Katherine Trujillo Useche
Latin Agency for News of Medicine and Public Health
In an exclusive interview for Medicine and Public Health (MSP), Dr. Ángel Chinea, a prominent neurologist from Puerto Rico, spoke about the scientific advances that have been found for patients with Multiple Sclerosis.
Multiple sclerosis (MS) is a disease of the brain and spinal cord that can lead to disability. With the arrival of the pandemic, it has been a bit more complicated to treat these patients, but the specialist committed to his patients developed some strategies to continue helping people who suffer from this disease.
Genetic studies carried out in Puerto Rico have revealed the types of genes that predominate in the Puerto Rican population, specifically of European ancestors of up to 75%, (for example, variants belonging to the HLA DR 1501 gene group), which could predict predisposition genetics of MS, since it is not a hereditary disease, but there are some poly-genetic factors that make the disease heterogeneous.
Likewise, within the ancestral order that could be influencing the origin of the condition in Puerto Rican it would be of Indian origin (13%) and then African (12 to 15%), according to data provided to this medium by Dr. Chinea.
“Genetics starts from knowing what the genetic map is, what we want to see is if there are differences between the Hispanics, Puerto Ricans, that can be identified from other populations, in this case Hispanics. With this we can have markers of the disease, markers that tell us what the risk will be. This disease is permanent, long-lasting, so what we want to see is that there are some markers that can give us an idea of what we are going to do with this patient, what type of medication, since it may be a not so aggressive medication ”, explained the neurologist .
What the expert hopes with the different studies is to find biological markers, and clinical markers that differentiate what type of disease abounds in this patient. The doctor advises that those people who have this disease and wish to be part of the different studies can register on the page of the Multiple Sclerosis Foundation.
Puerto Rico on the genetic map
“When they are new patients, we have two cubicles prepared where everything is aseptic and we send for the patient to be able to see him in person. Since it is very difficult to assess someone you do not know from afar, and more than important, a neurological examination is necessary. So, the number of cases per week is still between 2 to 3 new cases per week. And during the pandemic, we are calling patients who are new, it is seen that the number is maintained, it would be one 6 or 8 cases per month “, explained Dr. Chinea.
The specialist told how in some populations there is no multiple sclerosis, since in some indigenous tribes, either due to diet or genetics, they do not contract this disease. The doctor and his team conducted a genetic study of indigenous people to identify why this population does not contract the disease and after evaluating the results they reached that conclusion.
The prevalence of multiple sclerosis in Puerto Rico has placed the island on a map of epidemiology of the disease. The doctor explained that this is possible because there have been good epidemiological studies that have been published in reputable journals.
“We have a registry that, worldwide, we could be the only nation that has a registry, and that has a law that requires that all patients with multiple sclerosis be registered. And that means that we have all the data of our patients, which shows that in this region there are many cases of multiple sclerosis and that it was not believed that this was the case since we are in the tropics, ”Dr. Chinea stated.
With these data it has been possible to carry out different studies in various states of the United States, and this makes doctors happy, since thanks to these records and the possibility of being on the epidemiological map, many people wonder why there is so many people in Puerto Rico suffering from multiple sclerosis. In other words, the visibility of the disease worldwide and its existence on the island is achieved.
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