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Scientific Discovery and the Future of Medicine
May 7, 2020

Progress in Multiple Sclerosis Research: An Example of Bedside to Bench

Author Affiliations
  • 1UCSF Weill Institute for Neurosciences and Department of Neurology, University of California, San Francisco
JAMA. 2020;324(9):841-842. doi:10.1001/jama.2020.1522

A common perception among physicians is that new medical knowledge usually moves from “bench to bedside,” that is, from laboratory experiments to clinical care. However, in many instances progress has occurred in the other direction, from bedside to bench, beginning with clinical observations. This has been the case for multiple sclerosis (MS), one of the important success stories of modern molecular medicine.

The development of highly effective B cell therapeutics for MS has produced substantial gains for patients with MS, many of whom can now reasonably expect lives free from disability, and has fundamentally reshaped the understanding of pathogenesis of an autoimmune disease that affects nearly 1 million individuals in the US.1 Multiple sclerosis is a demyelinating disease of the central nervous system (CNS) consisting of 2 distinct but overlapping components, early relapses mediated by inflammation, and late progression due to neurodegeneration.

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    1 Comment for this article
    Multiple Sclerosis: Therapy versus Cause
    Gary Ordog, MD, DABMT, DABEM | County of Los Angeles, Department of Health Services (retired)
    I applaud the author for finding an improved disease-modifying therapy (DMT) for multiple sclerosis. I disagree with many authors that T- and/or B- cells are the the "cause" of MS. They are but a part of the pathogenesis of this disease, and are thus not the "cure." This is evidenced by the temporal increases of both incidence and prevalence of MS over the last two centuries, despite all of the DMT development. The "cure" will depend upon dealing better with the "cause." When the "cause" is dealt with adequately, then I expect the incidence and prevalence of MS to decrease. Thank you.