Predicting MS in children
new findings have recently been published by Dr Fabienne Brilot-Turville and
Associate Professor Russell Dale, from the University of Sydney and the
Children’s Hospital at Westmead, in the largest ever followup study of
Australian children after a first episode of demyelination.
MS is considered uncommon, however, it is thought that up to 10% of people with
MS either experience their first symptoms or receive a diagnosis in childhood.
Demyelination in children can be caused by a number of different conditions,
and only a small proportion may turn out to be MS. Therefore, being able to
predict which children with demyelination will develop MS, or another form of
inflammatory brain disease is crucial to allow early treatment decisions.
MS Research Australia with the support of the Melbourne MS Angels and initial
seed funding from the Trish MS Research Foundation, Dr Brilot-Turville and
Associate Professor Dale followed 73 children in New South Wales after their
first episode of demyelination.
was to study these children for as long as possible, on average around five
years, to see how many of them would experience repeated demyelination and
progress to a full diagnosis of MS. To date, 14% of the children in the study
have been diagnosed with MS.
researchers studied the immune systems of the children following their first
episode of demyelination in order to identify differences in immune system
molecules in children who go on to a diagnosis of MS, compared to those
children who do not. This project provides a crucial step towards identifying
those children who may benefit from early therapy to target their immune systems
and prevent further disease progression.
Brilot-Turville and colleagues have published new evidence in the prestigious
journal Neurology: Neuroimmunology & Neuroinflammation. They assessed
the levels of antibodies that are known to target components of the myelin
sheath, in particular a protein known as myelin oligodendrocyte glycoprotein
(MOG), within blood serum. Children with antibodies against MOG were much more
likely to be diagnosed with MS within five years. However, the team also
identified that a second subgroup of children with the highest levels of
anti-MOG antibodies were not diagnosed with MS, but instead may represent a
previously unreported form of demyelinating syndrome. In order to then explore
the mechanisms by which the immune system could cause myelin damage, the team
examined whether these anti-MOG antibodies were associated with structural
changes in cells producing white matter in the brain, and found a loss of the
normal skeleton supporting each cell’s structure. These findings have exciting
implications for our understanding of the molecules that may cause
demyelination in the brain.
project has achieved remarkable recognition, resulting in six publications so
far. These studies are important both for early identification of those
children who may be at risk of progressing to MS and predicting future
prognosis after an initial episode of demyelination.