Four things research into other autoimmune conditions has taught us about MS
Autoimmune conditions happen when our immune system mistakenly attacks our own cells. There are more than 100 autoimmune conditions and having one increases your likelihood of developing another. This is because they share a lot of the same underlying biology.
This Autoimmune Awareness Month, we take a look at four areas where research into other autoimmune conditions has transformed our understanding of MS.
1. Identifying lifestyle and environmental risk factors
MS is likely caused by a combination of factors, including lifestyle, environment, and genetics. For decades, we’ve known there’s a link between Epstein Barr Virus (EBV) and several autoimmune conditions, including MS, lupus and rheumatoid arthritis.
Lupus researchers helped us connect the dots with a concept called ‘molecular mimicry’. They found that the immune cells that were meant to attack the EBV were mistakenly attacking similar-looking proteins in the body. MS researchers then searched for something similar and discovered that part of the EBV looks very similar to a protein found in myelin. This revealed a possible way that EBV could trigger MS.
We’re currently funding studies investigating how EBV can trigger MS, and whether immune cells behave differently towards EBV in people with MS.
2. Understanding genetic risk factors
There’s no single gene that causes MS, but there are various genes we know can increase someone’s risk. Researchers have studied the genes of people with autoimmune conditions, including MS, type 1 diabetes and rheumatoid arthritis, and spotted changes in a specific gene called HLA-DRB1.
This gene helps our immune system to decide whether a cell belongs to the body or is a foreign invader. By studying these genetic changes in other autoimmune conditions, researchers were able to identify a specific change in the HLA-DRB1 gene that's now recognised as the main genetic risk factor for MS.
We've funded research to look at the genes of people with MS from non-European ancestries, so we can get a better understanding of MS risk factors for everyone. Recent results from the study confirmed that HLA-DRB1 is a universal risk factor, regardless of a person’s ancestral background.
3. Understanding immune biology
Genes are just part of the story. To understand more about MS and how we can treat it, we need to know exactly what goes wrong in the immune system.
The immune system is made up of many different types of cells. T cells kill infected cells. And B cells produce the tags that help identify harmful invaders and remember infections the immune system has seen before.
For years, we thought MS was driven mostly by T cells. But research in lupus showed that B cells were key drivers of damage. This prompted researchers to investigate whether the same could be true in MS. They discovered that B cells can activate T cells, summoning them into the brain to attack myelin. This revelation led researchers to test drugs that target B cells, which have revolutionised the treatment of both relapsing and primary progressive MS.
We know that a special group of T cells called follicular regulatory T (Tfr) cells are responsible for keeping the other T cells and B cells in check. There’s some evidence these Tfrs don’t work properly in MS, which could explain why T and B cells become overactive. We’re funding researchers to investigate why this happens.
4. Pioneering treatments
Chimeric antigen receptor (CAR)-T cell therapy is a cutting-edge type of immunotherapy initially developed as a cancer treatment. It’s designed to ‘reset’ the immune system.
It involves collecting a person’s T cells and reprogramming them, in this case to target and wipe out the faulty B cells. After promising results in trials in people with lupus, this approach is now being tested in people with MS.
We still have more to learn
We’re proud to be part of the Connect Immune partnership. This is a growing partnership of 16 UK organisations working together to accelerate the progress and impact of autoimmune research. Together, we’re working to understand the links between these conditions and find better treatments, faster.
Read more about some of the research we've supported as part of this partnership
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