Multiple Sclerosis

Multiple sclerosis (MS) is a degenerative neurological disease that can be unpredictable. Research has shown that patients with multiple sclerosis have brain tissue that has been atrophied. Nearly 2.5 million people worldwide have this disease (UCSF 2014). Multiple sclerosis is difficult to diagnose early due to the progressive nature of the disease. People who have this disease do not live normal lives, especially near the end of their lives. However, the life expectancy for these individuals is very similar to normal life expectancies (Mayo Clinic Staff 2012). The primary system that is affected by multiple sclerosis is the central nervous system (CNS). This research paper will analyze the disease with first a description of the disease, including symptoms, causes, risk factors, etc. then move into the generally accepted treatments of MS.

Multiple sclerosis is a progressive, degenerative disease that affects many people in our society. This calls for a complete understanding of this disease. MS targets central nervous system cells called neurons. It is interesting however that the attack is done on the coatings of these cells. This coating is termed the “myelin sheath” and is important in speeding up signal transduction between nerves of the CNS (Sospedra and Martin 2005). Eventually, with continued degradation to this tissue, a person will exhibit signs of cognitive impairment. The impairment can be exhibited by fatigue and distortions of many regular functions directly related to the CNS.

The CNS is the control center of the body. It is responsible for many automatic functions that are required for the life of the human being. When signals are not able to move to their destination in a biologically timely fashion, disastrous side effects ensue. Any function of the CNS may be distorted. This explains the symptom of fatigue. Mental fatigue generally leads to the body feeling physically fatigued as well. Other symptoms that result from this degeneration of the protective coating of nerve cells include impairment of vision, coordination sensations, and bladder and bowel control (UCSF 2014). Almost every function in the human body involves signal transportation by nerve fibers. Therefore the importance of them cannot be underestimated and when damaged the consequences are numerous. The symptoms of MS are well documented throughout its history in the human population, but the cause may not be so clear.

There are multiple theories on the subject of the cause of multiple sclerosis. There exists evidence that the onset of the disease may be genetically linked to an environmental stimulus or stimuli. Even though in certain explanations this may sound like a single theory, two predominant theories have emerged to explain the causes of MS. First, the environmental theory suggests that the surroundings of an individual greatly impact the risk of developing MS. This is evidenced by the increased number of diagnoses in specific regions of the world. Statistics show that more individuals are diagnosed with MS in more northern regions of the United States, suggesting that global location has an impact on the risk of developing MS (Mayo Clinic Staff 2012). The difference between the northern or southern regions in the United States is generally only the climate. Others have proposed that a specific pathogenic infection could be responsible for the onset of the symptoms of MS; this was concluded after the exhibition of increased MS symptoms directly following an infection (Sospedra and Martin 2005). Even if these conclusions are true, it is still possible that a genetic predisposition is present and determines the likelihood of individual developing MS in the presence of environmental risk factors.

This second theory that will be explained and analyzed is the genetic theory of the cause of multiple sclerosis. The evidence supporting this theory includes findings in experiments that indicate the presence of specific genes in people that develop MS. Generally, individuals from a certain part of the world have similar unique areas of their DNA that are specific to that part of the world. Tests to determine the presence of these genes are widely available in biochemical laboratories. Individuals whose family members have developed MS increase their own risk of developing the disease by a significant amount. This suggests that certain genes play a key role in the susceptibility of an individual for the development of MS. The disease is most common in Caucasians and is considered rare when exhibited by African Americans or Asian Americans (Mayo Clinic Staff 2012). The studies from which this data is extracted from accounts for those races inside the United States, which means they could be living in higher risk areas but are showing a decreased risk for developing MS. This is critical to the further knowledge of this progressive illness.

The two theories that have been outlined can be thought of together. An environmental factor initiates the development of multiple sclerosis in an individual who is genetically more likely to develop the disease. That is why it is important to analyze from all angles. Both theories accept the fact that something is not correct within the immune system. The immune system functions to defend the body from harm by a mostly chemical basis. Physical barriers are also considered part of the immune system and keep the goal on track by serving as a barrier between inside and outside the body tissues. The immune system is very complex and includes a large number of specialized cells and chemicals found in no other system of the body, making it very difficult to identify any specific culprit responsible for the onset of MS.

A third theory is supported by a relatively new study suggests that the onset, triggered by a viral infection, alters a specific protein in myelin, which marks the protein for destruction and hence the results are degenerated myelin coatings (Sospedra and Martin 2005). The argument is simply that there is not enough data concerning the central nervous system as it pertains to the development of MS and therefore cannot be ruled out as a possible cause. Without a clear and concise cause and reasoning for this cause, treatment for this disease is especially tricky.

