Multiple Sclerosis and Related Disorders 1 (2012) 1–2
Contents lists available at ScienceDirect
Multiple Sclerosis and Related Disorders journal homepage: www.elsevier.com/locate/msard
Editorial
Editor’s Welcome
We are proud to launch Multiple Sclerosis and Related Disorders (MSARD)—a journal dedicated to providing a new home for high quality manuscripts relating to MS. Why a new journal? The rate of published articles in MS is growing in a linear fashion year by year with no sign of leveling off. MS related articles increased by 8.5% per annum 1996–2009 compared to 3% for publications focused on other diseases. In the last year, PubMed listed over 3000 papers on MS alone. So what will be different about MSARD? We have created a user-friendly video-based instruction set to simplify and clarify the submission and review process and aim for a peer review turnaround of 4 weeks or less. The journal will be mostly web-based with the ultimate aim of web and e-reader only versions save for institutional subscribers that may wish to have a shelf copy. MSARD will have a journal club, an associated Wiki and Twitter account to create an MS community and include an RSS feed. Free online access to a selection of highimpact papers will be provided. A special section will be created to provide timely information on key discoveries written for a lay audience—a resource accessible by the public and suitable for physicians who wish to provide patients with information. Sciverse ScienceDirect (www.sciencedirect.com) and Elsevier Health Advance (www.MSARD-journal.com) will allow readers to download articles via the Internet either through institutional or personal subscriptions. The Sciverse SCOPUS abstract and citation database operated by Elsevier should further increase MSARD’s accessibility. Perhaps now is an appropriate time to stand back, take stock of where we are in MS as a whole and where we should devote more effort. The last 15–20 years have born witness to spectacular advances in treatment. The care of patients with relapsing– remitting MS has evolved from the first successful chronic immunomodulatory therapies to an increasing number of both oral and intravenous therapies with enhanced efficacy. The success of MS therapeutics, however, remains challenged by between-nation variation in the approval process, hesitancy by some clinicians to endorse treatment, and by a lack of consensus on timing of treatment initiation, individualized treatment models, and paradigms for use of sequential treatment options. What would you include in a multiple sclerosis wish-list? We suggest the following five goals: 1. Etiology: Discovery of the underlying cause of MS is a key priority—at least for the neuroscientist. Despite intensive genetic research, advances in understanding of the molecular basis of MS have been modest. All would agree that the role of environmental triggers, such as Epstein Barr Virus (EBV), remains to be solved. The association between vitamin D 2211-0348/$ - see front matter & 2011 Elsevier B.V. All rights reserved. doi:10.1016/j.msard.2011.07.001
2.
3.
4.
5.
insufficiency or reduced sun exposure and MS prevalence is well supported, but the specific role of vitamin D in the pathobiology of MS has yet to be elucidated. The increasing incidence of MS, especially in females, and most notably in Iran and Arabian countries, and an increasing recognition of MS onset during childhood, suggests a change in the relative frequency or contribution of MS risk factors in certain populations. A specific diagnostic test: Although serum and spinal fluid assays have identified increased frequency of immune markers in subsets of MS patients, no single biomarker has been identified that associates reliably with MS. The sensitivity and specificity of aquaporin-4 antibodies in patients with neuromyelitis optica highlights the diagnostic value of biomarker discovery. Effective therapy for chronic disease: We must not forget the thousands of MS patients for whom the key therapeutic issues are not only disease suppression but also neural repair and recovery of function. To date, nothing as yet has been shown convincingly to repair the damage caused by MS. Emerging data has highlighted molecular pathways that lead to neurodegeneration in the progressive phases of MS. Many putative neuroprotective agents targeting these pathways have been identified and need to be tested in clinical trials. Similarly, new insights into the control and maturation of oligodendroctye precursors and myelin production should provide new targets for the pharmaceutical companies to explore. Prevention of MS: Arguably, this might be achieved through, for example, the study of public health measures such as a population-based physiological vitamin D supplementation program. Based on epidemiological data some would favor, a nationwide vaccination program of children to prevent delayed symptomatic EBV infection, an aspect that remains contentious. Expansion of patient-oriented resources: Although there are widely available web-based sources of information and support, direct patient care is not always optimal. One solution is the creation of specific MS Resource Centers—a centralized ideally walk-in facility that focuses on MS-specific multidisciplinary care.
To assist in the launch of MSARD, we have commissioned three reviews. With respect to MS diagnosis, Drs. Gafson et al. discuss the recently revised MacDonald criteria for MS diagnosis. Released in early 2011, the criteria may now allow MS to be diagnosed in certain patients on the basis of a single enhanced
2
Editorial / Multiple Sclerosis and Related Disorders 1 (2012) 1–2
MRI. Dr. Lublin addresses the complex issue of MS disease activity: – what defines ‘‘no active disease’’ – and is this ever achieved once the MS disease process has begun? Finally, Dr. Banwell explores the insights gained through the study of the youngest MS patients. As inferred by the title, MSARD aims to attract high quality papers relating to MS as well as other inflammatory disorders of the central nervous system. We would welcome articles concerning disorders such as neuromyelitis optica, infectious or parainfectious diseases or other forms of autoimmune CNS disease. Inherited or metabolic disorders that share clinical or pathological features of MS would also be of potential interest.
