Introduction 

Welcome to The Raw Nerve, the official podcast of MS Australia, a conversation space for all things multiple sclerosis. Join us for news and views on the latest research, treatment and advocacy efforts, as well as candid and informative interviews with our community. Those living with MS and their families and carers, together with leading clinicians, researchers and advocates.  

Jeremy Henderson  

Hello. Welcome to The Raw Nerve. I’m your host, Jeremy Henderson. Today on The Raw Nerve, we’re talking about new and innovative MS research. Research that’s just been funded under MS Australia’s latest research grant round announced earlier this month. Today, we’ll be speaking with four distinguished MS researchers about their new research projects. Let me welcome two of those researchers into the studio now. Firstly, we have Associate Professor Yvonne Learmonth from Murdoch University in Western Australia. Welcome, Yvonne.  

Associate Professor Yvonne Learmonth  

Welcome. Thank you for having us. Jeremy 

Jeremy Henderson 

And from the other side of the country, we have Dr Seyhan Yazar from the Garvan Institute and the University of New South Wales. Welcome to you, Seyhan. 

Dr Seyhan Yazar 

Thank you. Jeremy. It’s a pleasure to be here. 

Jeremy Henderson 

I’m also joined today by one of my colleagues who’ll be familiar to our guests today and to many of our listeners. Dr Julia Morahan is, of course, the Head of Research at MS Australia. Welcome, Julia.  

Dr Julia Morahan 

Thanks, Jeremy. Hello, everyone. 

Jeremy Henderson 

Okay, let’s jump right in. Julia, first question to you. I wonder if you can talk to me about the research funding round that’s just been announced? 

Dr Julia Morahan 

Absolutely. So we’re very pleased, to be able to announce $5.7 million worth of grants that are going to be happening over the next three years from MS Australia. And these grants are looking at all different aspects of MS research. And this is a very complex disease, and we’re really trying to have a diversity of topics so we can tackle this disease from all directions to get better outcomes for people living with illness.  

Jeremy Henderson 

MS Australia plays this vital role not only in funding research, but also in coordinating MS research in Australia. I wonder Julia, just quickly, if you can sort of give me a, talk to me about the role MS Australia plays in the stewardship of MS research in this country and why that’s, so vital? You talked about MS itself and MS research being such a complex field. It is really a sort of a vast jigsaw puzzle, if you like and I imagine it needs a degree of coordination. 

Dr Julia Morahan 

Yes, it does. And I think one of the great things about MS Australia’s research program, which I think is potentially different from other not-for-profits, is we have another funding arm for our research program in our national collaborative platforms, and they really try to bring together researchers around particular topics of interest, to make sure that we are really trying to accelerate outcomes and promote collaboration and make sure that we avoid duplication. So bringing people together to really try to fast-track the outcomes for people living with MS. 

Jeremy Henderson  

Thank you, Julia. Seyhan, I wonder if we can turn to you and talk to you about your research project. And I understand you’re conducting research that can potentially get us closer to ways of diagnosing MS much earlier. I wonder if you could tell me about your research. 

Dr Seyhan Yazar 

Yes, definitely. So if you think of, like, in everyone’s lifetime, we are born with our genetic makeup, which predispose us to certain conditions. And as we grow up, we are exposed to also environmental stimuli, which shapes our lifestyle. And unfortunately, at some stage of our life, some of those people will unfortunately get a condition like MS, but the MS diagnosis does not happen until actually the patients get the clinical symptoms which can be actually diagnosed by the doctors. So what we would like to look at that like period when actually the disease process starts within the body and until like you know those clinical symptoms start so that period is specifically called MS prodrome. So what we are trying to identify by looking into the MS patients who have diagnosed priority, their treatment commencement, to look at their blood samples, basically, and identify any signatures that we can identify, which will help us to actually, identify them early on. 

In addition to that, we are also looking at their medical history. And so sometimes, once you have, like, you know, the neurological symptoms, that we already like to know where the disease are already started. But prior to that, sometimes, people with MS could have non-specific symptoms and signs, which can be very familiar to general symptoms. We would like to investigate further to be able to actually find any specific MS-related, general signs and symptoms. So that will also allow us to identify individuals early on, in this MS prodrome phase. 

