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Exploradio: MS - Cause and cure unknown
People are living longer and better with MS, but finding a cure or even a cause of the disease remains elusive
by WKSU's JEFF ST. CLAIR
This story is part of a special series.


Reporter / Host
Jeff St. Clair
 
Dr. Daniel Ontaneda is a researcher at the Mellen Center at the Cleveland Clinic. He's developing advanced techniques for early detection of MS, and studying the role of Vitamin D in treating the auto-immune disease.
Courtesy of Robert Sustersic
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Multiple sclerosis affects 20,000 Ohioans, and 400,000 people nationwide.  There is no known cause or cure for MS, but researchers in Northeast Ohio are making progress on both fronts. 

In this week’s Exploradio, WKSU’s Jeff St.Clair looks at the roles of stem-cells and sunshine in our struggles against MS.

Exploradio: MS cause and cure unknown

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The Cleveland Clinic's Mellen Center for MS research has two MRI machines.  The imaging technology can detect lesions inside the brain of an MS patient.  A larger, more sensitive MRI scanner will arrive in January.
The Mellen Center at the Cleveland Clinic specializes in care of MS patients.  More than 20,000 Ohioans have MS.
Dr. Jeffrey Cohen is testing a new stem-cell treatment for MS.  He says the results so far have been encouraging, all 18 people in the phase I study have seen improvements with the stem-cell therapy.
Patty Rancourt is a nurse in the infusion room at the Mellen Center.  Patients here are given monthly stem-cell therapy as part of an experimental treatment for MS.
The stem-cell therapy requires patients to sit in these chairs to receive specially grown cells taken from their bone marrow.
Construction is underway at the Mellen Center, making way for the new MRI scanner.  The powerful 7 Tesla magnet of the new MRI machine is a first for Ohio.  The high-res instrument will arrive in January.
Patti Blake is a nurse at the Oak Clinic in Uniontown.  She says today's MS patients have several treatment options that were unavailable when MS struck her 30 years ago.

From untreatable to manageable
The Oak Clinic in Uniontown was designed specifically for people like head nurse Patti Blake.  A bout of multiple sclerosis left her wheelchair bound 30 years ago.  

She recalls the day that her life as a young nursing student suddenly changed, “I went from walking to not walking.  I had a major MS exacerbation, I lost all feeling below the waist, I lost all function below the waist; I went partially blind in one eye.”

Her doctor told her to quit school, go home, get on disability… there was no treatment.  But Blake ignored the doctor’s advice.  She finished school and a decade ago helped found the Oak Clinic, one of a handful of independent charities nationwide dedicated solely to treating MS.

Blake says great strides in treating MS have been made since it struck her three decades ago.  Doctors now have an arsenal of drugs to delay the symptoms and advanced diagnostic techniques to catch it before a crisis hits.

Doctors at the Cleveland Clinic’s Mellen Center detect the first signs of the disease with advanced MRI scanning.  Dr. Daniel Ontaneda points to an MRI scan of a patient’s brain, “this spot here, this is an MS lesion.”

The vitamin D link
MS attacks nerve cells in the brain and spinal cord.  Like stripping the insulation off an electrical wire, in MS, the body’s own defenses strip nerve cells of their protective sheath.  It’s an auto-immune disease that leaves people with everything from numbness to total paralysis. 

The cause remains a mystery, but Ontaneda is studying one important clue. 

“People in northern hemispheres tend to have more MS,  and the higher you go up in latitude, the more and more MS you find.”

He says MS is rare near the equator, but common in Canada.  That’s because sunshine creates vitamin D in your body, and Ontaneda says a vitamin D deficiency is linked to MS. 

But mega-dosing patients with vitamin D has shown mixed results. 

“It remains to be seen if vitamin D has an effect on neuro-degeneration itself, I think it does based on the gray matter data from several cohort studies, but we still have to prove that.”

Stem-cell therapy 
In another part of the Mellen Center, Dr. Jeffrey Cohen is enlisting people’s own healing arsenal to fight MS.  His secret weapon is a rare cell found inside our bones.  Cohen says mesenchymal stem cells comprise half of a percent of the cells inside the bone marrow, the rest are the cells that give rise to the blood cells.  

Cohen and his team developed a technique to harvest these stem cells, and grow them. He then injects them back into the body, and -- like the miniature aquanauts in 1960’s movie “The Fantastic Voyage,” Cohen’s mesenchymal cells find their way to the brain, make repairs, and reduce the inflammation of MS.

He says the theraputic action of the mesenchymal stem-cells seem almost, "too good to be true."  Cohen says they’re probably analogous to a cell that’s been known to pathologists for many years called pericytes that sit outside the blood vessels in the tissues in virtually all parts of the body.

His theory is that mesenchymal stem-cell trigger the pericytes to send out growth factors to heal the damaged nerve cells.  Cohen has tested only 18 people in the first phase of the study, but says the results are encouraging.  

Still, even if it works as well as expected, it could be 5 to 10 years before stem-cell therapy will be widely available.

Patti Blake, at Uniontown’s Oak Clinic, sees the progress made in one of her patients who is part of Cohen’s study.  She says the hope of a cure, and identifying a cause of MS, keeps her going, and new medications and diagnoses make it so that today's MS patients, "don’t have to suffer like we did.”

Every hour, another person in the U.S. is diagnosed with MS.  As the research advocate for the Ohio Chapter of the National MS Society, that’s a clock that Blake would like to see wind down.

 
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