Partnerships, national research leadership grow Multiple Sclerosis Program
Partnerships have proved fundamental to UT Southwestern’s efforts to understand, manage, and uncover the mysteries involved in multiple sclerosis, an autoimmune disease of the central nervous system.
A key component of UT Southwestern’s Multiple Sclerosis and Neuroimmunology Program, for example, involves a multidisciplinary weekly clinic that combines the expertise of nutritionists, social workers, and multiple sclerosis (MS) and gait specialists. Comprehensive care teams bring together physicians, nurse practitioners, physician assistants, nurses, social workers, and others.
Building extensive expertise in MS has been a priority of Program Director Dr. Elliot Frohman, Professor of Neurology and Neurotherapeutics, and Ophthalmology, since UT Southwestern launched the program in 1995. His partner in growing the Program has been his wife, Teresa C. Frohman, a physician assistant in Neurology and Neurotherapeutics. In an important milestone, the two co-authored a congressional appropriations bill in 2001 establishing a national MS training program at UT Southwestern, the first such federally funded program in the nation. The program has since trained more than 1,000 physicians, residents, fellows, nurses, physician assistants, and nurse practitioners in managing chronic MS illness.
Recognition of UT Southwestern’s leadership in MS research has followed. Last fall, Dr. Frohman, who holds the Irene Wadel and Robert I. Atha, Jr. Distinguished Chair in Neurology, and the Kenney Marie Dixon-Pickens Distinguished Professorship in Multiple Sclerosis Research, was awarded the 2015 Barancik Prize for Innovation in MS Research from the National Multiple Sclerosis Society, along with two research team collaborators. The other team members were from New York University Langone Medical Center and Johns Hopkins School of Medicine. The Barancik Prize is considered to be the most prestigious award in the world for MS research.
Over the past 10 years, the winning team of physician-scientists has produced novel, groundbreaking, and impactful research about the anatomy and biology of the retina and other structures of the eye in MS patients, mainly using optical coherence tomography (OCT), a common and easy-to-use eye scanning technique. The team has utilized the eye, as a window into the brain, to understand the mechanisms of the disease and to identify preventive, protective, restorative, and performance-enhancing properties of novel neurotherapeutic agents for MS and other neurodegenerative disorders.
Thanks in large part to the team’s efforts, OCT has become a mainstream tool to study the pathological underpinnings of MS. In particular, research from the group has shown that OCT can identify unsuspected damage in nerve fibers at the back of the eye, and that this damage echoes more global injury in the brain during the course of MS.
“This technique has the potential to provide a powerful and reliable assessment strategy to measure structural changes in the central nervous system, both for diagnostic purposes and in clinical trials to monitor whether potential treatments can prevent deterioration or restore nerve function,” said Dr. Frohman, who has authored a comprehensive review of multiple sclerosis in the New England Journal of Medicine, published over 250 peer-reviewed articles, book chapters and monographs, and serves as a principal investigator on a number of MS clinical trials.
From initial research at three sites, the collaborative work of the three-person team is now expanding to 35 centers worldwide. This team approach, also embraced on campus, has propelled UT Southwestern’s Multiple Sclerosis and Neuroimmunology Program to the forefront in both clinical care and research.
At UT Southwestern, other research by Dr. Frohman has demonstrated that as body temperature rises in MS patients, the severity of an eye-movement disorder called INO, or internuclear ophthalmoparesis, also increases. Other breakthrough discoveries at UTSW relate to the immune system’s ability to suppress autoimmunity, antibody production within spinal fluid, the effect of medications on the immune system in MS patients, and heat-induced MS symptoms. Ongoing work includes studies to develop disease biomarkers and examination of the impact of B cells – a type of immune cells – on MS.
In the clinical arena, the UT Southwestern Clinical Center for Multiple Sclerosis, Transverse Myelitis/Neuromyelitis Optica sees more than 7,500 patients and includes clinical and research teams with more than 70 researchers and physicians.
“There are many facets related to the delivery of outstanding multidisciplinary care to a patient with a chronic neurological disease like MS,” said Dr. Frohman. “Our team of physicians, physician extenders, nurses, social workers, technicians, and support staff have all combined to make the MS Program at UT Southwestern a place of significance to patients and families with MS everywhere.”