How close are we to predicting who will get MS, you know, how close are we to predicting?
So that’s a slightly separate question from biomarkers. There isn’t a test that you can just do that tells you whether somebody’s going to get MS. The cause of MS is unknown. There are risk factors and there are things that contribute and, you know, the stock answer is it’s a combination of genetic and environmental factors, and while that’s frustrating and vague, it’s true. You know, there are genetic aspects that influence the occurrence of multiple sclerosis and if you have a family member with multiple sclerosis, a first degree family member, your risks are much higher than the general population. But it’s very important to understand that if you have a family member with multiple sclerosis – mother, father, brother, sister – it’s still far more likely that you won’t get MS than that you will. So let me just explain that.
If we take the kind of Scottish population rate of MS as around one in 500 – it’s about right, one in 500 – and if you have a first degree family member – mother, father – your rate goes up to around, between one in 50 and one in 100, so it’s a vastly increased rate, but you’re still 49 times out of 50, you’re not going to get MS. So it’s important to understand, yes, the risk is higher but still, the odds are that you won’t get MS if you have a first degree family member rather than that you will. There are environmental factors, there are well-known risk factors which are smoking, obesity and vitamin D deficiency. You know, we think that all of these are contributory factors and all of these are correctable, easily correctable, with no risk, you know, there’s no risk to taking a vitamin D supplement, nor is there any risk to losing weight, nor is there any risk to stopping smoking, so do it, you know. But there are factors that you can’t control as well and I think that, you know, this is one of the things that troubles me in these conversations people have with people with multiple sclerosis, you know, I mean there’s this sense that somehow it’s their fault. It’s not their fault, you know? The large proportion of multiple sclerosis is unexplained, we don’t know why people get it, and you can’t control it, you can’t stop getting it by doing something, you know. So don’t feel it’s your fault, correct the things that you can correct, make the most of what you have, but you know, don’t feel that it’s somehow what you’ve done or what your family member is doing, because there’s a great big area that we just don’t understand and, you know, the vast majority of serious diseases that we see, not just MS but elsewhere, it just happens. You know, it just happens. And, you know, it’s not your fault. [laughs]
It’s plain and simple, yeah. No, fantastic, I mean it’s very true what you’re saying, and the things that we can control, I mean I hope people do make those efforts, so ,i.e, if you’re a smoker, you know, obviously it’s something so obvious and it’s not going to help you. Weight control, get it under control, you know, everything else, just try and manage it.
It’s, you know, it’s just about being pragmatic, you know. There are some things you can change and some things you can’t and making the most of what you have. You know, maybe you are disabled, maybe you do walk with a stick, but that’s no reason not to exercise, that’s no reason not to go on the weights machine. You know, make the most of what’s left.
I’m thinking of joining the gym now when I go back.
Thanks for that.
Dr Overell works at the Glasgow MS clinical research centre. He gained his MD from Edinburgh Medical School in 1994. Scotland has the highest rate of MS in the world as such the Glasgow centre is one of the largest in the world. He is currently leading a major UK-based observational study examining the use and safety of new monoclonal therapies.