By the UBC hospital, there is a shiny new building with a giant web of white neurons painted onto its glass surface. This is the Djavad Mowafaghian Centre for Brain Health, home to UBC and VCH's Multiple Sclerosis and Neuromyelitis Optica clinics. A global leader in innovative research, this clinic brings a diverse, multidisciplinary team together with patients in an effort to redefine MS research and treatment — and it’s paying off.
“One of our main goals here is to be involved in clinical trial type research,” said Anthony Traboulsee, a neurologist and director of the MS and NMO clinics. “That gives our patients a first chance to try new medication[s] that might be very helpful for their MS … roughly 10 years before they’re on the market”.
The latest clinical trial they were involved with was the OPERA study, testing a drug called ocrelizumab for MS patients. The trial involved about 1,000 patients at 200 different clinics around the world during its final stage before being sent to health authorities for approval. While the average clinic might have had five patients participating, the UBC clinic had 59.
“The general feeling that I get from patients is that they’re excited to be part of the solution,” Traboulsee said. “I think part of the reason they feel that way is because we try to create a real strong team spirit here. It’s a partnership between the patients, the doctors, the nurses, the researchers and the students. We’re all working together, as opposed to the old school way where it’s the doctor telling everyone what to do.”
Multiple sclerosis is an autoimmune disease that affects the central nervous system, damaging the protective myelin coverings around nerves. Canada has the highest rate of MS in the world and it is theorized that the disease could be linked to vitamin D deficiency.
To monitor the effects of MS treatments on the nervous system, the clinic places an emphasis on MRI techniques. MRI is an important tool in this field as it allows researchers to visualize the scars produced by the disease in unsuspected regions of the brain where there aren’t any symptoms. It gives researchers more data on how damaged the brain is and helps them keep track of new scar formation.
“Without any medication, the average MS person gets four new scars a year. On an average medication, a person might get one to two new scars a year. On the latest medication — the OPERA medication — a patient would get zero new scars a year. So it completely shuts down that process,” said Traboulsee.
In addition to working towards a cure for MS, it is also the only clinic in Canada that treats neuromyelitis optica, another less common autoimmune disease that used to be misdiagnosed as MS. This disease attacks the central nervous system more severely, causing loss of vision and numbness or weakness in the body. People of Asian ancestry are more prone to NMO, while MS is more common in Caucasians.
Traboulsee was part of a recent publication defining the new diagnostic criteria for NMO. This redefinition was spurred by a revolutionary blood test developed around 10 years ago that allowed researchers to realize that more people had the disease than previously thought.
“It’s incredible how complex our immune system is and we only know part of it. So whoever can figure out one autoimmune disease [and] what caused it ... [that’s] a Nobel Prize. It would be the key to understanding all autoimmune diseases. There’s a good challenge for your classmates.”
Looking to the future of the clinic, Traboulsee said he is most excited about meeting the many newcomers who have trained here at UBC in fields such as physics, computer science, experimental medicine and psychology.
The clinic has started a new program that gets volunteer students researchers involved in the consenting process, which happens when patients are invited to participate in the research.
“By meeting the community, they’re doing research for, as opposed to research on. They get inspired as to why they’re doing the research,” Traboulsee explained.
Clinic is very hopeful that their integrative approach is having a positive effect. MRI has enabled them to see signs of repair or remyelination for the first time and some of the new treatments that have been developed have been very successful in improving the lives of those living with MS.
“We’re really enthused about where the future is going with MS. It’s a time of hope and achievement.”