New rare genetic variants in multiple sclerosis

In recent years, our understanding of genetic factors associated with multiple sclerosis (MS) has considerably increased as a result of new analytical approaches to genome-wide association studies, together with the large numbers of samples available through international collaborations. It is now clear that MS risk is multigenic, and that common variants (now numbering more than 150) contribute only a relatively small proportion to the overall heritability of MS. As a result, attention has once again turned to the possibility of identifying rare variants through a number of novel as well as more traditional methodologies. However, detecting effects of rare variants once again poses challenges of statistical power, and several different approaches can be applied to manage this issue, some of which are illustrated below. In this month’s Journal Club we review five recent publications that have employed large international cohorts, multiplex families, or candidate gene approaches to investigate rare genetic variants and their association with MS risk

Alemtuzumab for multiple sclerosis: Long term follow-up in a multi-centre cohort

Background: Alemtuzumab has recently been approved for treatment of relapsing MS, but concerns remain about its use since long-term studies of adverse events remain limited. Furthermore, a clear understanding of its application and durability of effect in clinical practice has yet to evolve. Objectives: To investigate long-term efficacy and safety outcomes in a multicentre cohort of patients treated with alemtuzumab. Methods: Patients treated from 2000 and followed-up at three regional centres were identified. Baseline and prospective data were obtained and validated by clinical record review. Results: One hundred patients were identified with a mean follow-up of 6.1 years (range 1–13). Forty patients were retreated with at least one further treatment cycle. Annualized relapse rates fell from 2.1 to 0.2 (p<0.0001) post-treatment and were sustained for up to eight years of follow-up. Mean change in EDSS score was +0.14. Forty-seven patients developed secondary autoimmunity. Conclusion: Observed reduction in relapse rates reflected those reported in clinical trials, but we were unable to corroborate previous observations of disability reversal. 40% of patients required additional treatment cycles. Autoimmune adverse events were common, occurring at a higher rate than previously reported, but were largely predictable, and could be managed effectively within a rigorous monitoring regime

In the land of becoming: the gendered experience of communication doctoral students

This article investigates two aspects of the experience of communications graduate students. It examines their relations with their departments and the academic staff most close to their work (supervisors and mentors), and the existence and impact of other factors, such as age and dependants, on the duration of their studies. Despite the differences of the educational systems and socio-economic factors between countries, the findings show that the experience of the communications doctoral student is gender specific. To that a number of factors may play an important role such as academic environment and personal/private life commitments