Abnormalities in normal appearing tissues in PPMS

Art, Thanks for this post. Only 20 months ago at the time of my dx I was told that MS was a disease of myelin (the white matter in the CNS). It was an auto-immune disease where the immune system attacks the myelin etc. Research published in the last six months or so has suggested that MS is a global disease of the CNS involving white matter and grey matter. The research you have posted is another example. It is also an example of 'observation' rather than what we really need - an explantion of why it is happening. MS is like a bad onion, every time another layer is peeled back, it becomes much worse than originally thought. But still no explantion of why it is happening. Until this is known then there is little chance of any real progress. The recent research findings may also explain why the current disease modifying drugs are so ineffective. Unfortunately, most drugs in the pipline are focused on suppressing the immune system and there is still no real evidence that this has any real long term benefits or affects the underlying cause of the disease. In many ways the Campath 1-H trials showed this. For those with SP the drug stopped inflammation / attacks, but despite this, the report noted that there was still 'unrelenting cerebral atrophy'. The findings from the research also raises questions about the value of the current research into stem cells to replace myelin (being undertaken in the UK, Canada etc). This to me looks like papering over the cracks if the problem is wider than the white matter (myelin). It doesn't take a genius to work out that something (virus, bacteria etc) is slowly killing the nerve cells in the brain, spinal cord and optic nerves. As one would expect, the immune system gets involved as it attempts to mop up the damage and may cause more damage (or might help if it keeps some nerve cells alive). I have no medical or scientific training but we have been failed big time with an obsession about MS being an auto-immune disease. One of the top UK MS specialists told me that all diseases are auto-immune - until the virus or bacteria is identified. It's about time the so called MS experts identified the culprit. Relapse rates, numbers of lesions etc are easy to measure and that's why the so called experts have sought to measure these. The difficult question of why has still to be addressed. There is currently no therapies which can halt this disease - there are some individuals who have seen benefits from some treatments e.g. Campath, Tovaxin etc, but these are not cures by any extent. Every week another pharma company announces another drug in trial but I guarantee it will focus on inflammation / the immune system (rather than the real underlying disease). Apologies for being so negative so early in the New Year Art, but some day someone might work out that the myelin / auto-immune theory has had its day. Thankfully the ACP is leading the way on this, it's just a pity that the experts can't see the wood for the trees. Unfortunately, the auto-immune / inflammation theory is where the money is.