Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, May 9, 1995 TAG: 9505090061
SECTION: EXTRA PAGE: 4 EDITION: METRO
SOURCE: JANE BRODY
DATELINE: LENGTH: Long
Fifty years ago this week, this was published as a classified ad in The New York Times, placed by a distraught young woman whose brother was becoming increasingly disabled by the disease.
The woman, Sylvia Lawry, was hoping to find a cure. But instead she received 54 replies from people as desperate as she, most of them asking her to let them know if she did learn of anything promising.
Fifty years later, there is still no cure for multiple sclerosis and neurologists are still not certain of its cause or causes. But much has been learned about the nature of the disease, and Betaseron, the first drug that can alter its underlying course in some patients, was recently approved.
Two other drugs that act like Betaseron, limiting the frequency and severity of multiple sclerosis attacks by regulating the immune system, will soon be submitted for government approval.
Some of that progress can be attributed to the support for research from the indefatigable Ms. Lawry. Inspired by the replies to her ad and not willing to give up on her brother or her correspondents, she took what to her was the next logical step. She started a society devoted to research into the cause and treatment of this sometimes devastating chronic neurological disease, which now affects about a third of a million people in this country.
Originally organized as the Association for the Advancement of Research into Multiple Sclerosis, the group soon realized that people with the disease needed services as well as research. It reorganized and renamed itself the National Multiple Sclerosis Society, with Ms. Lawry serving as its founder-director, a post she held until 1982.
In 1967 Ms. Lawry took her quest worldwide and founded the International Federation of Multiple Sclerosis Societies, a 34-country network. She was also a moving force behind the establishment of the National Institute for Neurological Disorders and Stroke, which now spends about $59 million a year on research related to multiple sclerosis.
Now in her late 70s, Ms. Lawry is still battling this enemy. She is trying to establish a multiple sclerosis society in the Arab world and continues to work full time as a volunteer in charge of international programs for the society, even though the hoped-for rewards can no longer help her brother, Bernard. He died in 1973 of complications related to the disease.
As with cancer, studies of multiple sclerosis still have a long way to go before medical researchers can develop preventives and broadly effective treatments. Indeed, even the diagnosis can be difficult, typically arrived at only after first eliminating other possibilities.
But recent leads and advanced new research techniques have opened promising areas that sooner or later could produce what doctors might legitimately call breakthroughs.
Multiple sclerosis is now known to involve an immunological reaction run amok. So-called T cells, immune system cells whose job it is to attack invading viruses and bacteria, mistakenly assault the sheath of myelin that protects nerves in the brain and spinal cord much the way insulation protects an electrical wire.
Without their myelin, the nerves in effect short-circuit and are unable to transmit messages properly from sensory organs to other nerves and to muscles. As a result, patients gradually lose the ability to control their movements, speech and other bodily functions and sometimes lose cognitive functions like memory as well.
But what starts the T cells on their misguided mission? And how do they get past the barrier that normally protects the brain and spinal cord from such substances in blood?
Scientists at Harvard University reported that certain common infections might touch off the attack against myelin. By exploring a phenomenon called molecular mimicry, Dr. Kai Wucherpfennig and Dr. Jack Strominger found that T cells from patients with multiple sclerosis reacted not only against myelin from the brain and spinal cord but also against various common viruses and bacteria.
The finding suggests that the mistaken attack on myelin may result from an inability of some people's T cells to distinguish between myelin and infectious organisms.
Other researchers are exploring ways of promoting regrowth of myelin.
Just how T cells penetrate the blood-brain barrier in the first place and how that entry can be blocked are being studied by Dr. Joseph Madri at the Yale University School of Medicine.
Glue-like proteins on the surface of T cells interact with specific proteins on the surface of the blood-brain barrier, and Madri is exploring the molecular mechanisms that control T cell penetration. A Seattle company has already begun clinical trials to test the safety of monoclonal antibodies that block such penetration.
These projects are among 200 research efforts that are currently being supported in whole or in part by grants from the society that Ms. Lawry founded half a century ago.
Judging from the accelerating pace of research, experts believe that long before another 50 years have passed, there will be effective ways to help nearly all who develop multiple sclerosis to avoid or recover from the crippling destruction of myelin that is the hallmark of the disease.
- New York Times News Service
Jane Brody writes about health issues for The New York Times.
by CNB