There are many studies that show that the risks for getting multiple sclerosis (MS) vary according to the month a person is born. However, the differences between the months of birth are slight.

For example, a 2005 study of people with MS living in northern latitudes found that more people (9.1%) had a birthday in May and significantly less (8.5%) were born in November. The opposite pattern is seen in the southern hemisphere. Thus, worldwide there is a slight increase in MS risk in those born in the spring and a decrease in those born in the winter.

The cause of this has not been determined. Some ideas include differences in:

• Vitamin intake during pregnancy (more folate in fresh vegetables in the spring, more vitamin D from sunlight in the summer)

• Birth weight - Heavier babies born after summer and fall pregnancies
• Exposure to viruses - More people experience viruses in spring and fall. This may affect the not only the viruses a baby is exposed to during pregnancy, but also after birth.

A recent article in JAMA Neurology describes ...

On March 27, the U.S. Food and Drug Administration approved the newest treatment in the increasing number of disease modifying therapies (DMTs) available to treat multiple sclerosis. Tecfidera (BG-12) is an oral capsule to treat adults with relapsing forms of MS. Research participants at the MS Center at Swedish participated in clinical trials for Tecfidera.

The trials reported that people taking Tecfidera had fewer relapses and less frequent worsening of disability compared to people taking a placebo. There were also fewer and less-severe side effects with Tecfidera than other treatments.

The studies found that ...

Increased dietary salt was reported to increase the immune attack on myelin in three studies this week. All three were published in the journal Nature.

1. A study by Kleinewietfeld, et al, looked at TH17 cells, which is a type of lymphocyte that is highly inflammatory and that causes substantial tissue damage. These cells were grown in cultures in the lab. Some had normal and others high salt levels in their cultures. Those grown in a high salt environment had increased markers for inflammation. This seemed to be due to activation of one particular set of chemical signals in the cell, called the p38/MAPK pathway. They also looked at mice with an MS-like disease called experimental allergic encephalomyelitis (EAE). Mice fed a high salt diet had worse EAE than those fed a normal diet.
2. A study by Wu, et al, also looked at TH17 cells. An analysis was done on genes associated with activation of TH17 cells, and SGK1 was identified as an important protein in this process. The SGK1 pathway was found to be more active if cells were cultured in a high salt environment. This was then studied in mice with EAE. Mice fed a high salt diet had more severe EAE. Blocking the SGK1 pathway seemed to reverse the effect of the high salt diet on the EAE.
3. A study by Yosef, et al, also looked a the genes associated with activation of TH17 cells. They identified 22 sets of related genes that increased TH17 cell activity and 5 that decreased activity.

TH17 cells are highly inflammatory and likely contribute to the severe damage done to tissues in a number of diseases. Their precise role in MS is not fully understood, but it is believed that ...

Once again, multiple sclerosis patients’ area buzz over a new theory and treatment for the disease. The theory is called chronic cerebrospinal venous insufficiency (CCSVI); and, this time, social media is driving the patient excitement.

CCSVI is based on a controversial idea that impaired venous drainage of the brain due to blockage in venous structures causes MS. Increase in venous pressure promotes leakage of blood across capillaries, with inflammation resulting from the iron deposition into the brain. In 2009 Paolo Zamboni, M.D., reported that virtually all MS patients in a study had abnormalities in the jugular or azygous veins, whereas no control patients had such findings. The Zamboni, or Liberation, procedure involves either angioplasty or stenting of the abnormal vein. Many MS patients are understandably enthusiastic about this theory and treatment.

There are, however, a number of problems with the CCSVI theory that patients and MS neurologists should consider.

The Multiple Sclerosis Center continues to grow. We have added an additional MS nurse, Reiko Aramaki, RN. Reiko joined us from the Evergreen MS Center. She is certified by the International Order of MS Nurses and will expand our ability to respond to patient’s needs.

Outreach programs also continue. Dr. Bowen was recently interviewed by Kathi Goertzen from KOMO TV4 regarding CCSVI. This interview can be seen at http://www.komonews.com/home/video/106166123.html.

Also, Chaz Gilbert, a patient care coordinator won the Seattle Verizon Urban Challenge on 10/30/10, racing through 12 checkpoints in their city using only clues, their feet and public transit.