Jeremy Henderson 

Julia, I wonder if we just come back to you, and you can sort of maybe unpack some of that for me. I’m most interested in how MS is currently diagnosed and why that’s problematic, and it’s problematic because at the time of diagnosis, a certain amount of…a certain degree of damage has already occurred. So that’s obviously problematic. But I wonder if you can speak to that and speak to why finding ways of diagnosing MS much, much earlier is just obviously, so, so beneficial and something that could be potentially so promising in terms of MS research. 

Dr Julia Morahan 

Exactly. So I think as Seyhan said, the diagnosis that people receive of MS happens clearly after they’ve already developed symptoms. But we know that the disease process in the brain, in the spinal cord is happening much earlier. And really if we can kind of understand what’s happening in that earlier window, which Seyhan has called the prodrome, then we might be able to make diagnosis quicker. And the reason that we want diagnosis to be as early as possible is because we’ve shown over and over and over again, that early, optimal treatment of people with MS makes a massive difference to long-term outcomes. So the further kind of upstream, we can identify people who might go on to have clinical symptoms, hopefully the sooner we can get them onto a treatment plan that works for them and the better their outcomes can be. 

So this is a really exciting project in terms of actually affecting long-term outcomes for people that may go on to have MS 

Jeremy Henderson 

Seyhan, I wonder if you can unpack for me a little bit about how you go about this actual research project. And, and I’m imagining that potentially some of the work you’ll be doing is building on the work, some work that’s come before? I wonder if you just tell me exactly what the project looks like and how you’ll go about this work. 

Dr Seyhan Yazar 

This project is actually two arms. And the first part is like looking at the biomarkers for that. We are actually building on the Open Coast-to-Coast Australian consortium work, which was started like, you know, in 2002, in which the funding that we had received from MRFF, so using some of that cohort resources, and then also like, you know, recruiting new participants, as controls, we are actually comparing blood signatures between different groups. And to do that, we are using more advanced technologies like single cell, genomics, or single cell sequencing. And these technologies became, like, available in the past ten years. And they are actually like, you know, becoming much more popular. And they are the go-to tools for individualised, like, treatments, and diagnostic tools. 

So we will generate, like, you know, these types of data, to be able to identify blood markers. On the other arm of the study, we are, looking at like, medical records of individuals who are already diagnosed with multiple sclerosis, collaborating with a research group at the Liverpool Hospital at the Ingham Institute. We are doing investigations looking at the up to 20-year medical history of multiple sclerosis patients to see what signs and symptoms they had had in previous visits to their hospitals or their care. So we can actually see, how these things develop, what frequency they have been hospitalised and what for, and what they were treated with, and how the disease has progressed if it’s like diagnosed in the past. 

So we are looking at their history of disease in a nutshell.  

Jeremy Henderson 

Seyhan, I know I’m not meant to ask a scientist this question ahead of the experiment, but, you know, what are you hoping for? How hopeful are you in terms of progress you’ll make with this research? 

Dr Seyhan Yazar 

I guess, I have to agree with Julia. This is like, you know, this research speaks to more long-term goals of, like, you know, MS research. So, we are aware that, like, you know, it might not be that quick to find like in the some of the answers, for causes and like for prevention of multiple sclerosis, but definitely these will like, you know, will be the seeds that will take us eventually. And there are already other like a…groups around the world who’s working in this field. And so we are hopeful that, like, you know, that our efforts will be combined with like, an average that, from overseas will allow us to, like, take this type of research, and advance it as much as possible. Sometimes, it is challenging to find these markers. 

It really depends on the numbers of individuals, we have. And since MS is a rare disease, we have to collaborate, within Australia and overseas to actually find, and validate some of our findings. But once it is done, I think it will be really important. And we see examples of this, like in cancer research where they can get the genetic makeup of an individual and generate an individualised treatment, for patients who actually respond to treatment on time, and they usually you know, have a better outcome. 

So if we could actually find a method like this, by looking at a blood signature for MS patients, that would be the end that we are looking at. So being able to find that individualised treatment, for better outcomes in patients. 

Jeremy Henderson 

Julia, Seyhan’s observation that so much of this work, so much of this important work can be incremental, that it can be building on other work that’s come before, I think goes to your earlier point about the importance of making sure this work is funded, but also making sure this work is coordinated so that there is that degree of stewardship from MS Australia, looking at that big jigsaw puzzle, looking at the different areas, areas of opportunity and making sure that we’re building on the great work that’s come before. 

