A New Avenue for MS Research

The search for multiple sclerosis risk factors, causes, and predisposing influences has been an important area of MS research for years. Studies have uncovered a variety of possible mechanisms for the development of MS, but have not been able to pinpoint a single, consistent cause.

Etiology of Multiple Sclerosis

Genetics seems to play a role in the etiology of MS, as there is a noted familial pattern, but not a strong one. Environment also seems to contribute to the development of MS, as regional variations in incidence affect individuals who are second and third generation inhabitants of regions with a higher incidence of the disease. But there are a number of diverse environmental factors and they don’t seem to consistently correlate with the presence or severity of MS.

Epigenetics

Epigenetics is an interesting area of biological science that begins to unravel the complexities behind the inconstant expression of genes, rather than the genes themselves. In other words, DNA structure may be identical between individuals, but expression of particular genes that contribute to MS may differ among individuals.

Through epigenetics, DNA methylation or DNA histone deacetylation have been identified in MS patients. It may be possible that some of the recognized MS risk factors, such as infection and vitamin D deficiency, may produce these alterations in DNA activity in individuals who are predisposed to MS. Elevated levels of micro RNAs have been isolated in the brains of patients with MS, suggesting that genetic activity at the transcription and translation levels may be responsible for some of the underlying MS-producing pathophysiology – such as demyelination and inflammation.

How Does Epigenetics Affect your Patients?

From a preventative standpoint, the likelihood that genetics and environment are intertwined in the development of MS suggests that identification of people who have an inherited tendency to become affected with MS can be useful in proactively counteracting risk factors that may not be of significant consequence for people who are not predisposed to MS.

Share your Thoughts

► How does this information impact your approach to the idea of genetic testing for your MS patients?

► Would you consider genetic testing for relatives of MS patients worthwhile?

► Recognizing the lifelong personal burden and financial cost of living with MS, do you think genetic testing would be a good investment for your patients?

► Given the healthcare costs of MS treatment, do you think genetic testing would be a good investment for your patients’ insurance providers?

References:

Iridoy Zulet M, et al. Epigenetic changes in neurology: DNA methylation in multiple sclerosis. Neurologia. 2015 May 11. [Epub ahead of print]

Küçükali Cİ, et al. Epigenetics of multiple sclerosis: an updated review. Neuromolecular Med. 2015 Jun;17(2):83-96.