Dr Barry Singer discusses latest research trends including genetic risks

<p >Have you noticed any strong trendsemerging in research in MSParis2017? Well I just came out ofsessions on a couple of hot topics one is genetics and environmental factors.</p><p >So weknow that some people have with MS there&#39;s a genetic background it makesyou more susceptible to MS now most people don&#39;t have a family history of MS.</p><p >The risk of passing it on to a daughter is only 5% and son is 1% to 3% butthere&#39;s a genetic background but the genetic background also is amplifiedwith certain environmental exposures such as smoking.</p><p >So if you have a certaingenetic background and you smoke you can go up over 12 times increased risk ofgetting MS.</p><p >So if you have a certain genetic background and you&#39;re exposed toepsteinbarr virus that increases your risk of getting MS so it&#39;s combinationof that your genetic background and environmental.</p><p >Childhood obesityunfortunately increases adolescent obesity which increases the risk of developingMS and low vitamin D which is a huge issue so we definitely look at thattrying to reduce the risk.</p><p >So again it&#39;s a combination.</p><p >Another hot topic that Ijust came out of is pregnancy.</p><p >So it&#39;s a big concern with MS you knowmost doctors there&#39;s some different approaches some people continue on thedisease modifying therapies until they get pregnant, other doctors and depending on the drug would stop it while you try to conceive.</p><p >In the US that&#39;s kind of my approach, we stop the medication while you&#39;retrying to conceive to prevent that risk for fetal harm but then there&#39;s a riskof relapsing, and then during pregnancy relapse risk goes downthen it can go back up right after you deliver.</p><p >We were chatting about how yourimmune system gets a bit of a boost when you&#39;re pregnant it&#39;s like it leaves youalone whilst you&#39;re pregnant.</p><p >Well, you have something in your body that&#39;sonly half genetically like you so it&#39;s so you have to be tolerant to it, your immune system dampens down but then it can come raging back.</p><p >So there&#39;s data beingpresented about safety for example I just came out of session with Natalizumab or Tysabri and like when you know could you continue it and what&#39;sthe safety look like if you stayed on it during pregnancy.</p><p >It looked pretty goodin terms of safety during pregnancy but after 30 weeks there could be someblood count abnormalities for the fetus temporary, transiently if you were stillon it past 30 weeks of the pregnancy so and then we saw some favorable safetydata for getting pregnant on Aubagio which has had some warnings aboutpregnancy and the data looked pretty good for those people that accidentallydid get pregnant on Aubagio.</p><p >So again it&#39;s very important so that people can makethe right decisions for themselves.</p><p >I think for me coming here it&#39;s crucialthat people talk about it and make it aware but I mean it might be a topicthey don&#39;t want to talk about because you know pregnancy and MS it&#39;s theyget upset but it&#39;s so essential to talk about it and ask the right questions.</p><p >It really is and you know frankly we&#39;re we&#39;re in this 25 years of treatment andwe still don&#39;t know about frankly a lot of these some of the drugs interferonsdon&#39;t even get into the breast milk because the molecule is too big so whyis it not safe you know to nurse? And we don&#39;t have these answersand we need to get the answers so again.</p><p >Chop chop, get on it! Advocacy is important to, youknow, to get those issues pushed forward.</p><p >It really is.</p>

Source: Youtube