Chris Polman: improving care for patients with multiple sclerosis
The scientists in the multiple sclerosis centre are working hard to reduce the impairments the disease causes to the life of patients. Dramatic breakthroughs are not crucial to the MS research field, Chris Polman thinks. 'Progress is made by solving small parts of the puzzle, which you have to do many times.'
The last ten years have finally brought the first treatments for multiple sclerosis (MS) that are able to really slow down the progress of the disease. With the introduction of biologicals, compounds that specifically alter physiological functions, especially interferon, clinicians now have a treatment modality at their disposal that can slow down the development of neurological symptoms. Chris Polman, professor of neurology, says: 'We try to optimise treatment for our patients. Still, the condition cannot be completely cured. Clinical research should focus on rapid diagnostics, and effective medicine: early and targeted. We want to know how people will react to the treatment, but must realise that not everyone needs to be treated in the early phase, and that not everyone needs the same treatment in the end. Patient profiling is very important.'
In multiple sclerosis, the main problem is the degradation of the white matter in the central nervous system, leading to neurological symptoms. It is thought the disease is caused by an aberrant immune response that targets the cells that produce myelin, the fatty layer insulating the long extensions of nerve cells responsible for transmitting the electrical signal. The loss of insulation results in faulty signalling by the affected parts of the central nervous centre, leading to symptoms like paralysis, vision loss or changes in touch sensation of the skin.
Chris Polman started his work on MS during his specialisation in neurology. During his residencies, he did his PhD project on an animal model for the disease. From that time on, he was involved in the developments in the field of MS research, and now leads the MS Center at the VUmc. Patients from all over the Netherlands visit the outpatient clinic, and its scientific work is highly valued internationally.
As the Director of the MS Center, Polman applauds even more possibilities for collaboration. 'I welcome the Neuroscience Campus Amsterdam initiative. On the campus many things in the field of neuroscience are done that we do not know about, and it would be great to get to know each other better. If we can achieve that, we can make better use of each others' qualities. I already collaborate with many people within the campus and beyond: we work closely together with other MS specialist centres abroad.'
Biomarkers
Steadily, the care is getting better. Polman: 'At this moment, one of the main research topics is imaging of the degeneration of the central nervous system to confirm the diagnosis and to monitor disease progression, therapy effectiveness and patient subtype. Imaging is very important, as the use of other biomarkers for multiple sclerosis turned out to be rather problematic. Blood markers for example are not reliable, maybe because the nervous system is so distinct from the vascular system and brain fluid is hard to obtain, as the procedure of a lumbar puncture is rather unpleasant. Fortunately, some biomarkers for the effectiveness of the therapy are now being developed, which helps us to monitor the responsiveness to for example interferon treatment. That will not reveal much about the progression of the disease, but will at least tell us if the medicine is working.'
