Genetic variant linked to faster multiple sclerosis progression

A study of 22,000 MS patients reveals a genetic variant linked to faster disease progression.

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A genetic mutation related to the faster progression of the disease, an accumulation of disability that can strip patients of their mobility and independence over time, was discovered in a study of almost 22,000 persons with multiple sclerosis (MS).

The study, published in Nature on June 28, is the first to find a genetic mutation that enhances disease severity, which the scientists say is a significant step towards understanding and eventually fighting this progressive type of MS.

Multiple sclerosis starts as an inflammatory illness in which the immune system attacks the brain and spinal cord, causing symptom flares known as relapses and longer-term damage known as progression.

Despite developing effective treatments for the inflammatory autoimmune illness, none can avoid growing disability throughout the disease’s neurodegenerative phase.

Previous research has indicated that an accumulation of disability that can strip patients of their mobility and independence over time was discovered in a study of almost 22,000 persons with multiple sclerosis (MS). Susceptibility, or risk, is significantly caused by an immune system malfunction. Some of this dysfunction can be treated, reducing the disease’s course.

Inheriting this genetic mutation from both parents shortens the time needed for a walking aid by about four years. These risk factors, however, do not explain why, ten years after diagnosis, some MS patients are wheelchair users while others continue to run marathons.

Dr. David Hafler, the William S. and Lois Stiles Edgerly Professor of Neurology and Professor of Immunobiology at Yale School of Medicine, chair of the Department of Neurology, and an author of the study, said, “While we have identified genetic variants that are predominantly immune-related associated with risk of developing MS, this is the first study to identify neuronal genetic variants associated with the neurodegenerative aspects of the disease.”

International Multiple sclerosis is an inflammatory illness in which the immune system attacks the brain and spinal cord, causing symptoms known as relapses. Genetics Consortium (IMSGC), which comprises more than 70 institutions worldwide, collaborated extensively on the project globally. The IMSGC’s co-founder is Hafler.

In the first section of the new study, researchers merged data from more than 12,000 MS patients to conduct a genome-wide association study (GWAS). This research strategy employs statistics to correlate genetic variants to particular behaviors precisely.

The qualities of interest, in this case, were those associated with MS severity, particularly the number of years it took for each person to progress from diagnosis to a particular level of disability.

The researchers looked through more than 7 million genetic variants before identifying one linked to a quicker illness development.

The mutation is located between the genes DYSF and ZNF638, which had no known association with MS. Patients with MS who had two copies of the gene variation, which is close to genes involved in cell damage repair and one involved in viral infection management, progressed their condition more quickly.

They discovered that MS patients who had two copies of the variant gene, which is situated close to two genes that aid in the repair of damaged cells and one that aids in the control of viral infection, progressed their disease more quickly. The placement of the variation raises the possibility of an accelerated progression mechanism.

Baranzini said, “Inheriting this genetic variant from both parents accelerates the time to needing a walking aid by almost four years.”

Adil Harroud, assistant professor of neurology at the Montreal Neurological Institute and lead author of the study, said, “These genes are normally active within the brain and spinal cord, rather than the immune system; our findings suggest that resilience and repair in the nervous system determine the course of MS progression and that we should focus on these parts of human biology for better therapies.”

The research provides the discipline with its first important leads for addressing the MS nervous system component. The researchers looked into the genetics of almost 10,000 more MS patients to corroborate their results.

They discovered that individuals who had two copies of the variation deactivated more quickly. This presents us with a fresh opportunity to create novel medications that might support maintaining the health of all MS patients.

The researchers looked into the genetics of almost 10,000 more MS patients to corroborate their results. Once more, they discovered that individuals having two copies of the variation deteriorated more quickly.

Harroud said, “This gives us a new opportunity to develop new drugs that may help preserve the health of all who suffer from MS.”

This research was partly funded by grants from the Multiple Sclerosis Society of Canada, the European Union’s Horizon 2020 Research and Innovation Funding Programme, and the National Institute of Neurological Disorders and Stroke (a division of the National Institutes of Health).

Journal Reference:

  1. Baranzini, Dr. David Hafler, et al. A locus for severity implicates CNS resilience in the progression of multiple sclerosis. Nature.DOI: 10.1038/s41586-023-06250-x

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