6 ms·

To me, following modern MS research progress is as exciting of an inward journey as space exploration is an outwards one. In fact to the point where I have cons

To me, following modern MS research progress is as exciting of an inward journey as space exploration is an outwards one. In fact to the point where I have considered leaving the tech field within the next 5-10 years to partake in it so it's fun to see this here on HN. Just 20 years ago the first disease modification treatments were introduced. These were recurring injections of interferon-beta (1b/1a) for a 18-38% reduction in relapses and annual relapse rate (ARR) of 0.256[1]. Today there are about 20 different options, with Rituximab and humanized variants indicating an annual relapse rate of 0.044 for RRMS patients with a well understood safety profile[2]. On such medications an MS patient can expect a relapse every 22 years vs every 2.5 years unmedicated. My pet theory is that MS research will ultimately lead to significant breakthroughs in longevity research. This is based on the morbid view that the disease is serious enough for risks to be taken in understanding auto-immune responses, crossing the blood brain barrier and remyelination. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474703/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474703/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5109942/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5109942/

melling 6y ago
“Just 20 years ago..." Personally, when people think we are making good progress on something, I’m reminded of these words: “Before this decade is out...” Sure, great and rapid progress might require a couple percent of US GDP, and a million people working on a problem, but advancing medical research a few decades in the next 10 years, would benefit everyone.
- aplummer 6y ago
  The thing about clinical trials, is there is a minimum time it takes to run one. You can up concurrency but it only gets you so far - you really need to know the long term impact before you can iterate much.
  - melling 6y ago
    So, that wouldn’t be a good way to address basic medical research for some sort of Manhattan project. To make great progress over a decade, we’d need to do something else to advance medical science.
    - panabee 6y ago
      what's the craziest idea you have heard of that would advance medical science?
      - peterlk 6y ago
        Usage of BIL Gates in gene therapy - https://en.m.wikipedia.org/wiki/Transcriptor https://en.m.wikipedia.org/wiki/Transcriptor The possibilities boggle my mind
        sizzle 6y ago
        "Biological computers will probably obviate the use of many pharmaceutical drugs." My mind is blown, to say the least. Thanks for sharing!
    - aplummer 6y ago
      The thing is honestly, we make incredible progress every decade. What's important is doing it carefully, correctly, and investing in the right areas to make real positive change (less viagra and hair loss probably). Just a decade ago, Hepatitis C wasn't curable in nearly 100% of patients (in 12 weeks with limited side effects!). It isn't great news cycle content to focus on rehashing the great achievements we have recently made. It's heartbreaking to have such a methodical approach for sufferers now of course.
      - melling 6y ago
        Here’s the story about the accidental discovery of Viagra. https://www.theguardian.com/lifeandstyle/2017/jul/11/from-viagra-to-valium-the-drugs-that-were-discovered-by-accident https://www.theguardian.com/lifeandstyle/2017/jul/11/from-vi... For some reason, every time this discussion happens, people think we spend a lot of research money on hair loss and impotence drugs. Next, move onto how much care for people with Alzheimer’s is costing: https://www.cbsnews.com/news/alzheimers-costs-americans-277-billion-a-year-report/ https://www.cbsnews.com/news/alzheimers-costs-americans-277-... It would be cheaper to invest into medical research...
  - trentnix 6y ago
    As Brooks said (paraphrasing), "you can't make a baby in one month with nine women".
sputr 6y ago
As someone with NMO and on rituximab ... I'm all for you joining the many, many people working on these conditions. You have no idea how thankful I was to everyone that has worked in this field (and fought for funding in this field) because only a few decades ago my prognosis would have been MUCH worse. This news item gives me even more hope.
gavinray 6y ago
My partner suffers from relapsing-remitting MS and it's horrible. Out of nowhere, body and brain half-quit working. Needs wheelchair, constantly confused. And then suddenly one day it stops. I like to hope we'll figure this out during our lifetime.
- 6d6b73 6y ago
  Check out Wahls Protocol.
  - treeman79 6y ago
    Looks similar to AIP diet. All anti inflammatory foods
    - faeyanpiraat 6y ago
      I’m not convinced these diets work as advertised.. I’ve read tons of scientific papers and there are too many contradictions. For example these diets tend to forbid gluten intake, but some research imply better outcomes for patients with high whole grain intake. I’ve also read that inflamation is useful for preventing cancer, so what good is not having relapses when you get cancer from all the anti imflammatory stuff..
      - taurath 6y ago
        In theory if you’re comparing white bread eaters to whole grain eaters I’d imagine there would be a net benefit. I wonder if whole grain vs no grain has been studied.
      - Madmallard 6y ago
        Are you deep in biology like with a minimum BS or higher degree? If not, might just be too difficult to understand the value of the ideas. The lady prescribing the Wahls protocol is an MD so has a lot more invested into the field than the layperson. That said, she could still be wrong. One thing is for sure, there is no one-size-fits-all and there is no magic bullet. If there's something helpful for one condition, it's probably harmful for another. The body is a complex holistic system after all.
caycep 6y ago
I'm reminded of the joke between the cardiologist and immunologist...but the story of MS therapies goes hand in hand with the revolution in molecular biology - and by extension, immunology. https://twitter.com/nachristakis/status/1291414168713797638?lang=en https://twitter.com/nachristakis/status/1291414168713797638?...