The treatment of multiple sclerosis can vary from patient to patient because of each unique situation. Many of the strategies to treat MS involve the reduction of serious symptoms of the disease and help to maintain a normal lifestyle for the patient. This is because there is no cure for the disease at present. Instead, treatment plans attempt to alter the progression of the disease and the natural disease course. These treatments include medications, physical therapy, and emotional support from various sources. Each of these treatments will be separately analyzed, however they are usually used together to better manage the symptoms of multiple sclerosis.

Multiple sclerosis and its associated symptoms are treated with regular intravenous and oral drug administration. Corticosteroids are used to reduce inflammation that happens in an MS individual. Inflammation is common in MS individuals and causes many of the physical symptoms associated with the disease (Mayo Clinic Staff 2012). Another class of drugs used in treating MS is muscle relaxants. These are employed by physicians to combat muscle spasms that can be extremely painful (UCSF 2014). Other classifications of drugs have been used to ease the many secondary symptoms of MS. These, mentioned above, included fatigue and bladder control issues.

Physical therapy has been used in modern medicine for many injuries or neuromuscular diseases and multiple sclerosis is no different. However, it is different in the approach. Many situations that require physical therapy or rehabilitation involve a patient that is capable of handling a couple of hours exercise session. With MS this is most often not the case and sessions must be shorter and strategically scheduled for fatigue to not circumvent the purpose of the therapy. Unfortunately, it is often very difficult for MS patients to obtain physical therapy sessions either because of the limited availability of facilities in their area or because of insurance complications, in which case the patient may be terminated from the coverage prematurely.

The third category of treatment that often helps individuals suffering from multiple sclerosis is emotional support groups or activities. These are often coordinated by local facilities such as hospitals or rehabilitation clinics and are usually free of charge. It is important to keep a stable emotional state for MS patients. Both reaction to the diagnosis and the body damaged caused by the disease in time have significant effects on the CNS that can mean emotional changes as well. Experimental data support the connection between MS and depression because of changes in various body systems, such as the immune system and nervous system, which affect the processing of stress (Wazenkiwitz and Terrill 2013). These emotional effects are serious and controlling them before they take over can make all the difference in a patient’s life.

A combination of these treatments is necessary for a normal life with multiple sclerosis. Each case is different and needs a specific regiment of each category of treatment. Physicians across the world identify certain characteristics of each diagnosis to create the best course of action to combat the disease.

There is still a lot that is not known about multiple sclerosis. This is mainly because there are just too many proteins in the body for them to be completely documented, at least of yet. What has been completed is the map of the human genome and has helped make a case for the genetic theory of the cause of multiple sclerosis. There are new studies constantly being conducted and are working toward a complete database of the human proteins. By analysis of genes extracted directly from cells in MS lesions, scientists were able to single out specific proteins involved in triggering the onset of physical symptoms (Steinman L 2008). The knowledge obtained by this experiment is the foundation for the future treatment of multiple sclerosis. They have also discovered that proteins in paths that are understood are exhibiting new functions when exposed to MS physiological conditions (Steinman L 2008). The new data could also help modify existing medications used in treating other diseases, not just multiple sclerosis. It is simply amazing and interesting to see how medicine changes with the addition of new scientific data.

I chose to research multiple sclerosis because the disease has close ties to me and my family. My younger sister was diagnosed with multiple sclerosis early in her life. She has been an inspiration to me and my other siblings as she has fought through the treatment plan. I hope that the treatments being developed soon may offer a more permanent solution that might completely cure the disease. The disease is too common and affects too many people to be ignored.

References

Mayo Clinic Staff. 2012. Diseases and conditions multiple sclerosis [internet]. [cited 7 Apr 2014]. Available from: http://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/basics/definition/con-20026689

Wazenkiwitz J. and Terrill AL. 2013. Depression and MS [internet]. [cited 12 Apr 2014]. Available from: http://msrrtc.washington.edu/info/factsheets/depression

Sospedra M, Martin R. 2005. Immunology multiple sclerosis [internet]. [cited 7 Apr 2014]. 23. p. 683-747. Available from: http://www.annualreviews.org.huaryu.kl.oakland.edu/doi/full/10.1146/annurev.immunol.23.021704.115707

Steinman L. 2008. New targets for treatment of multiple sclerosis. Journal Neurological Sciences [internet]. [cited 7 Apr 2014]; 274(1-2). p. 1-4. Available from: http://dx.doi.org/10.1016/j.jns.2008.06.040

UCSF. 2014. About multiple sclerosis [internet]. [cited 7Apr 2014]. Available from: http://multiplesclerosis.ucsf.edu/education_and_support/about_multiple_sclerosis