Our aim is to promote better understanding of MS, a disease which is now within our grasp to treat effectively. We hope you share our views and that you will support this new venture. We welcome our new readers and sincerely thank Elsevier, the section editors and members of the new editorial board for volunteering to help make this journal a success. The Editors-in-Chief Brenda Banwell Gavin Giovannoni Chris Hawkes Fred Lublin
Contents lists available at ScienceDirect
Multiple Sclerosis and Related Disorders journal homepage: www.elsevier.com/locate/msard
Editorial
Editor’s Welcome
We are proud to launch Multiple Sclerosis and Related Disorders (MSARD)—a journal dedicated to providing a new home for high quality manuscripts relating to MS. Why a new journal? The rate of published articles in MS is growing in a linear fashion year by year with no sign of leveling off. MS related articles increased by 8.5% per annum 1996–2009 compared to 3% for publications focused on other diseases. In the last year, PubMed listed over 3000 papers on MS alone. So what will be different about MSARD? We have created a user-friendly video-based instruction set to simplify and clarify the submission and review process and aim for a peer review turnaround of 4 weeks or less. The journal will be mostly web-based with the ultimate aim of web and e-reader only versions save for institutional subscribers that may wish to have a shelf copy. MSARD will have a journal club, an associated Wiki and Twitter account to create an MS community and include an RSS feed. Free online access to a selection of highimpact papers will be provided. A special section will be created to provide timely information on key discoveries written for a lay audience—a resource accessible by the public and suitable for physicians who wish to provide patients with information. Sciverse ScienceDirect (www.sciencedirect.com) and Elsevier Health Advance (www.MSARD-journal.com) will allow readers to download articles via the Internet either through institutional or personal subscriptions. The Sciverse SCOPUS abstract and citation database operated by Elsevier should further increase MSARD’s accessibility. Perhaps now is an appropriate time to stand back, take stock of where we are in MS as a whole and where we should devote more effort. The last 15–20 years have born witness to spectacular advances in treatment. The care of patients with relapsing– remitting MS has evolved from the first successful chronic immunomodulatory therapies to an increasing number of both oral and intravenous therapies with enhanced efficacy. The success of MS therapeutics, however, remains challenged by between-nation variation in the approval process, hesitancy by some clinicians to endorse treatment, and by a lack of consensus on timing of treatment initiation, individualized treatment models, and paradigms for use of sequential treatment options. What would you include in a multiple sclerosis wish-list? We suggest the following five goals: 1. Etiology: Discovery of the underlying cause of MS is a key priority—at least for the neuroscientist. Despite intensive genetic research, advances in understanding of the molecular basis of MS have been modest. All would agree that the role of environmental triggers, such as Epstein Barr Virus (EBV), remains to be solved. The association between vitamin D 2211-0348/$ - see front matter & 2011 Elsevier B.V. All rights reserved. doi:10.1016/j.msard.2011.07.001
2.
3.
4.
5.
insufficiency or reduced sun exposure and MS prevalence is well supported, but the specific role of vitamin D in the pathobiology of MS has yet to be elucidated. The increasing incidence of MS, especially in females, and most notably in Iran and Arabian countries, and an increasing recognition of MS onset during childhood, suggests a change in the relative frequency or contribution of MS risk factors in certain populations. A specific diagnostic test: Although serum and spinal fluid assays have identified increased frequency of immune markers in subsets of MS patients, no single biomarker has been identified that associates reliably with MS. The sensitivity and specificity of aquaporin-4 antibodies in patients with neuromyelitis optica highlights the diagnostic value of biomarker discovery. Effective therapy for chronic disease: We must not forget the thousands of MS patients for whom the key therapeutic issues are not only disease suppression but also neural repair and recovery of function. To date, nothing as yet has been shown convincingly to repair the damage caused by MS. Emerging data has highlighted molecular pathways that lead to neurodegeneration in the progressive phases of MS. Many putative neuroprotective agents targeting these pathways have been identified and need to be tested in clinical trials. Similarly, new insights into the control and maturation of oligodendroctye precursors and myelin production should provide new targets for the pharmaceutical companies to explore. Prevention of MS: Arguably, this might be achieved through, for example, the study of public health measures such as a population-based physiological vitamin D supplementation program. Based on epidemiological data some would favor, a nationwide vaccination program of children to prevent delayed symptomatic EBV infection, an aspect that remains contentious. Expansion of patient-oriented resources: Although there are widely available web-based sources of information and support, direct patient care is not always optimal. One solution is the creation of specific MS Resource Centers—a centralized ideally walk-in facility that focuses on MS-specific multidisciplinary care.
To assist in the launch of MSARD, we have commissioned three reviews. With respect to MS diagnosis, Drs. Gafson et al. discuss the recently revised MacDonald criteria for MS diagnosis. Released in early 2011, the criteria may now allow MS to be diagnosed in certain patients on the basis of a single enhanced
2
Editorial / Multiple Sclerosis and Related Disorders 1 (2012) 1–2
MRI. Dr. Lublin addresses the complex issue of MS disease activity: – what defines ‘‘no active disease’’ – and is this ever achieved once the MS disease process has begun? Finally, Dr. Banwell explores the insights gained through the study of the youngest MS patients. As inferred by the title, MSARD aims to attract high quality papers relating to MS as well as other inflammatory disorders of the central nervous system. We would welcome articles concerning disorders such as neuromyelitis optica, infectious or parainfectious diseases or other forms of autoimmune CNS disease. Inherited or metabolic disorders that share clinical or pathological features of MS would also be of potential interest.
Our aim is to promote better understanding of MS, a disease which is now within our grasp to treat effectively. We hope you share our views and that you will support this new venture. We welcome our new readers and sincerely thank Elsevier, the section editors and members of the new editorial board for volunteering to help make this journal a success. The Editors-in-Chief Brenda Banwell Gavin Giovannoni Chris Hawkes Fred Lublin
