To people with multiple sclerosis: there is still hope

There is no single pattern of suffering in multiple sclerosis (MS): every patient has different symptoms, because the disease affects nerves in the brain, the spinal cord and even the eyes. Doctors still aren't sure what causes it or why it affects one person and not another.

"I have a patient aged 6 and another aged 71, and others of all ages and jobs," says Dr Daniel Kantor.

A second gene linked with MS was discovered recently, giving researchers hope of using it for treatment. Last year researchers announced a gene that raises the risk of the disease by 30%, the first such finding in thirty years, and the search for others continues. These genes are excellent targets for developing treatments.

Symptoms vary because the disease attacks different parts of the nervous system: one patient has trouble walking, another severe fatigue, another double vision, tremor, stiffness or bladder problems.

MS is an autoimmune disease of the central nervous system. Nerve fibres are surrounded and protected by a fatty tissue called myelin, which helps them carry nerve signals. In MS, myelin is lost in many areas, leaving scar tissue called sclerosis, and sometimes the fibre itself is damaged. When the myelin or fibre is damaged, signals to and from the brain are disrupted, causing the various symptoms.

Most people with MS are diagnosed between 20 and 50, and women are affected twice as often as men. About 400,000 Americans have MS, about 200 new cases are diagnosed each week, and about 2.5 million people worldwide have it, according to the National Multiple Sclerosis Society.

"The main cause isn't known, but genes and environment both play a part," says Dr Kantor. "Often there is a genetic tendency, then exposure to some trigger, and through an immune process the body attacks itself."

Dr Lou says new research has succeeded in using stem cells to help replace myelin in the brains of mice, raising the possibility of using stem cells to treat MS. Last year researchers also showed that an experimental DNA vaccine against MS is safe and may help stop the immune system attacking the nerve fibres.

"Early, better diagnosis is now possible with imaging," Dr Lou adds, "and medicines reduce how often and how badly symptoms occur and the build-up of lesions in the brain and spinal cord. There are also special rehabilitation programmes for MS." Research continues to understand and treat this disease, so don't lose hope.

Update: many more effective disease-modifying treatments for MS have been approved since this article was written, and dozens of genes linked with MS are now known.