There were a number of interesting presentations. The keynote lecture was given by Dr. Hauser of
UCSF, and was on the role of B cells in MS. This is a very timely topic since a B cell depleting antibody, ocrelizumab,
is likely to be approved soon in the US.
There was an interesting session on diet and MS.
Dr. Ralf Linker gave an interesting talk on the effects of dietary fat in MS, which combined work in mice, in tissue culture
and in humans. He investigated the effect of short chain fatty acids, mainly propionic acid, on the immune system.
Adding propionic acid has several immune regulatory effects in tissue culture and decreases disease in the mouse model of
MS. This may be a future therapy for MS. Interestingly, a high fiber diet increases the amount of propionic acid
in the gut, through the action of gut bacteria, and might have the same effects as administering the propionic acid directly.
Other talks included the effects of vitamin D and salt on MS.
I found the session on infections
and MS particularly interesting. Three different speakers discussed different viruses that have been linked to MS.
Dr. Dolei discussed endogenous retroviruses. These are viruses that have inserted themselves into our DNA and become
part of the human genome. Most are no longer functional and don’t express any proteins, but some can make proteins
or even whole virus. One, called MSRV, is particularly strongly linked to MS and might play a role in causing disease.
An antibody against this virus is currently in testing. Dr. Jacobson discussed HHV-6 in MS. This is a herpesvirus
that infects almost everyone, and establishes a latent infection in the brain. Finally, Dr. Ascherio discussed Epstein-Barr
virus in MS. He strongly asserted, based on the evidence his group has accumulated over the years, that EBV is involved
in causing MS. I hope he is right, since I have spent the last 10 years of my career working on EBV in MS.
The final session I will comment on is the microbiome in MS. This has been an active area of research
for the last several years. The microbiome is essentially all the bacteria and other organisms which live on us, mainly
in our gut. Our gut bacteria have a surprising influence on our health, and can affect the activity of the immune system.
Conversely, we change our gut bacteria by what we eat and also when we take antibiotics. People with MS have different
bacteria in their gut than healthy people, and investigators are making the first attempts to change the bacteria in the gut.
This area is in a very early stage, since we still don’t know what types of bacteria are good for us.