Dr Julia Morahan 

Exactly. And I think, so there has been a bit of work on the prodrome, both here and internationally previously, but one of the pieces of Seyhan’s work that is really exciting is the blood biomarker, the marker in the blood, the signal in the blood. 

And whether or not we can find something that’s a bit specific or bit more specific than what we already have for MS. And this story of trying to figure out some sort of a blood test to identify MS is older than I am. It’s a long process, but if we can find, and probably a combination of signals, to be honest, a constellation that makes sense, it would just honestly transform how we go about identifying people as… in an accessible and easy way. 

So I think a lot of these projects are three years. But they’re really a snapshot of a piece of work that is going to go for a very long time. But each project in itself is one of those pieces of the puzzle that we’ve been talking about.  

Jeremy Henderson 

Thanks, Julia. Yvonne, I wonder if we can bring you in now and talk to you about your project. 

A very different project, but an equally valuable one. I wonder if you can just tell listeners a little bit about the work that you’ll be doing.  

Associate Professor Yvonne Learmonth  

Yeah, sure. But before I do that, I would just like to respond to a lot of the work that Seyhan’s doing because it’s really important. And maybe at the end we could see linkages with some of the work that I’m doing. And those blood biomarkers could help future-proof the behavioural research that I’m about to go and talk about now. So yes, my MS Australia-funded project is called Co-designing Exercise Promotion for MS Healthcare Providers. And as a physiotherapist, I know of the unfortunate outcomes that come from patients looking after their health. Obviously, management of multiple sclerosis comprises two main forms. We’ve got pharmacological interventions, but over the last two or three decades, we’ve really realised that behavioural interventions can play a pivotal role in improving health outcomes. 

So my area in particular, or our area in particular in this project, is looking at exercise promotion. Now, exercise has been known for many years to improve physical and mental outcomes for people with MS. It can help with their mobility, can help with their fatigue, can help with mental health outcomes and their interaction with society – returning to work for example. So a few years ago, we went and we asked individuals with MS who they would like to receive advice from regarding exercise. And they all told us so that healthcare professionals and particularly doctors and nurses were the main people who they would like to receive confident conversations with. So whilst people like me, physiotherapists and exercise specialists were mentioned, you definitely want to hear messages from the neurologists and from the nurses. 

And this brings us really to the project that MS Australia is helping us do over the next three years. And that’s to take what we’ve learned from designing modules and training outcomes for exercise physiologists and physiotherapists to promote exercise and MS, but to better train MS nurses and to better train neurologists to have those conversations when they’re in the moment with their patients, with their clients, and to be able to inform them about things like exercise, things like how to best refer to and the community, and to make sure that the message is universal and that we’re all telling similar stories because confusion can arise and that can really take people down the wrong path. So it’s often about educating healthcare professionals, and we’re going to be doing that through a lot of consumer-informed work.  

Jeremy Henderson 

Yvonne, that’s not really surprising in terms of confusion. I mean, even among the general population, there’s often not consensus, about, you know, what the ideal exercise regime might look like for most people or what, you know, the best diet might look like for most people. A couple of observations. I wonder whether we’re at least heartened by the fact that, the community want to get expert advice from experts? We’re living in 2024, where there are so many people that are not experts giving advice that is not great. So is there some comfort in knowing that people want to get that advice from doctors? 

And I guess the other the other question I have for you is…this is an exciting area of research, in as much as we know people living with MS want some agency over their condition, over progressive illness, that they don’t in many, many ways have a great degree of control over. 

And that, in terms of those behavioural aspects you talked about in terms of exercise or diet, for example, that that’s an area of their lives that they can actually take control in and have real agency. 

And I imagine a question maybe for you, Julia, that’s something that’s…we know from talking to the MS community that’s something that really matters to them. 

Dr Julia Morahan 

Absolutely. So I think we talk a lot about modifiable lifestyle factors, at MS Australia and, and I imagine, in the clinic and in the community because there are so many aspects of MS that really are a little bit beyond your control. So people living with the disease are very interested in these interventions. 

But one of the aspects of Yvonne’s study that I really appreciate and is really aligned with MS Australia’s strategy and, way of thinking I guess, is the co-design piece. So involving people living with MS in the actual design of these toolkits to make them as effective as possible. 

