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MS slowly but surely unravels its secrets

Written by DS on in the category Interviews with the tags , , , , , .


Piet Stinissen is Professor and Dean at the Faculty of Medicine and Life Sciences at the University of Hasselt, where he is head of the Immunology and Biochemistry laboratory. He is a biochemist and obtained a PhD in molecular genetics in the lab of Christine Van Broeckhoven (UA). He is chairman of BIOMED (Biomedical Research Institute), a research centre that has about 200 scientists that are active in several domains including neurology and neurosciences. He is active in the field of autoimmune diseases with research on multiple sclerosis (MS) and rheumatoid arthritis (RA). Furthermore, he is the chairman of LifeTechLimburg and a board member of Biomedica.

What are you working on with your research team?
MS is a complicated disease so we address several facets of the condition. We try to understand what goes wrong at the level of the immune system. In patients with MS, we see an uncontrolled immune response of the regulatory T-cells. If autoreactive T-cells arrive in the brain, they cause harm there. What are the mechanisms that cause this damage? And how could we repair this? We found a positive effect of neurokines in animal studies and are now pursuing this pathway further.

We also focus on cholesterol metabolism, as cholesterol is an important building block of myelin. The myelin of MS patients is damaged and this could be due to deregulated cholesterol metabolism. Furthermore, in cooperation with our colleagues, from the VIB and KULeuven, we are trying to unravel the impact of genetic susceptibility. We are attempting to find a link between genetic factors and the immunological phenotype. 

More recently, we expanded our research to look at the effect of movement and rehabilitation during MS. We developed important insights that have been implemented into clinical practice.

How do you diagnose MS?
Both for MS and RA, we found new biomarkers that can be used to monitor the progression of the disease. This research was mainly performed in the lab of Prof. Veerle Somers (BIOMED, UHasselt). She uses immunomics to profile autoantibodies of MS and RA patients. The biomarkers could help to determine what stage the disease is at; whether the patient has early, established or late stage RA. Patients in an advanced stage of the disease should receive a more aggressive treatment than patients who are still in an early stage. An aggressive treatment comes with more undesired side effects, so it should not be imposed if it is not necessary. Right now, these assays are the most developed for RA as diagnostic tests are already on the market for this disease.

How do you get your discoveries on the market?
We team up with a variety of partners in the pharmaceutical as well as in the biotech industry. Development of our biomarkers for RA is being done in cooperation with the American company INOVA diagnostics.  We also collaborate with Janssen Pharmaceutica and have some projects running with a couple of biotech companies. For example we work with with the spin-off Apitope (Diepenbeek), who have a phase II clinical trial for the treatment of MS ongoing.

MS is a heavy diagnosis to bear. How well can it be treated?
A lot has changed and improved over the last twenty years. Medication is available on the market that can slow down the progression of the disease. MS is not a deadly disease, but patients used to end up in a wheel chair 10 to 20 years after diagnosis. Nonetheless the course of the disease can differ substantially between patients, most patients can remain professionally active for a long time. With advances in this field, people are able to remain mobile much longer.

What causes MS?
That is a big question and it is a dream of many researchers to find this out, but the answer is not straightforward. MS is a very complex disease. Genetic susceptibility plays a role and about 30 different genetic factors involved in development of MS are known. However, it does not mean that if you have these factors that you will definitely develop MS. We see a link with certain infections that might trigger the immune system to cause MS. Still, no infection has been found that triggered MS in all patients. It might also be a combination of infections, but we have no hard proof.

Fortunately, it is not necessary to know the exact cause of MS to develop a treatment. We focus on understanding the disease and using that knowledge to interfere with disease progression, this gives us the best chance to succeed. 

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