1. Mixed outcome to UK cannabis trial (posted: 07/11/2003)
2. Smoking increases risk of MS (posted: 07/11/2003)
3. Bone marrow transplant study - update (posted: 16/10/2003)
4. Potential donors invited to register with UK MS Tissue Bank (posted: 16/10/2003)
5. What ever became of Cari Loder's "Treatment"? (posted: 16/09/2003)
6. Human Tests for Promising Vaccine (posted: 25/09/2003)
7. Childhood exposure to sun may help to prevent MS (posted: 25/09/2003)
8. Reflexology relieves symptoms of MS (posted: 25/09/2003)
9. Evidence that Cooling can improve symptoms of MS (posted: 02/07/2003) clinical governance, consent and audit.

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Items posted 2003

1. MIXED OUTCOME TO UK CANNABIS TRIAL

   The eagerly awaited outcome of the large UK clinical trail of the effectiveness of extracts of cannabis in relieving muscle stiffness, spasms, pain, and tremor is reported in the November Lancet. The study involved over 600 people with MS in various centres around the UK. Dr John Zajicek, Peninsula Medical School, Plymouth and his colleagues reported that there was no beneficial effect when spasticity was measured on the Ashworth scale but that there was a significant improvement difference reported by those on cannabis extract compared to those on a placebo. Although a mixed bag outcome, the authors suggest that the evidence of reported improvements by patients in mobility and pain reduction mean that cannabinoids could have clinical value.

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2. SMOKING INCREASES RISK OF MS

   Male smokers are up to three times more likely and female smokers up to twice more likely to develop multiple sclerosis than their counterpart nonsmokers, according to a report in the 28 October 2003 issue of Neurology. A team at the University of Bergen in Norway and Harvard University in Massachusetts surveyed 22,000 people aged 40 to 47 on a number of health issues. The researchers found that most of the 87 people in the study who had multiple sclerosis started smoking 15 years before they developed the disease. Of the multiple sclerosis patients, nearly 24% had never smoked and about 76% were current or past smokers. The research could not account for the differences between men and women.

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3. BONE MARROW TRANSPLANT STUDY - UPDATE

   The Canadian Multiple Sclerosis Scientific Research Foundation is funding a project to determine whether transplanting bone marrow stem cells in people with MS can stop the disease. The study is led by Dr. Mark Freedman (MS neurologist) and Dr. Harold Atkins (bone marrow transplant physician) of the University of Ottawa. It involves 32 people with rapidly progressing multiple sclerosis who are likely to become severely disabled. Twenty-four of the participants are to receive bone marrow transplantation the other eight people with the same kind of MS constitute a control group. Seven participants have been treated to date with six coming through the procedure safely. Bone marrow transplantation is used frequently to treat leukemia. Because of the invasive nature of the treatment, there is a statistical possibility of a 5 to 8% mortality rate. There is evidence that the MS of some people treated for leukemia stabilised. Six of the seven transplant recipients had no serious complications as a result of the treatment. In initial follow up, the indications are that their disease has stabilized. They are being monitored closely with MRI scanning and immunological testing. Unfortunately, the seventh person has died, apparently because of the effect of the drugs used. The details surrounding the death are being reviewed and no further transplant will take place pending the outcome. Further details are available at the site of the Multiple Sclerosis Society of Canada

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4. POTENTIAL DONORS INVITED TO REGISTER WITH UK MS TISSUE BANK

   In 1998, the UK Multiple Sclerosis Society awarded a grant to Imperial College School of Medicine at Charing Cross Hospital in London to enable the setting-up of a national MS Tissue Bank. The aim of this centralised facility is to co-ordinate the collection of tissue donated for MS research from people that had MS and from people that did not have MS, and to distribute samples of the tissue to scientists conducting research into the causes and treatment of MS. The Tissue Bank acts as an essential resource for scientists conducting research into MS. The bank supplies tissue to a wide range of research projects in England, Northern Ireland and across the globe from America to Japan. The preference is to supply tissue to projects being carried out in the country from which the donors were recruited. Any one donation can provide enough tissue for a number of projects in some or all of the five groups. For details, including advice on how to register as a donor, go to the Tissue Bank's website.