melling 6y ago

“Just 20 years ago..." Personally, when people think we are making good progress on something, I’m reminded of these words: “Before this decade is out...” Sure, great and rapid progress might require a couple percent of US GDP, and a million people working on a problem, but advancing medical research a few decades in the next 10 years, would benefit everyone.

aplummer 6y ago
The thing about clinical trials, is there is a minimum time it takes to run one. You can up concurrency but it only gets you so far - you really need to know the long term impact before you can iterate much.
- melling 6y ago
  So, that wouldn’t be a good way to address basic medical research for some sort of Manhattan project. To make great progress over a decade, we’d need to do something else to advance medical science.
  - panabee 6y ago
    what's the craziest idea you have heard of that would advance medical science?
    - peterlk 6y ago
      Usage of BIL Gates in gene therapy - https://en.m.wikipedia.org/wiki/Transcriptor https://en.m.wikipedia.org/wiki/Transcriptor The possibilities boggle my mind
      - sizzle 6y ago
        "Biological computers will probably obviate the use of many pharmaceutical drugs." My mind is blown, to say the least. Thanks for sharing!
  - aplummer 6y ago
    The thing is honestly, we make incredible progress every decade. What's important is doing it carefully, correctly, and investing in the right areas to make real positive change (less viagra and hair loss probably). Just a decade ago, Hepatitis C wasn't curable in nearly 100% of patients (in 12 weeks with limited side effects!). It isn't great news cycle content to focus on rehashing the great achievements we have recently made. It's heartbreaking to have such a methodical approach for sufferers now of course.
    - melling 6y ago
      Here’s the story about the accidental discovery of Viagra. https://www.theguardian.com/lifeandstyle/2017/jul/11/from-viagra-to-valium-the-drugs-that-were-discovered-by-accident https://www.theguardian.com/lifeandstyle/2017/jul/11/from-vi... For some reason, every time this discussion happens, people think we spend a lot of research money on hair loss and impotence drugs. Next, move onto how much care for people with Alzheimer’s is costing: https://www.cbsnews.com/news/alzheimers-costs-americans-277-billion-a-year-report/ https://www.cbsnews.com/news/alzheimers-costs-americans-277-... It would be cheaper to invest into medical research...
- trentnix 6y ago
  As Brooks said (paraphrasing), "you can't make a baby in one month with nine women".

sputr 6y ago

As someone with NMO and on rituximab ... I'm all for you joining the many, many people working on these conditions. You have no idea how thankful I was to everyone that has worked in this field (and fought for funding in this field) because only a few decades ago my prognosis would have been MUCH worse. This news item gives me even more hope.

gavinray 6y ago

My partner suffers from relapsing-remitting MS and it's horrible. Out of nowhere, body and brain half-quit working. Needs wheelchair, constantly confused. And then suddenly one day it stops. I like to hope we'll figure this out during our lifetime.

6d6b73 6y ago
Check out Wahls Protocol.
- treeman79 6y ago
  Looks similar to AIP diet. All anti inflammatory foods
  - faeyanpiraat 6y ago
    I’m not convinced these diets work as advertised.. I’ve read tons of scientific papers and there are too many contradictions. For example these diets tend to forbid gluten intake, but some research imply better outcomes for patients with high whole grain intake. I’ve also read that inflamation is useful for preventing cancer, so what good is not having relapses when you get cancer from all the anti imflammatory stuff..
    - taurath 6y ago
      In theory if you’re comparing white bread eaters to whole grain eaters I’d imagine there would be a net benefit. I wonder if whole grain vs no grain has been studied.
    - Madmallard 6y ago
      Are you deep in biology like with a minimum BS or higher degree? If not, might just be too difficult to understand the value of the ideas. The lady prescribing the Wahls protocol is an MD so has a lot more invested into the field than the layperson. That said, she could still be wrong. One thing is for sure, there is no one-size-fits-all and there is no magic bullet. If there's something helpful for one condition, it's probably harmful for another. The body is a complex holistic system after all.

caycep 6y ago

I'm reminded of the joke between the cardiologist and immunologist...but the story of MS therapies goes hand in hand with the revolution in molecular biology - and by extension, immunology. https://twitter.com/nachristakis/status/1291414168713797638?lang=en https://twitter.com/nachristakis/status/1291414168713797638?...