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Headlines 17 M ultiple sclerosis (MS) is an autoimmune condition of the central nervous system. The body’s immune cells become misdirected and attack myelin (the protective covering of our nerves), resulting in its destruction – a process known as demyelination. Continued demyelination causes the electrical signals, which run through our nerves to the brain, to become disorganised and function incorrectly. This leads to neurological symptoms such as loss of feeling and paralysis. The current treatments for MS are known as ‘disease modifying therapies (DMT),’ which suppress the immune system to prevent this continued demyelination. While they work well, these types of therapies leave people immuno- compromised, increasing their risk of severe infection, and vulnerable to developing cancer. The research undertaken by Dr Dyer aimed to determine whether re-setting the diseased immune system, through a method called autologous haematopoietic stem cell transplant (aHSCT), could be used as an alternative treatment. aHSCT is a process where haemopoietic stem cells (cells which will form our immune system) are taken from the patient and reinfused following chemotherapy treatment to destroy the diseased immune cells. This can effectively give the person a new, non-diseased immune system. Importantly, compared to current MS therapies, it does not leave them immuno-compromised in the long-term. However, aHSCT does involve significant up-front risks and side-effects. This process is used worldwide for the treatment of immune cell cancers, such as lymphoma, but mounting evidence suggests it may be of benefit for the treatment of autoimmune disorders too. The trial is ongoing but results to date showed aHSCT was highly effective in preventing flare-ups in disease severity (known as relapses) for most individuals who underwent this therapy, indicating that it is an excellent treatment option for some patients. Further clinical research aims to improve the effectiveness and reduce the side-effects involved in aHSCT. Dr Dyer has recently returned to Auckland, but will continue working with the team at St Vincent’s to further improve aHSCT as a therapy for MS. She hopes the experience she has gained, as well as the positive results coming out of this trial, will help in expanding access to aHSCT for people with MS here in New Zealand. An alternative treatment for multiple sclerosis? Could re-setting the diseased immune system be an alternative treatment for multiple sclerosis? Dr Zoe Dyer, a clinical neurologist based in Auckland, received the VJ Chapman Fellowship in 2021. She’s been undertaking research at St Vincent’s Centre for Applied Medical Research in New South Wales, with promising results. “The trial is ongoing but results to date showed aHSCT was highly effective in preventing flare-ups in disease severity.”