Multiple sclerosis research is continually evolving and producing results that have changed the lives of people with the disease. But more can and must be done for a pathology that every year, in Italy alone, affects 3,600 people: there are around 3 million in the world, over 140 thousand in our country where a diagnosis is recorded every 3 hours. Starting from the prevention and diagnosis of the disease, the themes at the center of the annual congress of Fism, the Foundation of the Italian Multiple Sclerosis Association, starting today in Rome (Hotel Villa Pamphili) until 30 May. It is titled “Brain Health: Rethinking the Diagnosis of Multiple Sclerosis and Related Conditions.” The successes of research into MS and related pathologies are increasingly linked to a global agenda aimed at brain health. And as evidence of global research work, the Fism Congress opens with the presence of many international researchers who, with Aism and Fism, are carrying out considerable projects to find that definitive cure that does not yet exist.
New scientific evidence – reports a note – shows that research into the causes of MS has made enormous progress in recent years: this today allows us to imagine prevention strategies which, if they cannot yet prevent the onset of the disease, can help identify risk factors and avoid disability. Or to understand which roads to take. As happens in the case of the Epstein-Barr virus, recalls Kjell-Morten Myhr of the University of Bergen, guest of the first day of the congress. “It is now demonstrated – explains Myhr – that EBV infection is an essential prerequisite for the development of the disease, but it is not yet clear how such a common virus can contribute to MS”. To find out, Myhr and colleagues launched the EBV-MS project financed by the European Union for a value of 7 million euros – which also sees the participation of Fism – to study the virus at 360 degrees, its interactions with the host, lifestyles and imagine possible therapeutic strategies, from antivirals to vaccines.
On the second day Luca Battistini, director of the Neuroimmunology Laboratory, Santa Lucia Irccs Foundation in Rome, with his reading for the awarding of the Rita Levi Montalcini Prize will recall the growing importance of the intestine-brain axis and dysbiosis as a further “trigger” (detonator) for the development of multiple sclerosis and as a risk factor which can be prevented.
But the research goals have already produced concrete results destined to change clinical practice – the note reports. This is the case of the new diagnostic criteria for MS which will be presented at the next Ectrims congress – scheduled for September in Copenhagen – but Xavier Montalban of Cemcat, the Multiple Sclerosis Center of Catalonia, anticipates their contents at the Fism congress. “Thanks to the review work carried out by expert radiologists, clinicians, epidemiologists and with the contribution of the patients’ point of view – he explains – we have reached a consensus on what will be the new diagnostic criteria for multiple sclerosis”. “The periodic review of the diagnostic criteria on the basis of scientific evidence allows us to be able to increasingly anticipate the diagnoses and thus the treatments, perhaps even before the symptoms appear – adds Montalban – And this, we have shown, is associated with a better long-term prognosis, also capable of lowering the risk of disability and improving patients’ quality of life”.
Among the topics at the center of the review, Montalban anticipated, the characteristics of the optic nerve, the analysis of new magnetic resonance imaging markers and the assessments relating to patients with concomitant vascular risk factors. “We need research that produces concrete impacts on the lives of people with MS – declares Rachele Michelacci, vice-president of Aism – and the arrival of new diagnostic criteria that promise to improve people’s prognosis and quality of life fully responds to the first of points included in our Bill of Rights, the right to health”. From the Fism congress emerges the importance of investing in a new discipline: science with and of the patient because an early diagnosis of the disease towards preventive medicine can only progress by knowing the person’s experience of the disease and making it scientific for all the actors of the system.
“Science with the people of the person – underlines Paola Zaratin, director of Fism scientific research – must be one of the fundamental disciplines of a multidisciplinary and participatory model of research and care, unique in guaranteeing that scientific innovation and digital transformation can be introduced into clinical practice”. In this spirit, patients are called to join the research table. “We people with MS must feel co-responsible towards research – adds Rachele Michelacci, vice president of Aism – For an early diagnosis of progression, to know the causes of the disease, to find treatments we must be at the research table and give , together with all the other actors, those answers that are not yet there. We must be an active part of the scientific plan. It is a job that must be done together, mutually.”
The creation of an EU Brain Data System is also at the center of a program for brain health and preventive medicine. “In this context – declares Marco Salvetti, full professor of Neurology at Sapienza University, Director of Neurology at the S. Andrea University Hospital, Rome, member of the Board of Directors of Fism – we continue our commitment to the creation of an integrated clinical data system , genetic, neuroimaging and patient-reported (Barcoding MS), for the characterization of all newly diagnosed cases of MS in Italy and Europe”.
Rethinking the diagnosis of MS and guaranteeing brain health also means continuing to invest in research into potential biomarkers and risk factors for the disease. This will also be discussed at the congress, with the presentation of the results of the projects supported by Fism which have investigated, among other things, the role of air pollution as a possible trigger of inflammation in MS, and the search for biomarkers in the blood and in the cerebrospinal fluid for disease monitoring and to study the effectiveness and side effects of therapies, also thanks to the clinical data coming from the Italian Multiple Sclerosis and Related Pathologies Registry, which today includes over 90 thousand patients.
On the third and final day of the congress, top stem cell experts will meet with representatives of institutions and experts in health economics and drug development to discuss the concrete prospects that come from stem cells for MS and the challenges – clinical and regulatory – posed since the advent of advanced therapies. The proceedings will close with presentations on the central role of rehabilitation through the physical and cognitive research carried out by the Foundation, as the key to keeping the brain healthy, preserving people’s function and quality of life.
The presence on the international scene of Aism and Fism is “more fundamental than ever in a period like this – underlines Frédéric Destrebecq, executive director of the European Brain Council and guest of the congress – The European elections are a great opportunity to bring to the attention of the new Parliament the importance of brain health. We hope that this can translate into a European-level strategy that dialogues with national plans. The number of people in Europe living with neurological problems is high and discussions on these issues must take place with the contribution of those who are experts from their own experience, to break the stigma and isolation. The involvement of people will help to increase attention especially on a condition like MS, where we have the opportunity to talk about how research has led to the development of many therapies”.
The congress was made possible with the non-conditional sponsorship of the Main sponsors Alexion, AstraZeneca Rare Disease, Biogen, Merck Italia, Neuraxpharm, Novartis Italia and the Sponsor Bristol-Myers Squibb.
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