MS progression linked to immune response triggered by infections and other factors

New research shows that inflammation outside the brain is linked to the progression of multiple sclerosis (MS).

Inflammation is one way the body fights illness and infection. White blood cells are released by the immune system to surround and protect the affected area.

This inflammation can be caused by a number of factors. These include infections, like colds and urinary tract infections (UTIs), other medical conditions, trauma and an unhealthy lifestyle.

The Systemic Inflammation in Multiple Sclerosis (SIMS) study was led by the University of Southampton and University Hospital Southampton.

It involved 50 people living with progressive forms of MS. Researchers followed them for two and a half years.

They found a link between inflammation and a major underlying cause of MS progression.

The study was funded by the MS Society. It was led by Professor Ian Galea, a Consultant Neurologist at UHS. He is also a Professor in Clinical & Experimental Neurology at the University of Southampton.

The new findings are being spotlighted by BBC South Today.

Lifelong condition

Multiple Sclerosis (MS) is caused by the immune system mistakenly attacking the nerves in the brain and spinal cord. Loss of these nerves over time leads to MS progression.

Over 150,000 people live with MS in the UK - with 135 diagnosed each week.

The condition affects how people move, think and feel. Symptoms are different for everyone. They can include fatigue, pain, vision problems and mobility issues.

Building on years of research

Research in animals has shown that inflammation outside the brain can exacerbate loss of nerves.

In this study, researchers showed that the same thing happens in people with MS.

They measured inflammation in the body by looking at a weekly urine sample. 

Prof Galea said: “Our results build on decades of research showing inflammation causes nerve cell loss in the laboratory. Now we've shown a connection between inflammation and loss of cells in the spinal cord in humans.”

The loss of nerve cells from the spinal cord is a major underlying cause of MS progression.

“In the future, lab research could help us understand what's going on at a molecular level when this inflammation happens”, Prof Galea explained. “This could perhaps help us develop new drug treatments.”

He continued: “The results of this study suggest it is important for people with MS to minimise inflammation where they can. This includes receiving all recommended vaccinations and seeking prompt attention for bladder infections.

“Following a healthy lifestyle could also be beneficial, as factors like smoking, alcohol and obesity are linked to inflammation. And as health care professionals we can help too, by talking about these things with our patients so they have the facts they need."

Richard’s experience

Richard Humpston, a 43-year-old from Portsmouth, took part in the study at UHS. He was diagnosed with primary progressive MS in 2014.

“I participated in the SIMS study, which meant freezing my urine every week and going into hospital for various tests and check-ups”, he explained.

“I was told afterwards that there was some evidence that I had urine infections during the study. The results have highlighted how vital it is for me to stay hydrated to avoid this type of infection in future.”

Richard is now medically retired, but he previously worked within the NHS on a neurological rehabilitation ward. His symptoms include difficulty with walking and bladder issues.

He got involved in research to help make a difference for people in the future.

“When I was first diagnosed there was no disease modifying treatments (DMTs) at all for people with my type of MS”, he said.

“I’m now on a licensed DMT which has improved my life. Thanks to research we’ve already made so much progress.”

‘Vital insight’

MS can affect people of all ages, ethnic backgrounds and genders. Most people are diagnosed in their 30s or 40s.

Bladder infections are very common for people living with MS.

Dr Clare Walton, Head of Research at the MS Society, said: “This study gives us vital insight into the relationship between inflammation outside the brain and MS progression.

“It is important for people with MS to recognise the symptoms and seek help early for urinary infections. It is also important that they take up any vaccinations they are eligible for.

“The findings demonstrate the need for access to good and timely primary care, with GPs who understand the risk of infections and MS progression.”