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Neuroimmunology & Equity: Multiple Sclerosis and COVID-19

Dr. Carrithers

Through collaborations with the University of Illinois Urbana-Champaign and the Jesse Brown VA Hospital, new clinical and research programs in the Section of Neuroimmunology aim to discover the causes of inflammatory diseases of the brain and spinal cord and identify new treatments. These diseases include multiple sclerosis (MS) and emerging clinical syndromes due to the novel coronavirus, SARS-CoV-2, the cause of COVID-19. A primary focus of these programs is to determine why undeserved minority populations are at increased risk of more severe and disabling effects from these diseases.

Multiple sclerosis (MS) is a disease of demyelination of the central nervous system. Depending on the location of the damage, symptoms can include weakness, vision loss, numbness and tingling, and other problems. These symptoms typically follow a pattern of relapses. The symptom(s) can last for weeks before improving. MS can become disabling depending on the severity of symptoms and how the attacks accumulate over time. Most medications used to treat MS, known as disease-modifying therapies, help to reduce the frequency of relapses. MS was previously thought to be most common in Caucasian patients of Northern European ancestry; however, more recent research has shown that MS is most common in African American patients in the United States. In addition, risk of severe, disabling disease is higher in African Americans. Although the disease incidence is lower in Hispanic-Latino patients, these individuals seem to be at higher risk of earlier onset of the disease with possible increased risk of cumulative disability.

To address the needs of these populations, Dr. Michael Carrithers, MD, PhD, and Head of the Division of Neuroimmunology, has started a new translational research program that brings together clinical and scientific expertise at the University of Illinois at Chicago, University of Illinois Urbana-Champaign, and the Jesse Brown VA Hospital. The goal of this program is to identify novel biomarkers of MS in African American and Hispanic-Latino patients from our community. A biobank of patient samples was started at the UI Health Biorepository. These samples have been analyzed by big data approaches that include integrated analysis of acquired DNA modifications due to environmental exposures (methylomics) and by gene expression in specific immune cells (single-cell RNA sequencing). Using these approaches, several biomarkers of MS were discovered that are relevant to mechanisms that cause MS and increase the risk of disability. These novel biomarkers provide the basis to develop new individualized treatments for MS.

An important feature of this translational research program is its collaboration across campuses and institutions. Dr. Zulma Hernández-Peraza, MD, MS, specializes in multiple sclerosis in Hispanic populations, and Dr. Demetrios Skias, MD, assist with recruitment of patients at our MS clinics. Processing and long-term storage of patient samples occurs at UIC, while many of the big data experiments and computational analyses are performed at the Urbana-Champaign campus.

In addition, we have a Neuro-COVID clinic at the Jesse Brown VA Hospital (JBVA). With the assistance of Dr. Jack Rozental, MD, PhD, Dr. Carrithers developed a national telehealth clinic to follow patients with long-term neurological complications of COVID-19. Many patients who recover from COVID-19 develop chronic conditions that can affect all parts of the nervous system. These are emerging clinical syndromes that are just being described in specific detail. Many of the affected patients in underserved populations may have similar risk factors as those individuals who develop severe forms of MS. Because of the similarity of these risk factors, a long-term goal is to identify molecular biomarkers that are common to MS and Neuro-COVID.