Highlights in Multiple System Atrophy Research | Congress 2023

[00:00:33] Dr. Alessandra Fanciulli: Good morning, Eduardo. 

[00:00:35] Dr. Eduardo Fernandez: So we are gonna discuss multiple system atrophy. Advances and challenges ahead. What do you think are the highlights of the last few years in, in multiple system atrophy research?

[00:00:47] Dr. Alessandra Fanciulli: Well, we have had quite some first a new MSA MDS criteria, the diagnostic criteria and have been released. This was quite a big work, which has been run during the Covid [00:01:00] time. And finally, we have a good tool in our hands to identify people with MSA with high diagnostic accuracy as you've shown in your validation study. The criteria also introduced a very important novelty element, which is prodromal MSA. So how this new research criteria, taking the very early stages of the disease and this is an important area of research where also biomarkers play a very important role. And there have been also some news in this direction this year.

So there are several papers on the roll of skin biopsies and differentiated the different alpha synucleinopathies, and I appreciate this is particularly important in countries where you do not have an easy access to their example functional neuro imaging. But also very, very exciting for, from Japan.

Results from [00:02:00] Japan were maybe we could be able to have blood biomarkers for MSA and PD. Can you imagine if we are able to identify the synuclein strains in the blood or what kind of revolution this would be? So I think these were the most exciting highlights in the last year in terms of diagnosing the disease.

But of course there are many groups also working on curing the disease. There has been another very interesting study also from published from Japan, which was proving efficacious. On slowing down a bit of the disease progression by using, exploiting the antioxidative effect of ubiquinol.

 And I think this is very exciting, not only for the Asian population, because many of the MSA patients who were participating in this trial were MSA-P. So this [00:03:00] might be applicable also to, let's say Western population. 

[00:03:05] Dr. Eduardo Fernandez: Excellent overview. We have seen some of those results being presented or discussed in some of the sessions here at the Congress, and we had excellent talks for example yesterday.

Just for the, for the listeners who will be able to catch up on some of these sessions, what are your highlights? Related to MSA here from the Congress? 

[00:03:25] Dr. Alessandra Fanciulli: Oh, well yesterday was indeed the the MSA day at the Congress. Mm-hmm. There was a plenary session, which was on atypical Parkinsonian syndromes, but the colleague made a terrific job in reviewing from the pathophysiology, the mechanism of disease. So the role of this detriment the detrimental role of the environment in determining alpha-synuclein oligodondrocyte pathology. This was an excellent lecture, but also reviewing so our care opportunities. But because while we are looking for a cure, we need to [00:04:00] secure the highest possible and personalized standard of care for these people, which also means developing care pathways which are not available in many regions of the world. So this has been reviewed yesterday during the plenary, this was Marina Picillo. And there were also some very interesting, were many abstracts on MSA topics, which is encouraging to see that many groups worldwide are working on this rare disease.

 And there were some interesting highlights. We saw the baseline data of the study with alpha-synuclein antibody in MSA, so no results yet, but the baseline data and they looked pretty solid. So, and, and this. Very good people working on this project. So we are excited to see the results. There were data published on the preliminary proof of efficacy of an norepinephrine transporter blocker for treating orthostatic [00:05:00] hypertension in MSA. There's another study which is up and running, and we hope we will have another weapon to treat this very disabling non-motor symptoms. There were also some very interesting basic science studies. One has been selected also for oral presentation, I believe, with an Abl tyrosine kinase inhibitor, which showed neuroprotective in MSA mouse model.

So there's something on the horizon maybe there. 

[00:05:32] Dr. Eduardo Fernandez: The field is moving very quickly. Yeah. And there is a lot of promising results and exciting development. So what do you think are the hot topics and what sorts of advances do you, do you predict for the year ahead? And also the challenges that we will have to face as, as MSA researchers.

[00:05:53] Dr. Alessandra Fanciulli: Well, MSA researchers face many challenges since ever, so this is no [00:06:00] news for us. 

[00:06:00] Dr. Eduardo Fernandez: We are used to it. Yeah.

[00:06:01] Dr. Alessandra Fanciulli: Yeah. We are used. This is definitely not, not an easy field to, to work in. I mean, key priorities, finding a cure for this terrible disease, but the good news, there's industry interest in working on this rare disease.

And this is definitely a priority. This is really important. So in this direction I see, and I hope we will have more. In the, in the future. But where it is very important, this is also very important, synergism between industry and academic university centers, so MSA centers and also being even more so now with the criteria we have, we have defined, we have reflected, there's this prodromal category of MSA and now we need to be to refine.

You know, trying to be as accurate as possible in the very early stages of the disease because you want to give the right track to the [00:07:00] right person. And so biomarker research is very important in this setting. On the other hand, I think it is very important to develop even better care pathways for the, for these people, especially towards the end of life.

And I believe Covid was a terrible thing, the pandemia, but introduced some novelty elements which I believe they can be really helpful in the setting of MSA, such as telemedicine to reach out to these people when they are they suffer from severe immobility. So this is something we are working on and exploiting in Innsbruck with a positive experience.

 So caring and curing.

[00:07:44] Dr. Eduardo Fernandez: I like the optimism and, and the ambitious objective of finding a cure. Yeah.

[00:07:48] Dr. Alessandra Fanciulli: Yeah. We need to find a cure and take care while doing this. 

[00:07:52] Dr. Eduardo Fernandez: Mm-hmm. Excellent. Thank you very much for this excellent overview of the MSA field. And thank you to [00:08:00] the listeners for the time.

Bye-bye for now.