Because as you say, Jeremy, and of one and anyone who you ask, we all know exercise is great for us. But it’s annoying and difficult to stick to sometimes. And so being able to get that message across, making sure that it’s as clear as possible, making sure that there’s cut through with the messages and it’s effective when you’re trying to get people to change behaviour, particularly, it’s crucial. 

And so I think for this particular project, the co-design is what is going to make it such a special piece of work and hopefully really actually change behaviour for people living with MS 

Jeremy Henderson 

Thanks, Julia. Yvonne, in terms of that co-design process, co-design of the toolkit, what does that look like? How do you go about that work? 

Associate Professor Yvonne Learmonth  

Yeah. So and we go back to the drawing board when it comes to something called implementation science. And that’s thinking about how feasible a project is, how well might it work in the real world. So what our plans are is to look for the evidence base at the moment and present that evidence base to individuals with MS. But other important people in this story are, of course, the doctors and the nurses. So presenting that evidence to them and also presenting the toolkits that we’ve already designed and seeing how appropriate they would be for delivery in the Australian healthcare system. 

So we’ll be having focus groups and we’ll be discussing those things that I’ve already talked about and thinking about the acceptability and the appropriateness. And then the plan in the first part of the project is to design particular toolkits that can be utilised in the clinic, test them out in a smaller group of healthcare professionals, again, get feedback from those interactions and then move on in later years of the project to really implement it in a larger group. 

And this project, we’re looking to change behaviours in two groups of individuals. So changing behaviours of the healthcare professionals. Are they feeling more confident to have those conversations? Do they have the information at hand so that they can answer questions that come from their clients? But then we’re also looking to see, has those conversations actually changed the behaviours of individuals with MS? 

Ad we’re going to be doing that by using little devices called accelerometers, which will be monitoring how much walking people are doing over the course of a period of time and seeing whether or not the discussions with the healthcare professionals actually change how active an individual is. 

Jeremy Henderson 

I wonder if I could ask a question, maybe of all three of you, but, you’re doing scientific research with purpose and scientific research that at the end of the day, can make a huge impact on the quality of, people’s lives. 

Is that what drives you? Is that what makes, you know, gets you out of bed in the morning and makes you so passionate and enthusiastic about the work you’re doing? 

Perhaps if I can go to you first Yvonne. 

Associate Professor Yvonne Learmonth  

Yeah, definitely it does Jeremy. Whilst the opportunity for me to do MS research has been happening for the last 15 years or so, I would say that it does get me up in the morning and being able to promote the many benefits of living an active life. And I could tell you stories, many, many stories about people whose lives have changed by being able to take control, of what they’re doing on a day-to-day basis. And as we’ve all alluded to, those changes can be difficult. 

But by using the guidance of healthcare professionals in this case and taking clear actions on our future health, it can make for better outcomes. And really, people’s lives can change when they take matters into their own hands with a little bit of guidance. 

Jeremy Henderson 

Thanks Yvonne. Seyhan, what motivates you and drives you forward every day? 

Dr Seyhan Yazar 

Yes. I have been in research for just like over ten years, but previously I was working in an ophthalmology clinic where we were actually seeing individuals with multiple sclerosis, which was actually, affecting their vision. And I also seen like, you know, individuals with many other diseases. And so what motivates me, I guess, to be able to help them with the hope that the research that we are doing may be able to help them out, and may help other researchers who would like to help out, like Yvonne, so we can actually combine our forces to be able to actually help those who are affected by MS, so their life would be improved. 

Jeremy Henderson 

Thank you Seyhan. Julia, I wonder if you can talk to me about, I often hear the MS Australia research program being spoken about in terms of being sort of the gold standard in terms of the checks and balances and the way the program is run and managed and the way the grant recipients such as Yvonne and Seyhan are selected and chosen. What does that process look like? And it’s incredibly competitive. And we can see the quality of the grant recipients that have been successful in this round. I wonder if you can just talk a little bit about that for me.  

Dr Julia Morahan 

Sure. So, we do have a gold standard investigator-led, grant program, and that’s because, we don’t do take this lightly. It’s not an ad hoc situation. We do not pull names out of a hat. And the process of application and review of applications and assessment of applications actually takes a full year. So we have just in fact, opened our first round for the grants that are going to start in 2026. And the process involves us receiving applications from researchers like Yvonne and Seyhan. But then we also send those applications out to specific reviewers who are experts in the exact field that that application topic is on. And we do that for at least three, if not more reviewers, and we ask them to assess it with their expertise. 

