2023-05-05 11:50:45
“Smouldering MS” is a term that is appearing more and more frequently, especially in the English-speaking media. A new form of multiple sclerosis perhaps? No, “smouldering” means “smouldering” and in fact the technical term “they will advance” naturalized.
However, “smoldering” provides a very fitting picture for this proportion of MS. Unlike one thrustwhich can be viewed as a rapidly erupting fire that dies out, i.e. the entigniteing part of MS, the progressive or just smoldering part of MS works largely in secret. It’s there, and it does do lasting damage, but it’s harder to detect. At least on conventional MRI images. Even more difficult, however, is the smoldering MS to treat.
Persistent smoldering in the central nervous system: smoldering MS
However, MS sufferers are aware of this part of their MS: the symptoms and possible disabilities slowly, over time, increase. Not like an attack, where nothing happened yesterday and clear symptoms can be felt today. And: The damage usually remains.
Nevertheless: The smoldering MS is initially a conceptual concept, although scientific work such as that of Dr. Martina Absinta ea suggest that the theory is also proven. The American researchers have discovered metal frames around old lesions in MS patients using particularly high-resolution MRI machines.
These lesions do not get smaller over time, nor do they stay the same size, but grow very gradually. The metal ring around them is characteristic. They are referred to as chronic active lesions. The number of such metal-coated lesions seems to correlate with the existence of smoldering MS, i.e. with the gradual progression of disabilities, possibly aggressive MS.
Drugs once morest progressive/ smoldering MS
So far, however, these special MRI recordings have only been made as part of studies. You don’t (unfortunately) need it to diagnose progressive MS: Patients who notice a gradual increase in symptoms in themselves are affected by insidious or smoldering MS.
The smoldering MS often increases in the course of the disease, more in some cases, less in others; however, it is usually present from the start. Most immunomodulatory agents also have an impact (albeit limited) on the smoldering/progressive portion of MS. Above all, they stop the inflammatory part of the disease: Fewer flare-ups also mean fewer permanent disabilities.
To have a therapeutic effect on the inflammatory part of MS is already very successful today. The smoldering MS is less easy to influence. To be able to treat them specifically and effectively with active ingredients, researchers around the world are working on this in an interdisciplinary manner and with combined forces. For example, the Progressive MS Alliance was founded to pool resources and knowledge (Prof. Alan Thompson reports on this in the AMSEL video interview). As things stand today, BTKi, the next large class of active ingredients that will probably be approved in the coming years, might also improve the treatment of smoldering or progressive MS.
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