During the Corona crisis, the focus has shifted to science – never before has societal interest in basic medical science been as high as during the Corona pandemic. There is widespread discussion in Germany about laboratory tests and study designs – many scientists are currently explaining to the public how modern basic research works, explaining backgrounds and thus making science more understandable to the general public. Understanding correlations in turn reduces fear and makes one less susceptible to fake news and conspiracy theories.
Therefore, due to the Corona pandemic, there should be an understanding in the public that science is not static, but a very complex system that constantly questions and must question itself. Spiegel columnist Christian Stöcker put this very aptly in a recently published article – science, properly understood, is doubt cast into processes.
I think we have all learned a lot in recent months – and with this knowledge, perhaps the view of basic scientific studies on multiple sclerosis will become more transparent in the future. And a study that will certainly be intensively discussed in public and on social networks is a study from the German Center for Immunotherapy (DZI) at the University Hospital Erlangen, which was recently published very highly in the scientific journal Nature (Azizov et al. Nature Communications 2020; https://www.nature.com/articles/s41467-020-15855-z)
The authors here examined the effect of moderate alcohol consumption primarily in a mouse model of rheumatoid arthritis, but (incidentally) also in an animal model of multiple sclerosis. The work primarily aimed at gaining insights into rheumatoid arthritis; the experiments in the so-called MOG EAE, an animal model of multiple sclerosis, were carried out as confirmation experiments – nevertheless, this work will probably be discussed in relevant MS forums.
In short, using immunologically very carefully chosen methods, the authors were able to show that alcohol and its metabolite acetate change the functionality of a certain subgroup of T lymphocytes – the so-called T follicular helper cells (TFH cells). These cells are significantly involved in the formation of germinal centers in the lymph nodes, where TFH cells interact with B lymphocytes and stimulate them to produce antibodies. Alcohol exposure reduces the expression of certain surface molecules and messengers that are important for the functionality of TFH cells and thus disturbs the spatial organization of TFH cells. This impairs the formation of TFH:B cell conjugates. This in turn results in reduced autoantibody formation and leads to a mitigation of the disease in the animal model of rheumatoid arthritis.
As I said, the work is very carefully carried out and deciphers which immunological and molecular mechanisms are responsible for the moderate immunoregulatory and anti-inflammatory effect of alcohol in the animal model. The experiments could offer an explanation for why a moderate protective effect of alcohol was observed in epidemiological studies on rheumatoid arthritis.
Even though the study significantly contributes to understanding immunological processes in the germinal centers, it is not suitable for deriving therapeutic measures from it – even if this is likely to happen when the media takes a simplified view. The conclusion that moderate alcohol consumption works against rheumatism and MS is far too broad – this should be clear by now through the Corona experiences.
On the one hand, these are animal experiments. These are always only an approximation to the reality of the actual disease, moreover, the immune system of humans and mice are not 1:1 comparable, so that concepts for human therapy studies can be obtained from the animal experiment, but no direct therapeutic conclusions should be drawn. In addition, the study isolates the effect of alcohol (in a certain predefined amount) on certain immunological processes, potential side effects are of secondary importance. Perhaps the immunological effects of alcohol in the human situation are similarly beneficial, but on the other hand alcohol could have detrimental effects on other organ systems (e.g. the brain), so that a therapeutic recommendation only makes sense if the overall situation is evaluated in a clinical study.
So, long story short – from this basic scientific work, it should not be concluded that moderate alcohol consumption is suitable for treating MS – especially since the animal model of MS in this publication only represents a side scene and rheumatism and MS have different immunological emphases.
Don’t fall for simplifying headlines, but we’ve learned that through Corona ….