It’s called peer review. It’s very time consuming. We also have a step where the researchers who have submitted the application can then respond to the review so that it becomes a bit more of a conversation. And then late in the year, we have an expert panel known as the Research Management Council that assesses all of the applications, all of the reviews that we have received, the rebuttals and decide on a score based on a range of different criteria. 

And the thing that I really love about our investigator-led program, unlike our national collaborative platforms which I mentioned before, are targeted around a particular topic. For these particular grant applications we simply do all… “simply do all of that process” …my grant coordinator is going to kill me. Simply do all of that process, and then we make a list, top to bottom.  

And when the money runs out, we draw a line. We don’t fund based on jurisdiction. We don’t necessarily fund even based on topic. We just fund the absolute best research. And that, for me, makes it really defensible in terms of people out there in the world, that are donating to us, raising money for us. I always say, I promise you, it will be spent as perfectly as possible, because we try so hard to make sure that the process is incredibly robust and transparent, and we come out the other end with beautiful grants, such as the ones we’re talking about today. 

Jeremy Henderson 

Excellent, Yvonne and Seyhan. If I can ask just one last question and it’s maybe a little bit self-serving, but, you know, what would the MS research landscape look like if MS Australia wasn’t here and wasn’t providing the investment and the stewardship that it’s doing currently? 

Dr Seyhan Yazar 

I could probably go first. If that’s ok. So I guess, this takes us to back to the start, and how Julia introduced. I think there’s two important aspects of MS Australia. It’s always a privilege to be one of these research grant receivers, that the funding in the landscape of…funding opportunities in Australia is known to many of us. So it’s this extra or very important part of the funding opportunities that we have as researchers, to perform our research. And, and the other aspect is MS Australia is bringing us together and introducing us together. Like. And today I got to know more about Yvonne’s work. And I will be following up that, since now and so I guess, like, you know, that’s the beauty of, like, you know, having this, platform where we as researchers will be supported, by, Julia’s team, to come together and work together, so we can actually have much better research than working in solo. 

Jeremy Henderson 

Thank you Seyhan. Yvonne? 

Associate Professor Yvonne Learmonth  

Yeah. And I’ll further that point and underline it a little bit with my accent being that it isn’t a particularly strong Australian accent. So, MS Australia has allowed me to come to this country. I’ve been here for almost ten years working directly in MS research. And throughout that time, MS Australia has advocated for the work that I’m doing and also enabled me to collaborate with researchers across the country. 

And without MS Australia, none of that would have been possible. So I wouldn’t be where I am today. But also, I think the strength of the research coming out of the country wouldn’t be in the same position that it would be if it wasn’t for the funding provided by the robust grant process that Julia and her team go through each year, knowing that in the competition for medical research is very, very high, it’s reassuring to know that we have funding, direct funding directed only to MS research, and the listeners can be assured that, as Julia said, hopefully the best research will, always rise to the occasion and we’ll do our best and to do you justice for all your donations.  

Jeremy Henderson 

Thank you very much. 

Julia. Maybe just one last question before we wrap up this first section of the podcast. You know, today, it’s obviously really, really exciting. We’ve announced these grants, but obviously this is the start of the process, not the end. And there’s like a lot of work to be done. Some of these projects are running over a period of three years. I wonder if you could just talk about that and the fact that that observation that this is really just the start of a journey. 

Dr Julia Morahan 

Yeah, absolutely. I love grant announcement day. Because it is the beginning of, of a lot of new things, but it’s also the continuation of a lot of work that we have funded and built, or people have funded and built over many years. 

And I think the momentum in MS research and in MS, in the treatment landscape, and the way that we manage people living with the disease is getting better and better. And obviously I’m biased, but I completely think that is due to the great research that is happening all around the world and definitely all around the country here. 

So, we look forward to seeing what happens over the next three years. And we do, check in with these guys and, and speak to them and harass them along the way and make sure that everything’s running smoothly. But mostly we’re just looking forward to the fantastic outcomes and wanted to say congratulations to you both on fantastic applications and projects, and it’s a pleasure to, have you on the rounds for this year. So best of luck. 

Dr Seyhan Yazar 

Thank you. Julia. 

