Is MS more than one disease?

MS is notorious for behaving differently in different people. People with MS know this and health-care professionals agree, but no one knows what the variation means. Scientists continue to question whether MS is just one disease--or more. While an international team of investigators involved in the Society-funded MS Lesion Project pushes for the big answer, its researchers are coming closer to understanding why some people respond to certain kinds of therapies--and not to others.

The MS Lesion Project's discovery

MS Lesion Project investigators have published findings showing that people with a specific pattern of tissue damage responded to plasma exchange therapy while others did not. This therapy--which involves removing blood, separating the blood cells from the fluid plasma, mixing the blood cells with replacement plasma, and returning the mixture to the body--is occasionally used to treat people experiencing severe MS attacks that do not respond to standard steroid therapy. Claudia F. Lucchinetti, MD, of the Mayo Clinic and Foundation published the team's findings in the August 13, 2005, issue of The Lancet.

Subtypes of MS

Dr. Lucchinetti and collaborators from the United States, Germany, and Austria studied a collection of more than 200 brain tissue samples from biopsies and autopsies of people with MS. The group has found four different types of MS lesions. But each person had only one type.

In the Lancet report, Dr. Lucchinetti and her team looked at the brain tissue samples of 19 people who had been treated with plasma exchange therapy and found that all 10 of the people who had lesion pattern II experienced moderate to substantial improvements following therapy. None of the nine people with other lesion patterns showed measurable improvement.

This suggests the possibility of tailoring therapies for people with specific kinds of MS disease activity. Dr. Lucchinetti and other researchers are now trying to find non-invasive ways for identifying lesion patterns.

About The MS Lesion Project

The MS Lesion Project is supported by the Society's Promise: 2010 campaign, which aims to raise at least $30 million for this and other targeted MS research and care programs.