Areas of Research
Biological Aging, Genetic and Environmental factors in MS
Our neuro-immunology research group is focused on studying the factors that drive disease severity in multiple sclerosis and related diseases. The host matters in autoimmune disease. We have demonstrated that somatic and reproductive aging markers are associated with disability accumulation and brain volume loss. In the youngest of patients with MS, with onset in childhood, we have demonstrated that environmental risk of MS may extend back to the perinatal period. Genetic polymorphisms shape the risk of the disease and we have begun to identify genetic factors that may influence disease outcomes.
Biosensing in Neurology
The common tools of neurology, the reflex hammer and tuning fork, were introduced in 1888 and 1889. Our research team is invested in leveraging modern technology and biosensors to enhance neurological assessments. We envision a 21st century exam with neurological 'vital signs' that can capture function quickly and cheaply in routine clinic visits.
Visual System in Neuroimmunological Disease
The visual system provides an opportune and elegant window into the inflammatory and degenerative aspects of MS. We can identify precise relationships between structural damage and functional outcomes that are difficult to achieve in other aspects of nervous system injury.
Clinical Trials Program
With a commitment to bring new therapies to our patients, we run a clinical trials program for MS and related diseases. Please contact Miryam Palomino or Annalise Miner for up-to-date information on enrolling studies.
International Multiple Sclerosis Microbiome Study
Our neuroimmunology team is participating in the International Multiple Sclerosis Microbiome Study (iMSMS). The cause of Multiple Sclerosis is yet unclear, but it is evident that it includes a combination of genetic factors and environmental factors. One standout environmental factor is the microbiome, or the genetic material of bacteria inside the GI tract. This study aims to understand how the environment influences MS risk, by studying microbiome of MS patients in comparison to their healthy cohabitants. We are collecting stool and blood samples from MS patients and a genetically unrelated healthy counterpart living in the same household (i.e a spouse, roommate or adoptive parent). This study is open for enrollment.
We are working with Johns Hopkins University and the Patient Centered Outcomes Research Institute (PCORI) to help identify the most efficacious treatment strategies for relapsing-remitting Multiple Sclerosis. In the last few decades, we have developed new, stronger and more aggressive therapies to prevent relapse and disability in MS. Since the advent of new therapies, it is important to investigate if new patients benefit from the older, milder therapies or if the risk of relapse and disability are best addressed with stonger therapies early in the disease course. The TREAT-MS study follows volunteer patients for the first few years of their MS therapy, and tracks their disease progression, disability risk and satisfaction. We will be accepting new volunteers until June of 2020.
The NOVA study is aimed at assessing the efficacy of Natalizumab (Tysabri) in Multiple Sclerosis patietns at an interval of 6 weeks between doses, in contrast with the traditional 4 week interval. The study aims to test if the risk of developing Progressive Multifocal Leukoencephalopathy, a fatal progressive neurological disease caused by the John Cunningham Virus, is decreased by extending the interval of dosage. We will be following patients for 72 months, tracking their health and disease outcomes. Enrollment for this study has closed.
Partners, Collaborators and Resource Links
UCSD Multiple Sclerosis Clinical Center
Altman Clinical and Translational Research Institute
Center for Multimodal Imaging and Genomics
National Multiple Sclerosis Society
International Pediatric Multiple Sclerosis Study Group