The conundrum of iron in multiple sclerosis – time for an individualised approach

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dc.contributor.authorJanse Van Rensburg, Susan
dc.contributor.authorKotze, Maritha J.
dc.contributor.authorVan Toorn, Ronald
dc.date.accessioned2012-06-15T10:37:58Z
dc.date.available2012-06-15T10:37:58Z
dc.date.issued2012-03
dc.descriptionThe original publication is available at http://rd.springer.com/article/10.1007/s11011-012-9290-1en_ZA
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund.
dc.description.abstractAlthough the involvement of immune mechanisms in multiple sclerosis (MS) is undisputed, some argue that there is insufficient evidence to support the hypothesis that MS is an autoimmune disease, and that the difference between immune- and autoimmune disease mechanisms has yet to be clearly delineated. Uncertainties surrounding MS disease pathogenesis and the modest efficacy of currently used disease modifying treatments (DMTs) in the prevention of disability, warrant the need to explore other possibilities. It is evident from the literature that people diagnosed with MS differ widely in symptoms and clinical outcome - some patients have a benign disease course over many years without requiring any DMTs. Attempting to include all patients into a single entity is an oversimplification and may obscure important observations with therapeutic consequences. In this review we advocate an individualised approach named Pathology Supported Genetic Testing (PSGT), in which genetic tests are combined with biochemical measurements in order to identify subgroups of patients requiring different treatments. Iron dysregulation in MS is used as an example of how this approach may benefit patients. The theory that iron deposition in the brain contributes to MS pathogenesis has caused uncertainty among patients as to whether they should avoid iron. However, the fact that a subgroup of people diagnosed with MS show clinical improvement when they are on iron supplementation emphasises the importance of individualised therapy, based on genetic and biochemical determinations.en_ZA
dc.description.versionPublishers' Versionen_ZA
dc.format.extent15 p. : ill.
dc.identifier.citationJanse Van Rensbrug, S., Kotze, M. J. & Van Toorn, R. 2012. The conundrum of iron in multiple sclerosis – time for an individualised approach. Metabolic Brain Disease, 27(3), 239-253, doi:10.1007/s11011-012-9290-1.en_ZA
dc.identifier.issn1573-7365 (online)
dc.identifier.issn0885-7490 (print)
dc.identifier.otherdoi:10.1007/s11011-012-9290-1
dc.identifier.urihttp://hdl.handle.net/10019.1/21422
dc.language.isoen_ZAen_ZA
dc.publisherSpringer USen_ZA
dc.rights.holderAuthors retain the copyrighten_ZA
dc.subjectMultiple sclerosis -- Alternative treatmenten_ZA
dc.subjectAutoimmunityen_ZA
dc.subjectBiochemistryen_ZA
dc.subjectGeneticsen_ZA
dc.subjectAutoimmune diseases -- Personalised medicineen_ZA
dc.subjectMultiple sclerosis -- Researchen_ZA
dc.subjectMyelinen_ZA
dc.titleThe conundrum of iron in multiple sclerosis – time for an individualised approachen_ZA
dc.typeArticleen_ZA
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