Jeremy Henderson 

Thank you. So look, we will take a short break. Can I just thank our guests, Associate Professor Yvonne Learmonth, and Dr Seyhan Yazar. Thank you very much for joining us on The Raw Nerve podcast. Julia Morahan…don’t go anywhere. We’ll be right back after this short break with our next guests. Thank you very much. 

Jeremy Henderson 

Hello. Welcome back to The Raw Nerve. Today on The Raw Nerve we’ve been talking about new and innovative MS research. Research that’s been funded under MS Australia’s latest research grant round that we announced just a few days ago. I’d now like to welcome our next two guests into the studio to speak about their research grants and the exciting work that they will shortly be getting underway. 

Firstly, we have Dr Jessica Fletcher from the Menzies Institute for Medical Research at the University of Tasmania. Welcome, Jess.  

Dr Jessica Fletcher 

Hi. Nice to be here.  

Jeremy Henderson 

And from the University of Adelaide in South Australia, we have Dr Iain Comerford; welcome.  

Dr Iain Comerford 

And great to be with you, Jeremy. 

Jeremy Henderson 

And still in the third chair, we have my colleague MS Australia’s Head of Research, Dr Julia Morahan. 

Julia, great to have you on deck, still. Thank you for staying with us and helping us unpack some of this work.  

Dr Julia Morahan 

No worries. 

Jeremy Henderson 

Now Jess if I can start with you. Tell me about a little bit about your project. I understand your research focuses on myelin repair. 

Dr Jessica Fletcher 

Yes. So a lot of the research that I’ve done throughout my career has been focusing on ways that we can make the brain stimulate its own repair mechanisms. And this is really important for MS. Because when there’s demyelination, that leaves the nerves vulnerable to damage and dysfunction. And so if we can actually recover that myelin or get the brain to make new myelin, it can then protect those nerves and hopefully prevent that neurodegeneration and neuron loss occurring.  

Jeremy Henderson 

That’s excellent. So what does your project look like? How are we going to go about that work?  

Dr Jessica Fletcher 

So my project is very molecular based. So it’s very kind of nitty gritty details. So I guess the main thing we’re looking at is actually what happens inside the cells that make myelin. So they’re called oligodendrocytes. And we’re really interested in, I guess, how the molecules that are responsible for controlling myelin production are switched on and off. 

And so we’re trying to figure out what those switches are and whether or not we can actually manipulate them to turn them on when we need them to.  

Jeremy Henderson 

What do you hope that your research will uncover? Where do you hope to be at the end of this project?  

Dr Jessica Fletcher 

So what I really hope we find is that we can actually push oligodendrocytes to make myelin when they don’t want to. And so hopefully that can actually be the foundation for, I guess, the next generation of treatments or treatment strategies to actually promote myelin repair in MS. 

Jeremy Henderson 

If successful, this this research could be hugely important, hugely significant. It’s been described as pioneering. Is that right? 

Dr Jessica Fletcher 

That’s what I’ve heard. I think one of the things is that for us as researchers, often we are just in the middle of it. And so not always as aware of what other people might be calling our research, because sometimes it’s very hard to get going. But it is one of the projects that I’m so excited about because of how we’re going about it and the new information that we can uncover, which will just be important, for understanding how we can prevent neurodegeneration and MS. 

Jeremy Henderson 

I know Julia shares that excitement and does see this research as being pioneering. Julia, why is it so exciting? Is Australia playing a really significant role in this particular space?  

Dr Julia Morahan 

I think we are Jeremy. And congratulations, Jess, on an amazing project. I’ve talked about this so often, but the repair piece in MS is so important for people living with the disease. We still haven’t got a handle on how to repair the damage that has already been done. We know a little bit about the immune system, and that’s where most of our therapies have come from so far. But being able to push repair or boost natural repair, which is what Jess is after with this project, could lead us to a whole new kind of class of therapeutics that would really fill that gap. 

So we’re very excited about this project. And I think, we have been thinking about this for a long time, and we’re getting closer and closer and it’s just fantastic.  

Jeremy Henderson 

Thanks, Julia. Iain, I wonder if we can turn to you. Now, I understand your research is investigating how inflammatory immune cells are switched on in MS. I wonder if you can tell me about your project, about your research? 

Dr Iain Comerford 

Yeah, sure. So the project that we are working on is trying to understand how cells of the immune system that cause the damage in MS actually emerge. So there’s lots of different cell types in the immune system, and they all have slightly different jobs. Not all of those cells cause inflammation and disease and diseases like MS. 