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5. WHAT EVER BECAME OF CARI LODER'S "TREATMENT"?

   In 1996 Cari Loder published a book claiming that a treatment consisting of a combination of oral lofepramine and L-phenylalanine with vitamin B12 injections dealt effectively with her MS. Scotia Pharmaceuticals provided the funding for a double blind, randomised, placebo controlled research carried out by D T Wade of The Oxford Centre for Enablement, Oxford, C A Young of The Walton Centre for Neurology and Neurosurgery, Liverpool, K R Chaudhuri of the Department of Neurology, Lewisham and King's College Hospitals, London and D L W Davidson of the Department of Neurology, Ninewells Hospital, Dundee. Both sets of volunteers were given B12 injections but the control group were given a placebo instead of the ofepramine and L-phenylalanine. Both groups showed a significant inprovement after 2 weeks but although there was evidence of some further improvement among those receiving the combination treatment, the researchers concluded that the further benefit was probably clinically insignificant. Overall they concluded that there was insufficient evidence to support the use of the triple combination therapy routinely in patients with multiple sclerosis but that a small beneficial effect could not be ruled out and that, consequently further studies may be justified. A report of the research was published in the Journal of Neurology Neurosurgery and Psychiatry 2002;73:246-249.

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6. HUMAN TESTS FOR PROMISING VACCINE

   Human trials are to begin next year on a vaccine that uses part of a common bacterium to halt the effects of rheumatoid arthritis in animal models. The research was carried out at the University of Bristol under the direction of Dr Neil Williams. He believes that it would also be effective in preventing other auto-immune diseases such as MS & diabetes. In auto-immune diseases tissues are damaged by the body's own immune system. According to Dr Williams, the bacterial protein stimulates an immune system regulator that dampens down the body's immune response.

   Webmaster's comment: If the human trials prove successful, this could represent a major breakthrough in the attempt to find an effective treatment against MS.

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7. CHILDHOOD EXPOSURE TO SUN MAY HELP TO PREVENT MS

   Research carried out at the University of Tasmania in Australia suggests that exposure to sun could help to protect from MS. Dr Terry Dwyer & colleagues studied 132 persons with MS and 272 without and concluded that those with the least sun exposure were the most likely to develop MS. There was some evidence that exposure to sun in winter might be more important than summer exposure. Dr Dwyer speculated that exposure to ultra-violet radiation may prevent the body from attacking its owm myelin. The findings were reported in the August 9 issue of The British Medical Journal. A research grant has been awarded by the National Multiple Sclerosis Society to Dr. Anthony J. McMichael and colleagues at the Australian National University in Canberra who will soon launch a more geographically expansive study to investigate the link between ultraviolet radiation and a first demyelinating event in tropical areas.

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8. REFLEXOLOGY RELIEVES SYMPTOMS OF MS

   The result of a randomized controlled study of the effect of reflexology on the symptoms of MS in Israel was reported in the 1 August 2003 edition of Multiple Sclerosis. The treatment included pressure on specific points in the feet and massage of the calf area. The authors concluded that the treatment helped to alleviate motor, sensory and urinary symptoms.

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9. EVIDENCE THAT COOLING CAN IMPROVE SYMPTOMS OF MS

   There is some evidence that cooling in persons with MS can have beneficial effects on symptoms of MS but research results to date have not been conclusive. The results of a new randomised controlled study carried out by the NASA/Cooling Group Study Group were published in the June 2003 edition of Neurology (Neurology, June 2003: 60: 1955-1960). Persons with mild to moderate disability symptoms were randomised to use a cooling garment for 1 hour a day for a month or to have observation only. Small but measurable improvements in motor and visual function as well as subjectively perceived benefits were recorded.