the general population.The researchers concluded that age-specific rates of vascular comorbidities in MS patients may be lower than or similar to rates in the general US population.Reference: Triche EW, et al. Vascular comorbidities among patients with multiple sclerosis at a comprehensive care center. Presented at: Consortium of Multiple Sclerosis Centers Annual Meeting 2015; May 27-30, 2015; Indianapolis, IN. Poster EG08. See abstract here.
Innate Lymphoid Cells Protect Against MS.MS affects more women than men.Using a mouse model of MS in which only females get the disease, these researchers found that signaling with the c-Kit growth factor regulates type 2 innate lymphoid cell accumulation and susceptibility to central nervous system demyelination in male and female mice.They showed that these innate lymphoid cells are activated and protect male mice from the disease.
Sex-specific Therapy with Fewer Side Effects.The researchers are investigating what activates type 2 innate lymphoid cells preferentially in males and not in females.They are looking for clues to explain potential activators of these cells and whether those activators can be used in therapy.The goal is to target these cells in a sex-specific way and provide a therapy with fewer side effects.Reference: Russi AE, et al. Cutting edge: c-Kit signaling differentially regulates type 2 innate lymphoid cell accumulation and susceptibility to central nervous system demyelination in male and female SJL mice. J Immunol. Published online before print May 13, 2015. See abstract here.
Take-home Messages.Survival is improving in the MS population, but remains a median of 7 years lower than the general population.MS patients may have lower rates of vascular comorbidities, including hypertension, diabetes, and hyperlipidemia, than the general population.For the first time, a study shows that type 2 innate lymphoid cells exhibit sex differences in their activity and actually can protect in autoimmune disease, using a mouse model of MS.