At the end of September, the 90th Annual Meeting of the German Society of Neurology (DGN) took place in Leipzig. The DGN congress is the most important and largest conference for German-speaking neurologists, where current scientific developments from all areas of neurology, as well as occupational and socio-political topics, are intensively discussed. Since all areas of neurology are covered, understandably multiple sclerosis research and the clinical care of MS patients are not the focus, but represent only a part of the congress. Accordingly, the latest scientific results of MS research are not communicated at the DGN meeting – however, current trends and developments are presented and commented on. Germany also has a very powerful neuroimmunological research in international comparison and makes important research contributions every year to the further development of the diagnostics and therapy of Multiple Sclerosis. Therefore, the current trends in MS therapy research can certainly be derived from the topics discussed at the DGN.
In terms of new therapeutic developments, the approval of the active ingredient Cladribin in August 2017 was a focus. The study results of the substance were extensively presented and discussed.
Despite these pleasing developments in the field of anti-inflammatory therapies, it is repeatedly emphasized that new concepts outside of anti-inflammatory therapies are needed to prevent the chronic progression of the disease. Concepts that aim to protect nerve tissue from degeneration play a particularly important role here.
One such concept is the promotion of remyelination of neurons demyelinated by inflammation, which was the subject of a complete scientific session at the DGN. The studies with the antibody Opicinumab (perhaps known to some as Anti-LINGO-1) were discussed here. The current study situation is not clear and the results are controversial. However, the antibody was able to improve the conductivity of the optic nerve, which can be interpreted as an indication of remyelination. An important problem in studies of neuroprotection and remyelination is the imaging and measurement of a relevant effect. The currently used parameters such as clinical scales (e.g., EDSS) or electrophysiological examinations are rather inaccurate, which is why new diagnostic developments for the representation of remyelination, such as specific MRI sequences or nuclear medicine tracers for myelin imaging, are of high interest and must be intensively researched in the future.
Another important topic in the scientific sessions was the microbiome and nutrition – this issue is becoming increasingly important for the development of autoimmunity. The results of the University of Bochum and the University of Erlangen on the dietary supplement Propionic Acid are of high interest. The research groups there were able to show that Propionic Acid mediates protective effects in cell cultures and can curb inflammatory activity in MS. Given these promising results, we can look forward to clinical studies that investigate Propionic Acid as an add-on therapy for MS.
In the poster session, I was personally pleased to see how important the concept of promoting movement in MS has now become and how many working groups are currently researching this topic intensively. The topic of movement and sport was still rather a marginal phenomenon a few years ago. The current results show that movement can lead to an improvement in balance and an improvement in cognitive functions. I am firmly convinced that this increased interest in MS and movement will ultimately lead to an improvement in care reality in Germany.
All in all, the DGN meeting certainly provides a good reflection of the current flow in MS research and MS therapy. This picture will probably become even clearer at the end of October when the European MS Congress ECTRIMS takes place in Paris, where the latest therapy studies and scientific developments will be presented. Here, further new developments for the treatment of progressive MS are expected. We can look forward to it.