And what we have discovered is, previously unrecognised interaction between two different cell types and the immune system. So that’s white blood cells in the bloodstream. So we’ve identified an interaction between two of these cell types that drives the development of a really inflammatory cell type that has been implicated in MS. So the research we’re doing is really to try and understand the nature of the interaction between these cell types, to understand the mechanisms that drive the formation of these inflammatory cells, with ultimately the goal of then being able to identify ways in which we could block those interactions to switch off the inflammatory immune responses that really drive MS. 

Jeremy Henderson 

And then if once we reach that point, we’d be able to potentially develop treatment therapies…? 

Dr Iain Comerford 

That would be the idea. So we would hope that we could identify treatments that can interfere with those interactions. And potentially that could be a more selective way to switch off damaging immune responses whilst maintaining immune responses that are beneficial to us. 

So one of the problems with the MS drugs that are currently available is that we don’t selectively target just the cells that cause MS. They also have effects on helpful immune responses and can leave patients receiving those therapies somewhat immunocompromised. So we hope to be able to develop a new generation of therapies that can get around that issue and be less harmful to the patients and keep the beneficial effects of reducing MS. 

Jeremy Henderson 

Julia, I think we spoke about this earlier in the episode, this idea of science often building on work, important work that has come before and often that it’s about, you know, adding sort of blocks to, to that foundation and you’re not necessarily going to get from the start to the end in one research grant. But whatever advancements and steps are made with each of these projects are just so critical and so important. Is that the case with both of these projects we’re talking about today?  

Dr Julia Morahan 

Absolutely. I think, I mentioned before that we do know a little bit about the immune system and how it’s behaving in MS. But Iain’s project particularly is about trying to be very specific about what is happening when damage is occurring and, in MS and where there is that kind of inflammatory response because we do have these immunotherapies. But I was just thinking as you were talking Iain, and I heard a neurologist refer to at once that we have a lot of carpet bombers in terms of our therapies and what we need is a sniper. So we’re knocking out a bunch of good stuff, potentially, when we’re treating people living with MS with some of these immunotherapies. So being able to understand at a molecular level with Iain’s project what’s happening, means that we can really kind of target more precisely how this damage occurs. 

And all of Iain’s work builds on all of the immunology that we know about MS so far, right? So these are the steps. And eventually we will hopefully have medications that are a lot kinder to people in terms of trying to live their daily lives, and we’re just knocking out those damaging parts. So actually, what we have here, this is really nice – Jess coming into repair damage at a molecular level and Iain trying to stop the damage in the first place from a molecular level. 

But we can’t get there without understanding what’s happening. 

Jeremy Henderson 

Thank you. Julia, that’s a nice segue to my next question. And for both Jess and Iain. You know, you’re working at the laboratory level, at the molecular level, as Julia has just said, you both are obviously got a passion and a sort of a connection to cause and I guess at the back of your mind, that realisation that this work isn’t just about academic curiosity. This is, at the end of the day, about changing and improving the lives of people and people living with MS. Obviously that drives you. But you know, what is, what is that reminder about the fact that this is not just about work in a lab, and this is about changing the lives of people. What’s your connection? I if I could ask you that first Jess? 

Dr Jessica Fletcher 

Yes. So I’m really fortunate. Down here in Tasmania, being part of the MS Research Flagship at Menzies, and we have such a, committed MS community, down here that play a really big role in, in our research. And so I think at the end of the day, being able to interact with people that have MS, and, identify what’s important to them and share what I’m doing with them is a really, big part of what we do down at Menzies and is something that has really kind of changed my outlook on when I’m having a really bad day in the lab, because even that bad day is still a step forward for the people living with MS.  

Jeremy Henderson 

Thanks, Jess. And to you Iain? 

Dr Iain Comerford 

Yeah, I’ve. I’ve seen firsthand you know what MS can do to people and their lives and, it’s always been something that I’ve wanted to make a contribution to in terms of improving the outlook for patients with MS. So, yeah, that’s it’s always in the back of my mind about what motivates me to, to do the research that I do. You know, there’s many things that we could study in, in the lab, but I think it’s always, easier to motivate yourself to, to really complex research and difficult at times research when you’ve got that, you know, ultimate goal of really being able to have, an effect on people’s lives and people’s health and their families’ wellbeing, etc. it’s just such a huge motivating factor that, yeah. 

