Multiple sclerosis (MS) is a common cause of non-traumatic disability in young adults. It is associated with damage to the brain and spinal cord, causing many different symptoms such as with cognition, vision, movement, coordination, bladder control and sensation. MS is triggered by an immune attack against the brain and spinal cord. However we have observed amongst people with MS that certain factors may bring on MS at a younger age or make it more severe. One factor appears to be their genetic makeup. For instance genes that control the integrity of brain tissue may influence MS severity. Other factors are acquired, so happen in the individual during their lifetime – these are important since they are modifiable and can therefore be targeted to lessen MS severity. Examples include other medical conditions – it is common clinical observation that people with MS who have other medical conditions do less well and there is some research to support this. Lifestyle factors such as smoking are probably also important. Blood-borne factors may also play a role, for example systemic inflammation and vitamin D. Another example of a blood-borne factor is haemoglobin, the red pigment in red blood cells, may cause brain damage if released from red blood cells. There is some evidence that red blood cells are more fragile in people with MS, releasing haemoglobin from the cells – this may happen in the presence of other medical conditions or lifestyle choices such as smoking or alcohol.
Several thousand UK Biobank participants have a diagnosis of MS. Control individuals with no neurological disease are easily selected from amongst the other participants. In this project we will address the hypothesis that genetic and environmental factors predispose to MS, compared to control individuals, or make the MS worse. We will investigate severity of MS based on patient report as well as brain magnetic resonance images. Patient report will include thinking, physical activity, employment, and other social and health outcomes.
This study may deliver new insights of public health importance since they may in turn lead to new ways of managing MS in terms of lifestyle modification and new treatments. It will provide a PhD student, working under close supervision, with experience in research and scientific publications to further their careers.