More than 10,000 people in Ireland are living with multiple sclerosis, or MS, which affects the body’s nervous system. At CÚRAM, Dr Una Fitzgerald leads a programme of research to uncover new ways to treat MS and help improve people’s quality of life, particularly in the later stages of the condition.
What is your lab working on at the moment?
A big focus we have now is looking at ways for people to more easily track their MS. We are developing a small testing kit, along the lines of a COVID-19 test, that would detect important markers or signs of MS in a bodily fluid such as saliva.
What kinds of approaches are you looking at?
PhD students in my lab at the University of Galway have been looking at how to detect these kinds of markers in tears, saliva and blood. We are also exploring how tracking a person’s upper limb mobility and even their sense of smell could be used to help to monitor the condition. They are brilliant researchers and we have been making huge progress. We recently carried out a pilot study comparing results from people who have MS and people who don’t have MS, and we are grateful to all who took part in the study.
Why would it be a benefit for people with MS to be able to test for signs at home?
When people are diagnosed with MS they may be in their 20s or 30s and they will live with the condition for the rest of their life. The insulating protective myelin covering around their nerves breaks down, and over time this can cause problems for walking and seeing, for instance. When people are in this so-called ‘progressive’ phase of the disease, being able to get the data at home instead of having to always go to the clinic could be an advantage, and their condition could be monitored more easily.
Is the research just at Galway?
It is across the EU, and Galway is a big part of it. I led the EU-wide Innovative Training Network Consortium; and we worked, in collaboration with Professor Pandit, Director of CÚRAM, who was a Co-investigator, on medical devices for treating progressive MS. We worked with colleagues in Denmark, Germany, France, Belgium, Italy, Spain and the Czech Republic, and we trained 13 PhDs and two researchers in industry, who have become expert researchers on the progressive phase of MS – we need as many of these researchers as we can get!
How did you become interested in MS research?
That happened when I was working at the University of Glasgow, in Scotland, in the 1990s, supervised by Prof Sue Barnett. I had been researching cancer, but really wanted to move into neuroscience, so I started working in a lab that was looking at a type of cell in the brain called an oligodendrocyte. These cells make the protective fatty myelin that insulates nerves, causing signals to move much more rapidly along nerve tracts in the central nervous system. That’s how I became interested in doing research on MS.
What kinds of things did you discover?
We found that a particular biochemical pathway, or a chain of reactions that happens inside cells, was switched on in MS, particularly around sites of damage. When I moved to Galway I developed this work further and we were able to show in brain samples in the lab that this pathway could respond to different factors. That was very exciting.
Why did you start to work with CÚRAM?
I was invited to join CÚRAM and I could straight away see that I would be joining a centre with people who had lots of different perspectives on the brain and nervous system. People were working on stroke, pain, anatomy and medical devices, and I wanted to bring MS into the mix.
Apart from the rapid testing devices, what other kinds of devices might help in MS?
I’ve been working with Prof Abhay Pandit at CÚRAM on a device that could deliver medicine more directly into the brain, as it is a difficult part of the body to target with medicines. This device would be minimally invasive and be located close to the surface of the brain, and use a type of material called a hydrogel to slowly release medicines into the outer layer of the brain, which is an important site to target in MS.
Why is the outer layer important?
As one example, we know that the immune system doesn’t work properly in MS and that immune cells called B cells tend to cluster together in the crinkles in the outside layer of the brain in MS, they form little nodes in those folds. We have been able to study that in our lab-based studies.
What’s the most important part of MS research for you?
One is spending time with people who have MS and groups representing people with MS. Speaking with and learning from people who live with the condition has made me want to see the lab discoveries being translated to make a difference to their lives. It’s also really important that early-stage researchers are trained and funded to do research in this area. There are so many new discoveries about the brain and the immune system and MS itself, we need to keep doing the research and working with people who have the condition. We want to make a difference.
You can find out more about Dr Fitgerald’s research in this series of videos
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