Jeremy Henderson 

Thanks Iain. Julia, likewise, I think we know from sort of our own research that the MS community – Australians living with MS are very engaged about the research that’s being undertaken, very incredibly supportive and interested. And likewise, the very many generous Australians that are supporting and donating towards MS research are likewise very motivated to support that area of work. What do we know about that? 

Dr Julia Morahan 

Yeah. So particularly since I’ve been part of MS Australia, I think, the involvement of people living, with the disease, with people with lived experiences is very much a part of research planning and co-design now; it’s part of thinking about outputs. It’s part of thinking about how you go about your research and making sure that it’s going to be meaningful at the end. 

And I think MS Australia has incorporated a lot of that into our practices. But also, over my time here, we’ve seen the research community as well incorporate a lot of that into their practices, which means that really, the research can only get better and make sure that we’re on the right track for things that people want out of research. 

But I think the other piece of your question is about the supporters and MS Australia’s supporters, both the people that we have living with disease that work with us, but then also the supporters, financial supporters and fundraisers and all of those guys that, give up their time and work on our behalf to allow us to have the funding in order to be able to give it to these guys so that they can do these incredible things right? So, we literally are nowhere unless we have that kind of support. And we are very grateful. The researchers are very grateful, and we hope that it will fund great things.  

Jeremy Henderson 

Thanks, Julia. Maybe just a beautiful segue off that response Julia. 

A question for you Iain – how valuable is the role that MS Australia plays in in funding, in coordinating, in stewarding the MS research program broadly in Australia? 

Dr Iain Comerford 

Yeah, it’s absolutely critical. MS Australia do a fabulous job of really bringing together MS patients, researchers, clinicians and, you know, taking a sort of broad view of every aspect that needs to be funded, I think, from the perspective of improving the lives of MS patients, whether that’s funding basic research, like what Jess and I do, whether it’s, you know, research and social care and things like diet that can help MS patients, or epidemiology, looking at, you know, EBV and viruses that cause the our big picture view of everything that, potentially can come together to improve the lives of MS patients. 

I think MS Australia do a fabulous job of keeping that broad set of different people with different skill sets and communication with one another and keeping a community of individuals and experts together, so that we can have a vibrant community to really help improve the lives of MS patients in Australia and around the world. 

Jeremy Henderson 

I imagine Jess that you would echo those thoughts. 

Dr Jessica Fletcher 

Absolutely. MS Australia has actually been…has made every step of my career possible essentially. And so without MS Australia as a research organisation and community organisation to, you know, as Iain said, look at all the different aspects that are needed to support people living with MS. And being able to make things happen in those spaces. Yeah. MS Australia does an incredible job. 

Jeremy Henderson 

Thank you both. So maybe just one last question to wrap up. And so this is obviously a really important, announcement for MS Australia. This is the start of obviously, a much longer journey. What does that look like Julia, in terms of MS Australia’s interaction now with these researchers and in terms of how progress on these projects is both reported formally, but also sort of informally in terms of Iain and Jess, you sharing, insights and knowledge with colleagues and just what that sort of roadmap looks like for the next three years, both for you as researchers and also you, Julia, in terms of coordinating this work. 

Dr Julia Morahan 

Yeah. So, well, we are extremely proud of Jess and Iain. We will be keeping a close eye on them over the next few years to see what they are up to. And we do have formal reporting and all those kinds of things, but we also interact with these guys in a whole host of other ways. And exciting new findings – we will communicate through our social media channels and through our newsletters. Hopefully see these guys at the Conference at the end of the year and involve them with some of our national collaborative platforms. So I think, unfortunately, once you’re part of the MS Australia family, you’re kind of ‘trapped’ with us. 

So we will keep in touch with these guys. We know that they’re going to be up to great things, and we will make sure that, the outcomes are communicated with everybody once they come to fruition.  

Jeremy Henderson 

Excellent. 

Iain and Jess and Julia, thank you very much for your time on the podcast. 

Congratulations on your new research projects. And thank you so much for being so generous with your time and sharing your knowledge and your expertise with us on the podcast today. Thank you very much.  

Voice Over 

Thanks for listening to The Raw Nerve, the official podcast of MS Australia. To hear more, subscribe to our podcast today at MSAustralia.org.au/podcast