If you're living with multiple sclerosis, there's reason to be hopeful that more effective treatments — even an MS cure — are on the horizon. That's because researchers and doctors who are working to understand the underlying causes of multiple sclerosis and to develop effective MS treatments are optimistic too.

“Someone asks me in every clinic if we are close to a cure,” says neurologist Khurram Bashir, MD, MPH, associate professor of neurology and director of the University of Alabama at Birmingham Multiple Sclerosis Center. “I am optimistic, but it’s hard to know if a cure will come in the next five years or longer. Science moves forward in small steps.” Current MS treatments are more and more effective, says Dr. Bashir. A quarter-century ago, no treatments existed. Today, nine MS drug treatments have been approved by the Food and Drug Administration, with two more anticipated in the next year and many others working their way through the pipeline.

However, says Jack Burks, MD, chief medical officer of the Multiple Sclerosis Association of America, based in Cherry Hill, N.J., “the cure will most likely come from new scientific information into the yet unknown cause of MS."

Since no MS cure has been developed so far, today's MS medications are aimed at "disease modifying" instead of curing, which means they slow the progression of multiple sclerosis and reduce the severity of MS symptoms. The most recent generation of drugs suppresses the immune response that may contribute to multiple sclerosis. Other drugs in the pipeline (yet to be approved) may help regenerate some lost myelin (the sheath that protects neurons). These drugs have some limitations, points out Bashir, because they cannot repair scar tissue or long-term injury to neural networks. Nonetheless, they offer some hope for protecting function and ability.

Understanding the mechanisms that cause complex diseases such as MS can help researchers develop strategies for prevention or even an MS cure. Genetic risk is one avenue of research that could yield some of the answers researchers are seeking.

Research published in PloS One found that there are more than 50 genetic locations that could be involved in an individual’s MS risk, and researchers expect there are even more genetic keys yet to be discovered.

The exact cause of MS remains unknown, but researchers have used genetic information to prevent the development of MS in genetically altered mice, a finding that suggests that a gene-based vaccine may be a possibility for multiple sclerosis in the not-too-distant future.

Included among the many possible cures for MS is the use of stem cell transplants. Animal studies have shown promise in using stem cells to replace lost myelin, a protective covering over nerves in the body that is damaged or destroyed by multiple sclerosis.

Multiple sclerosis remains something of a mystery, even as researchers continue to pursue new, more effective, ways to treat the condition and manage symptoms. And in a way, the more researchers know about treating MS, the more they don’t know.

More technologies are needed, argues Thomas P. Leist, MD, PhD, associate professor of neurology, chief of the division of clinical neuroimmunology, and director of the Comprehensive Multiple Sclerosis Center at Thomas Jefferson University in Philadelphia.

“It has been recognized in recent years that there is significant injury in the gray matter structures of the brain,” he explains. But, says Dr. Leist, imaging technologies don’t tell physicians much about that damage. Better imaging technologies, tests to determine which treatment works best, and a deeper understanding of what causes multiple sclerosis in different people are necessary to move toward an MS cure.

“I think MS is a syndrome. I don’t think that everybody with MS has MS for the same reasons,” he says. And he waits, with hope, as do patients all over the country, for a critical mass of information that can explain MS and point toward a cure.

SOURCE: EVERYDAY HEALTH