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Multiple Sclerosis (MS) is a complex multi-factorial disease, with underlying both genetic and environmental factors. Different populations have different susceptibility. The disease is characterized by 2 main phenotypes: relapsing-remitting or progressive course. Clinical disability is due to distraction of the CNS myelin.
Repair processes are mainly noted after the acute attack - and recovery of function can be spontaneous. However, in severe attacks sometimes there is need for adding STEROID TREATMENT (6 days IV) for the acute attack.
For the long term prophylactics - following the increased understanding of the disease, in the last 10-15 years there are new immunotherapies available (COPAXON / TEVA; Interferon -beta). However these can attenuate the disease (reduce the number of relapses per year) but are not cure. Also, they are beneficial in only ~40 % of the Relapsing -Remitting patients.
Currently there are no biomarkers available for MS (other than oligoclonal IgG in the CSF - which help confirm diagnosis but require invasive procedure and are not correlated with disease activity nor response to therapy) and - monitoring of MS and its treatment is by MRI - which is expensive.
Dr Hossam Haick from the Technion developed an electronic nose based nanomaterials for diagnosis of diseases (e.g., cancer, kidney failure, etc.) via breath samples.The research hypothesis is that Biomarkers of CNS inflammation and/or neurodegeneration and/or CNS repair can be detected by "electronic nose".
Full description
Multiple Sclerosis (MS) is a complex multi-factorial disease, with underlying both genetic and environmental factors. Different populations have different susceptibility. The disease is characterized by 2 main phenotypes: relapsing-remitting or progressive course. Clinical disability is due to distraction of the CNS myelin (mainly oligodendrocytes) due to 3 processes:
Inflammation- immune cells with aberrant activity invade the brain and spinal cord and cause distraction of CNS myelin.
Primary neurodegeneration - without prominent inflammation
Repair - the inflammatory and neurodegenerative processes are followed by an attempt of the CNS to repair - however, this is partial and incomplete repair is often the basis of residual deficits and disability.
Repair processes are mainly noted after the acute attack - and recovery of function can be spontaneous. However, in severe attacks sometimes there is need for adding STEROID TREATMENT (6 days IV) for the acute attack.
For the long term prophylactics - following the increased understanding of the disease, in the last 10-15 years there are new immunotherapies available (COPAXON / TEVA; Interferon -beta). However these can attenuate the disease (reduce the number of relapses per year) but are not cure. Also, they are beneficial in only ~40 % of the Relapsing -Remitting patients.
Currently there are no biomarkers available for MS (other than oligoclonal IgG in the CSF - which help confirm diagnosis but require invasive procedure and are not correlated with disease activity nor response to therapy) and - monitoring of MS and its treatment is by MRI - which is expensive.
Dr Hossam Haick from the Technion developed an electronic nose based nanomaterials for diagnosis of diseases (e.g., cancer, kidney failure, etc.) via breath samples. Research hypothesis Biomarkers of CNS inflammation and/or neurodegeneration and/or CNS repair can be detected by "electronic nose".
Aim(s)
Identification of biomarkers of:
Work plan outline:
Evaluate few groups clinically:
Evaluation of the Electronic Nose for Diagnosis of MS We will apply a four-phase approach in order to achieve the objectives of this research. In the first phase we will collect suitable breath samples from each patient and compare the patient data to age-adjusted healthy controls. In the second phase we will analyze the collected breath samples with the electronic nose setup. In the third phase we will carry out auxiliary chemical analysis, using gas-chromatography linked with mass spectrometry (GC-MS), of the breath samples under different aspects. The fourth phase will aim at the improvement of our electronic nose setup and will be conducted in parallel to the first three phases.
We will collect breath samples of a representative group of MS patients of all types and of age-matched controls. Our GC-MS chemical analysis will address: (1) the dependence of the MS breath biomarker levels on the type/stage of the MS disease; and (2) the effect of environmental factors such as age, diet, lifestyle (especially smoking and drinking habits) on the chemical composition of the breath. Based on the results of the GC-MS chemical analysis, we will improve and optimize our array of nanosensors setup so as to achieve: (1) maximum sensitivity to the MS biomarkers and their stage dependent concentration profiles; (2) minimum sensitivity to non-MS related changes of the chemical composition of the breath, and (3) minimum sensitivity to the major ingredients of the breath, such as water vapor. We will attempt to define MS sub-categories, supported by the information from the clinical/imaging reports, which might be relevant for clinical management, by more sophisticated statistical treatment of the collected data. Towards the end of this proof-of-concept study we will compare the performance of our electronic nose setup to the conventional MS diagnostic tools. The comparison will be done in terms of true positive, true negative, false positive, false negative, sensitivity and specificity.
Enrollment
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Inclusion criteria
MS patients:
Control subjects:
Exclusion criteria
Exclusion from the experiment during the study period:
71 participants in 2 patient groups
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Data sourced from clinicaltrials.gov
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