During the 1960s, scientific research into the cause of MS came to focus on two main lines of inquiry that are still being explored today.
The first emerged from analysis of the immune system. White blood cells that react against myelin, specifically against a component called myelin basic protein, were discovered in both EAE and human MS. This led scientists to consider the possibility that MS involves a direct immune-system attack on myelin.
The second idea came from studies that showed that people with MS have altered antibodies against viruses. This revived the older thinking that MS could be caused by a virus. But rather than a viral infection directly damaging the central nervous system, viruses involved in MS were now thought to alter the immune system and trigger it to damage myelin.
These two ideas remain closely mingled today: MS may combine features of both an infectious and an autoimmune disease. The treatments that were later developed for MS all targeted either an infectious or an immune mechanism.
In 1978, the first CAT (Computed Axial Tomography) scans were performed on people with MS. And, in 1979, a Nobel Prize was awarded for development of this powerful new tool. CAT scans use a computer to link a circular array of x-ray images to create detailed pictures of the human brain.
The diagnosis of MS was further improved with the introduction of brain wave tests called “evoked potentials” which measure nerve conduction throughout the optic nerves, brain and spinal cord and often detect hidden areas of scarring and damage.
Scientific research began to yield direct therapeutic dividends as well. Steroids to suppress immune activity were now widely used to treat MS attacks, and the first small studies were performed using interferons (substances that modulate the immune system). The first studies of beta interferon for MS began at the end of the 1970s.
In 1970, scientists studying EAE in lab animals suspected that some myelin protein fragments prevented the disease and actually seemed to protect the animals. Spurred by this finding, they synthesized a mix of protein fragments and used it to treat first animals with EAE and then humans with MS. The product was named copolymer1 and is today an approved disease-modifying therapy under the new name glatiramer, or Copaxone®.
Scientists began to understand in more detail how white blood cells are activated by foreign substances to mount attacks. One activating trigger can be a virus. Scientists also learned that parts of some viruses look so much like normal human tissue that white blood cells will inadvertently attack that tissue when they attack the virus. This is yet another mechanism by which viral infections could lead indirectly to destruction of myelin—when immune attacks on myelin-like viruses spill over onto the myelin itself.
At about the same time, the white blood cell type that causes the actual damage to myelin in MS was finally identified. It is the macrophage (or “Big Eater” in Greek).
The first studies of identical and fraternal twins begun in this decade extended knowledge about the genetics of MS. The twin of a person with MS often does not develop the disease, proving that genes determine only part of the MS risk, though their influence is important. Meanwhile, psychosocial and mental-health issues, as well as the cognitive changes that can be caused by MS, began receiving long overdue research attention.
CAT scanning technology was refined to produce the MRI (Magnetic Resonance Imaging) scan, which shows the brain in greater detail. The first MRI scans of people with MS were performed in 1981 by Dr. I R Young, in England.
By 1984, it became apparent that MRI could actually see MS attacks within the brain, including many which did not cause any symptoms. By 1988 sequential MRI scans changed the entire concept of MS by showing that it is a constant, ongoing disease even though relapses with symptoms may appear only sporadically.
The 1980s may legitimately be called the “treatment decade” in MS. There was an explosion of new drug trials. Guided by the National MS Society, scientists reached a consensus on the design and conduct of research for new treatments, and dozens of different therapies were tested in attempts to control or cure MS. Major clinical trials conducted during this decade finally found the first drugs in history shown to affect the course of this disease.
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