Unlocking the Mysteries of Multiple Sclerosis

A Medical College of Wisconsin physician-scientist is conducting research he hopes will improve the treatment of MS.

For all we know about multiple sclerosis (MS), a central nervous system disease that currently afflicts nearly 1 million Americans, there’s much we still don’t understand, says Ahmed Obeidat, MD, PhD, an associate professor who specializes in neurology at the Medical College of Wisconsin (MCW).

Scientists know that the disease causes the immune system to attack areas in the brain, spinal cord and optic nerves, which together comprise the central nervous system, but they don’t exactly know why.

“We have no clue what the immune system is doing and why the immune system attacks certain areas,” Dr. Obeidat says. “There are areas that are more likely to be affected, but we cannot predict why it goes to those areas and not others, and we cannot predict when it’s going to attack.”

According to Dr. Obeidat, who leads several research studies on MS, the key to understanding the disease lies within the patients themselves.

“They’re the ones who have the disease, they’re the ones who live with the disease, they’re the ones who know the disease well, and they’re able to tell us exactly what they’re feeling and what their story was,” he says. “We try to find commonalities between the stories, and that triggers us to say we have to go after this research question.”

Symptoms differ, Dr. Obeidat notes. Some can’t feel their hands or legs, some have no feeling from the neck down, while others have issues with their bladders, bowels or balance, or multiple symptoms. Multiple sclerosis is not contagious or hereditary (despite some genetic predisposition), but triggers the immune system to attack certain structures, causing collateral damage along the way.

Dr. Obeidat asks his patients questions about their home environments and family histories, looks at their genetics and studies the way the disease has presented itself in them. He believes all hold clues that will help move MS research to the next level.

“We’re trying to understand what these differences are and what they mean,” he says. “What we know is that early diagnosis and early treatment matter.”

The diagnosed patients are anxious to learn about developments in the treatment of MS, which gives them hope for the future. Dr. Obeidat is more than happy to share that information with them.

“What we tell people is that the treatment of MS has developed in a way that we now have very effective treatments,” he says. “Now we are diagnosing them earlier, we’re putting them on highly effective treatments early, and then we’re literally shutting down inflammatory activity in MS.”

He also lets them know that the future is a bit different. While the current focus is suppressing the immune system to control collateral damage, the future is targeting disease-causing mechanisms.

Emerging Treatments for Multiple Sclerosis

While many questions remain, Dr. Obeidat and other researchers have increased momentum toward answering them. There is a growing subset of patients who present MS later in life, but not enough is being represented in research to conclusively learn why. Immune modulators and suppressants as well acellular therapies show promise, but there are side effects and safety considerations of disease-modifying therapies for multiple sclerosis.

Another research finding coming to fruition is that a main trigger for MS could be the Epstein Barr Virus (EBV), also known as mono. In fact, Dr. Obeidat says, almost 100% of adult people with MS have been exposed to EBV prior to MS diagnosis. A clinical trial at MCW and other institutions, now in phase two, is following this issue closely.

“Ultimately, our goal is to have very safe treatments with minimal risk and with risk mitigation strategies, changing paradigms of how MS is treated,” he says. “Maybe we’ll be able to arrest the disease instead of just slowing it down.”

Also promising are current studies on new drugs to treat MS, including immunomodulators, which can change a patient’s immune response to MS, and other drugs created to repair the damage caused to nerves and restore cognitive functions. Researchers are hopeful there are some that will finally unlock the mystery of how the disease occurs in the first place.

Ongoing Mission to Treat MS

The origins of Dr. Obeidat’s interest in treating MS go back to his days as a medical student at Jordan University of Science and Technology on the outskirts of the city of Irbid. At the time, he says, there were no effective treatments, so people living with the disease had no interventions and were not doing well.

“There must be one day that we’re going to have a treatment and maybe a group of treatments and maybe we’ll do better, and I wanted to join the forces at the time,” he recalls.

After graduating from medical school with honors, he joined the graduate program in neuroscience and physiology at Wright State University, completed a neurology residency at the University of Cincinnati, and specialized in MS during fellowship training.

Soon after he joined the faculty at MCW, while also practicing as a physician at Froedtert Hospital.

“MCW is the perfect place for me to be because MCW really highlights the importance of the integration of all these missions: clinical excellence, education, research and community engagement,” Dr. Obeidat says.

Medical students bring their energy, talent and excitement to those goals, which inspires Dr. Obeidat to continue to teach while also learning from them. He works closely with medical students, residents and fellows, which helps him form a strong research team and innovate knowledge.

Together it creates an environment that leads to innovation and hopefully more breakthroughs in MS treatment.

“We can treat the disease, but can we prevent it from happening? That’s the next huge step,” he says. “Maybe someday MS will be just in our history books.”