Lesions May Explain MS Treatment Response

Some patients do well with blood-based therapy, while others do not, study finds

THURSDAY, Aug. 11, 2005 (HealthDay News) -- Key differences in lesion types between multiple sclerosis (MS) patients can determine whether a therapy called plasma exchange will work in fighting the debilitating disease, researchers report.

Only multiple sclerosis patients with evidence of antibody deposition or "complement activation" -- immune cell activity that can cause tissue destruction -- in their MS lesions are likely to respond to plasma exchange treatment for acute attacks, concludes a Mayo Clinic study in the Aug. 13 issue of The Lancet.

This study provides the first evidence that differences in MS patients' lesion types may predict patient response to treatment.

Plasma exchange treatment involves removal of the patient's blood. Blood cells are separated from the fluid plasma and then mixed with replacement plasma. The blood is then returned to the patient. This treatment for severe MS attacks is used when standard corticosteroid drug therapy fails. Plasma exchange does not prevent future attacks or restore neurological function that's been lost for more than three months.

The Mayo study of 19 MS patients found that the type of lesions they had influenced their response to plasma exchange.

"The new findings may partly explain why some patients respond to particular treatment and others do not," study senior author and neurologist Dr. Claudia Lucchinetti said in a prepared statement.

"The biological basis for the variable response to current MS treatments is not well understood," she added. "It may be that not all MS patients form lesions in the same way and therefore would not be expected to respond to a given treatment the same. Thus, MS treatments may need to be more individualized and tailored for different types of patients."

More information

The American Medical Association has more about MS.

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