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agate
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 Posted: Wed Jul 18, 2007 3:13 pm Post subject: Howard L. Weiner, MD, CURING MS |
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I've just finished listening to a book by Howard L. Weiner, MD, called Curing MS: How Science is Solving the Mysteries of Multiple Sclerosis (2004).
Has anyone else read it?
The author is well known in MS research. The book isn't going to help anyone who wants to know how to cope with the daily problems confronting MS patients. It's mainly an account of the developments in MS research over the last century, especially the immunomodulatory drugs.
The book came out before Tysabri, but it deals with the ABCR drugs in detail. It's clearly written and not overly technical.
Incidentally, the author defines "benign MS" as "MS that doesn't lead to disability over at least 15 years." Some doctors would say that there is no such thing as benign MS. Others have somewhat different definitions of it.
Last edited by agate on Fri Nov 01, 2013 8:41 pm; edited 1 time in total |
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lady_express_44
Joined: 22 May 2006
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Location: Vancouver, Canada
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| Posted: Wed Jul 18, 2007 7:14 pm Post subject: |
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I would like that subject matter. Did you enjoy the book, Agate? Learn anything?
Cherie
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agate
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| Posted: Wed Jul 18, 2007 7:47 pm Post subject: |
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I usually enjoy reading a book that is informative but not too difficult, and this one was one of those.
I learned more about interferons and about Copaxone--and how they work.
One small problem I had was that the author lists quite a few of his patients, with descriptions, and not one of them could be called impoverished or financially needy.
Of course, a major researcher like this Dr. Weiner would probably have only well-off patients (who can afford him), but I'd feel better about the book if he'd at least mentioned the ways in which MS can devastate some people economically. It's almost as if he's unaware of that angle.
But maybe this is an unfair criticism. He sets out to talk about the science of MS, and he does that very capably, IMO. |
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cricket52
Joined: 03 Oct 2006
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Location: northern Ontario
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| Posted: Thu Jul 19, 2007 6:56 am Post subject: |
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Just curious Agate - does he give any indication as to his theory about the cause of MS?
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lady_express_44
Joined: 22 May 2006
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| Posted: Thu Jul 19, 2007 8:19 am Post subject: |
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Weiner is (or was) Montel's doctor, right? I think he's one of the major big-wigs in neurology, if I remember correctly.
Sounds interesting! I think I'll have to go buy it. Thanks!
Cherie
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agate
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| Posted: Thu Jul 19, 2007 2:12 pm Post subject: |
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cricket, this is what he says about the cause of MS (and at one point he says that PPMS may turn out to be a different disease):
MS is
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| caused by a blood cell called a T-cell which goes astray and attacks one of many protein structures in the myelin sheath, which is what covers the nerve fibers in the brain and spinal cord. |
He says that there are many types of T-cells in the bloodstream that can cause MS. He lists different types of T-cells--
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| those that cause MS and those that serve as regulators that can keep the disease-causing cells in check. Something [is] wrong in the immune system of MS patients that upsets this balance. We don't know what triggers the T-cells to attack, but it probably relates to common viruses and how our immune system reacts to them. |
He emphasizes that there is no evidence that MS is caused by a unique MS virus,
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| and MS is probably not a single disease but a collection of subtypes. |
He mentions three T-cell types:
TH1--a T-cell that makes the chemical interferon gamma; it causes EAE and is believed to cause inflammation in MS
TH2 - a T-cell that makes the chemical IL4. It has anti-inflammatory properties and may regulate TH1 cells
TH3 - a T-cell that makes the chemical TGF-beta. It has strong anti-inflammatory properties and may regulate both TH1 and TH2 cells.
Cherie, I believe Dr. Weiner is well known in MS research. I've seen his name on many research papers, and he's Professor of Neurology at Harvard Medical School, founder and director of the Partners MS Center at Brigham & Women's and Massachusetts General Hospital, and co-director of the Center for Neurologic Diseases at Brigham and Women's Hospital in Boston.
He may be the doctor treating Montel Williams--I have to admit I hardly ever watch Montel's show (or much TV at all). Dr. Weiner does acknowledge help from the Montel Williams Foundation at the end of the book.
