2023-10-13 07:37:00
by Anna Fregonara
The molecules counteract inflammation. This is being discussed at the World Congress on autoimmune pathology underway in Milan where the parenting of patients who are mostly women between 20 and 40 years old is also discussed.
New molecules raise hope for the possibility of counteracting low-grade inflammation, which burns like an ember, which is one of the causes of multiple sclerosis (MS) and which so far it has not been possible to act on.
one of the innovations emerging from the most important world congress on MS underway in Milan, organized by The European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), in collaboration with The American Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS).
New class of drugs
MS is an autoimmune, chronic and inflammatory disease of the central nervous system, the most common degenerative neurological disease in young adults: it affects 2.8 million people worldwide, in Italy approximately 137 thousand people with 3,600 new cases per year.
Among the therapies that seem promising and which, still in the experimental phase, are showing long-term benefits in patients with the relapsing form, there is a new class of drugs which includes evobrutinib. an inhibitor of the action of Bruton’s tyrosine kinase (Btk) which has shown a prolonged clinical benefit for up to five years of treatment, explains Massimo Filippi, full professor of Neurology and director of the School of Specialization in Neurology at the Vita-Salute San University Raffaele, director of the Neurology Unit of the IRCCS San Raffaele Hospital. This new class of drugs passes the blood-brain barrier and appears to be able to modulate both the responses of B lymphocytes, involved in the immune response, and the activation of microglia, the cells responsible for the immune function of the central nervous tissue which are believed to be constantly activated since from the first day of the illness. The action of these new molecules is, therefore, to act on the two components that simultaneously and synchronously cause those processes that can lead to the accumulation of irreversible disabilities in MS: both the inflammation that comes from the periphery, the most classic that has been known for many years, both the lower grade inflammation called “smoldering inflammation”. It constitutes that part of the disease which for now remains difficult to attack and which, like a sort of ember burning under the ash, is always present and contributes significantly to the damage of the pathology. We must wait for the definitive research data.
Becoming parents is possible
Although the onset and duration of symptoms can vary, MS usually begins between the ages of 20 and 40, the stage of life when many couples dream of having children, and is three times more common in women than to men. It is possible to have children and breastfeed without problems, perhaps it will be necessary to remodulate the drugs in these months, with the advantage that the pregnancy is protective, reassures Professor Filippi. Furthermore, the disease is not transmitted because it is not a genetic pathology. First-degree relatives may have a slightly increased risk compared to the general population, but it must occur in conjunction with a series of factors, such as genetic predisposition, lifestyle, environmental events such as infections, for it to translate into the disease. If a woman with a serious pathology such as MS becomes pregnant, it means that she is doing well, otherwise she would not be able to plan for the future in this way.
A project for mothers and fathers
Precisely to help realize this desire, DaBy was born, an acronym for Dreaming a Baby. a concrete project that meets the needs of people with MS who want to become parents in the short or medium term from the moment of diagnosis, explains Maria Cristina Leone, director of the Neurology and Immunology Business Unit of Merck Italy. Through a documentary analysis and interviews with specialists in a multidisciplinary approach, a group of neurologists has defined the DaBy model: it provides basic indications to guarantee the best possible management of the parenting process. It will then be the task of the neurologist and the multidisciplinary team to decline the model in order to personalize it according to the needs of the patient in front of him. Needs that can be of various types, from psychological to gynecological help, just to give two examples.
Pilot experiment
DaBy started in 3 pilot centers (Tor Vergata, Cagliari, Turin) with the support of professors Gerola Marfia and Eleonora Cocco and doctor Paola Cavalla. From this year it will be sponsored by the Italian Multiple Sclerosis Association (AISM) which will have a central role in the diffusion of this model in order to integrate it into the greatest number of centers operating in Italy, adds Leone. The idea of DaBy was born after listening to the “appeal” of the National Agency for Regional Health Services which, in 2021, had underlined the need to integrate specific protocols, for the care of people with MS who wish to become parents , within the Regional Diagnostic Therapeutic Assistance (PDTA) Paths and hospital companies.
Il podcast
Another support to help respond to patients’ doubts and fears comes from the Thousand Facets of MS podcast, a title that well represents the multiple aspects and impacts of this disease. Available on Spotify, there are 16 episodes in which the topics are addressed from a multidisciplinary point of view. In fact, in addition to the neurologists, the participants also include the dietician, the gynecologist, the personal trainer, the nurse, the employment consultant, representatives of AISM and many other professional figures involved in the treatment process of people with MS.
October 13, 2023 (modified October 13, 2023 | 07:34)
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