IMMUNE RECONSTITUTION THERAPY FOR MULTIPLE SCLEROSIS

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IMMUNE RECONSTITUTION THERAPY FOR MULTIPLE SCLEROSIS

In the past decade, neuroscientists and immunologists have dedicated substantial research efforts to developing disease-modifying treatments (DMTs) for Multiple Sclerosis (MS). Patients often inquire about these new drugs, having read about them or received recommendations from other neurologists (https://www.topneurologistdubai.com/).

DMTs employ various immuno-modulatory and suppressing mechanisms, with differing intensities. Some therapies, such as Alemtuzumab, Cladribine, or Hematopoietic Stem Cell Transplant (HSCT), cause long-term depletion of crucial immune system components like B-cells derived from bone marrow.

Conventional MS medications, administered periodically or daily, offer temporary relief with short-lived effects. In contrast, Immune Reconstitution Therapy involves short courses in a pulsed manner, leading to brief drug presence but long-lasting clinical and MRI (Magnetic Resonance Imaging) benefits. It resembles a 'rebooting' of the immune system that erroneously attacks the nervous system.

Currently available Immune Reconstitution Therapies include Alemtuzumab, Ocrelizumab, Ofatumumab, Cladribine, and Hematopoietic Stem Cell Transplant (HSCT).

Long-term studies show promising results, with Alemtuzumab and Cladribine demonstrating a disease-free state (No Evidence of Disease Activity - NEDA) after 2 years, persisting up to 5 years, and HSCT showing NEDA in 70% to 85% of patients after 2 years.

In summary, Immune Reconstitution Therapies appear more effective than conventional medications like Fingolimod, Dimethyl Fumarate, Teriflunomide, and Interferons. However, these innovative therapies induce prolonged alterations to the immune system, raising concerns about potential devastating effects on the body's defense against pathogens and healing processes, including those related to diseases like cancer. The term 'reconstitution' might be misleading, as these drugs primarily 'deplete' rather than 'replete' the immune system.

The immune system comprises T-cells, B-cells, and various chemical immune-transmitters. MS, being an autoimmune disease, prompts the idea that temporarily destroying and rebuilding the immune system might halt the disease. The pivotal factor is the reversibility of this process. If such manipulation proves irreversible, it poses significant risks.

Developing these drugs involves substantial costs, and pharmaceutical manufacturers invest in extensive marketing campaigns. While the appeal of convenient therapies like swallowing pills or receiving infusions is strong, a careful evaluation of potential deleterious and irreversible effects on the immune system is crucial when choosing an appropriate therapy for MS. MS is not the sole potential health concern, and preserving the integrity of the immune system is vital for overall health.

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