Physical activity and the odds of developing MND

Physical activity has always been at the forefront of factors associated with MND, but studies investigating its effect have often been conflicting. The reason why we might see contrasting results is often due to different cohorts and numbers of people included in the study, the method by which the data was collected, or the types of questions asked and the way they were presented. Increased number of studies on the same topic might then improve the way these are conducted in the future and provide more reliable conclusions.

The most recent multi-centre study that included over 1,500 people with MND and nearly 3,000 control participants was conducted by the Euro-MOTOR consortium under the leadership of Prof Leonard van den Berg. Today (24 April), the group published a paper on their findings in the Journal of Neurology, Neurosurgery and Psychiatry . The study collected data using thorough questionnaires, presented to Dutch, Irish and Italian participants either face-to-face or on paper, asking about their exposure to smoking, alcohol, and the type and amount of physical activity throughout their lifetime – both occupational and leisure. A score was then assigned to each person based on the amount of energy expenditure each activity requires – this is called metabolic equivalent of task (MET).Read More »

Why we need biomarkers

Yesterday’s announcement by the biotechnology company Trophos SA of the lack of effectiveness of their compound olesoxime adds to the long list of drugs that have failed to live up to their early promise in the lab.

It’s a story that’s common across the world of neurodegenerative disease, including common conditions such as Parkinson’s disease and Alzheimer’s disease. The path from bench to bedside is fraught with pitfalls….

In their press release, Trophos suggested that trials have to be conducted when the ‘window of opportunity’ is greatest – the sooner a drug is administered the better its effect is likely to be. Otherwise, we don’t know whether these treatments genuinely do not work or is it simply a case of ‘too little, too late’?

Certainly, companies such as Biogen Idec have picked up on this, restricting the time limit for inclusion in their trial of dexpramipexole to two years from symptom onset, as opposed to the three year (and sometime longer) limit that has been used in previous trials. It means that Biogen Idec has to involve more local MND clinics to recruit the numbers needed, for the trial, which increases the cost, but they view this as necessary if they are to increase the chances of a positive result.

Similarly, the way MND manifests and progresses can be so different in one individual compared to the next, meaning that trials need to recruit large numbers of participants to reduce the statistical ‘noise’ – once again increasing the already high cost and complexity of the trial.

We will only make major inroads into earlier diagnosis and more accurate predictions of how the disease will progress if we can identify biomarkers – specific biochemical and/or structural changes that occur within the brain and spinal cord that provide us with a unique ‘fingerprint’ of MND. 

Biomarkers can also be tailored to look at the effects of specific drugs in trials. Even if it is unclear whether a drug is working on the ‘outside’ (on muscle function for example) it would at least be possible to confirm it was working on the ‘inside’ by reaching the right parts of the brain and spine and acting on the correct chemical processes.

In a nutshell, biomarkers would likely lead to smaller, faster and more accurate trials. That would mean trials could be performed more cheaply – and cheaper trials would almost certainly mean more trials.

This is why the MND Association sees biomarker research as so important. We are currently supporting three clinical biomarker projects (in London, Oxford and Sheffield) which are among the most comprehensive examples of this research in the world. Without the commitment and enthusiasm of those who participate, we wouldn’t be able to create these vital research resources which, as highlighted in previous postings, are beginning to generate promising early results.

But these projects are just the start. Their findings will need to be confirmed in much larger studies, involving the collaboration of MND clinics across many countries, collecting clinical data and samples to precise scientific protocols. This was the rationale behind a major biomarker funding initiative announced earlier this year under the European Union Joint Programme in Neurodegenerative Diseases (JPND). Established by 23 European countries, the JPND Research Call invited funding bids to assist the harmonisation of biomarker collections and the development of new methods of analysing the samples.

On Friday, JPND announced the four projects shortlisted on the basis of “scientific excellence” for a share of the €15 million (approx £12.6 million) research fund. One of these projects is SOPHIA (Sampling and biomarker OPtimisation and Harmonisation In ALS).

Co-ordinated by Prof Leonard van den Berg, the SOPHIA initiative will span up to 16 centres across 12 European countries, including the MND Association’s Sheffield and Oxford Care Centres. The precise level of funding has not yet been determined, but nonetheless this provides a fantastic platform on which major international biomarker research can be developed. We will of course keep you posted once the final outcome is known.

Stem cell conference part one: It begins…

It was a chilly -15oC in New York on Sunday night, but the temperature on Monday morning was considerably higher – fuelled in part by anticipation of the presentations and debate to come – as 60 delegates from 14 countries gathered for a workshop on the use of stem cells in research and treatment of ALS/MND.

As many of the leading names in the field started filing into the meeting room, I found myself thinking (rather morbidly) that if the hotel blew up, research in this field would be set back a decade…

Learning from the past to push stem cell research forward
The opening session was motivating, with Dutch neurologist Prof Leonard van den Berg and MND Association funded researcher Prof Chris Shaw providing overviews of our current understanding of the causes of MND and the clinical and pathological ‘spectrum’ of the disease.

A lot of Prof Shaw’s presentation focused on the TDP-43 protein, which is a ‘pathological hallmark’ of dying motor neurones. It struck me that scientists understanding of TDP-43 appears to be accumulating faster than it did for SOD1, 15 years ago – a consequence of the advances in technology and the fact that there are many more researchers around the world working on MND these days.

Dr Lucie Bruijn, science director of our counterpart organisation in the USA –the ALS Association, concluded the opening session with a scene-setting presentation, highlighting the work that has been done over many years in developing motor neurone cell cultures (from mice and rats) and using these to screen for potential protective drugs.

There have been many challenges every step of the way, but the learning from these past studies will be vital in moving stem cell research forward in the future.

In the next few blog posts, I will take you on a whistle stop tour of the questions asked by 60 of the world’s leading MND stem cell researchers at the stem cell workshop and the answers we were met with so stay tuned…

Please also read our press release on our website  for more information on how we are helping to shape the future of stem cell research.