(Incidentally, Dr. Weiner has also written a novel, called The Children's Ward--which I haven't read yet.) |
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cricket52
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| Posted: Thu Jul 19, 2007 3:46 pm Post subject: |
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Interesting theory Agate. Not being a scientist I can only speculate, but I think MS is more than just one disease too. I also think it has more than one cause or trigger.
Thanks for the info.
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lady_express_44
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| Posted: Fri Jul 20, 2007 9:31 am Post subject: |
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[quote="cricket52"]I think MS is more than just one disease too. I also think it has more than one cause or trigger.
quote]
I think I would have to agree with that too.
Thanks for the info, Agate.
Cherie
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agate
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| Posted: Mon Aug 23, 2010 10:58 pm Post subject: Review in New England Journal of Medicine (2005) |
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I just unearthed this review of the Weiner book in the New England Journal of Medicine, February 17, 2005:
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Curing MS: How Science is Solving the Mysteries of Multiple Sclerosis
N Engl J Med 2005; 352:736-737
Curing MS: How Science is Solving the Mysteries of Multiple Sclerosis
By Howard L. Weiner. 309 pp. New York, Crown Publishers, 2004. $24.95. ISBN: 0-609-60900-9
Scientists, medical researchers, and academic physicians share a fundamental shortcoming: we consistently fail to translate and describe our professional world — its struggles, its successes, and even its basic workings — to the general public. In science, this flaw, lamentably, affects the people who direct funding policies, and in medicine it denies knowledge to patients who hope for improvements in and possible cures for their condition. As science rapidly grows more complex and technical, the gap widens between scientific realities and public perceptions of how science works. Indeed, the daily televised diet of medical breakthroughs fails to convey the complexities of medical progress and the difficulties involved in bringing a bench observation to the stage of useful therapy.
Enter Howard Weiner, a veteran neurologist with decades of experience in medical research on multiple sclerosis, with a monograph on the medical history of such research and the clinical realities of the disease. He draws a rich, fascinating portrait of important failures and successes in this difficult field of medicine. Almost an autobiography, this book is well written and detailed. It also appeals through down-to-earth language that avoids trivialization and places complex biology within the grasp of the interested but uninitiated reader. With mastery, Weiner mixes anecdote with the teaching of biologic, statistical, and medical processes, rendering a living tale that keeps the reader's attention. There is much passion here as the author highlights decades of continuing frustration in the search for causes of the clinically varied and elusive, chronically progressive condition of multiple sclerosis and its many subtypes. This book will be instructive and interesting for patients, their families, and many people with other chronic diseases.
The book manages to entertain while drawing a clear picture of the evolving process that drives medical progress, however slowly and ponderously. Few issues remain untouched, from the need for (and danger of) ego as the investigator weathers the many frustrations before the rare successes occur to the stony path from bench observation to bedside use. The tone is inherently optimistic as the book highlights the development and regulatory approval of the small but slowly growing number of drugs approved or already used for the treatment of multiple sclerosis. By and large, the author avoids diving too deeply into science and technology, and he freely and frequently admits that an understanding of the mechanisms involved in multiple sclerosis (and in most other autoimmune diseases) is missing.
Much of this book is about clinical trials in a difficult field. The trials suffer from a lack of predictive, surrogate markers of intermediate to long-term outcomes, as well as from a paucity of practical measures of effectiveness, with magnetic resonance imaging a difficult but irreplaceable tool. The author excels at illustrating these points and at emphasizing the need for proper controls, questions, and answers that can be interpreted with confidence in such trials.
The title, Curing MS, is bold and misleading, but the author himself corrects the misconception about the likelihood of cures for this disease in the last chapter. The backbone of the book is the “Weiner list” of 21 hypotheses that describe the author's view of multiple sclerosis as a primary autoimmune disease that, possibly, is caused by unknown infectious episodes. Not all of these hypotheses are uniformly acknowledged in the field, but most are in the mainstream; some, such as a strong focus on cytokines, are somewhat dated, though not inappropriately for what is basically a history of the medicine surrounding multiple sclerosis. This book does not attempt to provide a critical assessment of the status of therapy for the disease — it really does not explain “how science is solving the mysteries of multiple sclerosis,” as the subtitle claims — but it does provide a realistic look at the field, with its challenges, its origins, and the more recent achievements that have been made with a modicum of therapeutic tools.
Hans-Michael Dosch, M.D., Ph.D.
Shawn Winer, Ph.D.
Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
hmdosch@sickkids.ca
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