Dr. Stephen Hauser on Multiple Sclerosis: B-cells, EBV, Genetics, the Future

Dr. Stephen Hauser is a well-known multiple sclerosis researcher and the director of the UCSF Weill institute for Neurosciences. In this interview, we discuss his career, the development of b-cell depleting drugs in MS, genetics in MS, and other important topics from his new book, “The Face Laughs While the Brain Cries.”
“The Face Laughs While the Brain Cries” on Amazon: www.amazon.com/Face-Laughs-Wh...
ATA 188 for Multiple Sclerosis (anti-EBV neurogenic t-cell therapy from Atara Biotherapeutics): • ATA 188 for Multiple S...
The MS Severity Gene: • The MS Severity Gene E...
The HERMES trial (rituximab in relapsing MS): pubmed.ncbi.nlm.nih.gov/18272...
The OLYMPUS trial (rituximab in progressive MS): pubmed.ncbi.nlm.nih.gov/19847...
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Check out my book “Resilience in the Face of Multiple Sclerosis” FREE on Amazon: amazon.com/dp/B07WP7H5LK It's about 5 people with MS who live incredible lives, the science and psychology of resilience, mindfulness, and ho’oponopono. Paperback priced to generate $0 royalty.
Dr. Brandon Beaber is a board-certified neurologist with subspecialty training in multiple sclerosis and other immunological diseases of the nervous system. He is a partner in the Southern California Permanente Medical Group and practices in Downey, California (South Los Angeles). He has several publications on MS epidemiology and has participated in clinical trials for MS therapeutics. You can follow him on twitter @Brandon_Beaber where he regularly posts about MS news and research.
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Music: INNER GRACE - Copyright 2018 Wilton Vought Source: Really Really Free Music Link: • Video T
he video material by Dr. Brandon Beaber is general educational material on health conditions and is not intended to be used by viewers to diagnose or treat any individual's medical condition. Specifically, this material is not a substitute for individualized diagnostic and treatment advice by a qualified medical/health practitioner, licensed in your jurisdiction, who has access to the relevant information available from diagnostic testing, medical interviews, and a physical examination. To the extent that Dr. Beaber endorses any lifestyle change, behavioral intervention, or supplements, the viewer should consult with a qualified healthcare professional to determine the safety and efficacy of the intervention in light of their individualized information.

[@martinschultz2631]

He is the reason why B Cell Therapies help so many people all over the world. 🌎

[@DrBrandonBeaber]

Indeed

[@joniangelsrreal6262]

M.S. a horrific disease where the entire family suffers …my mom passed at 38 from aftereffects of this awfulness diagnosed 1954-1967…RIP mom

[@EvenSoItIsWell]

Excellent interview. I often think about how lucky we are to live in this time where there are so many treatment options, so much ongoing research, and such a better understanding on how diet and lifestyle changes can help us to manage our symptoms.

[@DrBrandonBeaber]

Yes Vickie. Can you imagine being diagnosed with MS in the 1960s where so little information was available, especially to the general public.

[@EvenSoItIsWell]

I can't even...@@DrBrandonBeaber

[@joniangelsrreal6262]

Indeed …🙏🏼

[@angeliquetamsinpotgieter1165]

I have Multiple Scelrosis and I'm always researching and keeping up to date with what's going on this interview was very interesting, 🎗️🎗️

[@barbm1231]

Bless this man and his dedication. He has made a profound impact on the treatment of MS.

[@DrBrandonBeaber]

No doubt Dr. Hauser is a hustler

[@janeca10]

This was a fantastic interview! I am a neuropsychologist and I love learning from your videos Dr., Brandon and must say that today this interview with Dr Stephen Hauser was so special,. Your both commitment, passion and experience could only bring the best of medicine. I also believe that the cure for MS is very promising and I am happy to know that 18k people attended the Milan MS meeting. This is great!

[@DrBrandonBeaber]

Thanks. I unfortunately was unable to attend that conference but things have certainly changed over the decades. Multiple sclerosis used to be a very niche field.

[@UnCannyValley67]

Fascinating interview! I learned amongst other things, that B cells only constitute 2% of all white blood cells, which to my mind, explain why one’s immune system can remain robust even if they start a B cell inhibitor for MS? If I am correct, this makes me feel much more comfortable w/the idea of taking a B cell mediator med for RRMS.

[@DrBrandonBeaber]

Yes you are correct. Many people with depleted b-cells do not experience an increase in infections.

[@stonz42]

Excellent interview. Dr. Hauser gives us MS patients a lot of hope and positivity for the future.

[@DrBrandonBeaber]

Indeed

[@ellie698]

Yes. It's so easy to give up when battered down by the disease. This conversation made me feel that I need to hang on in there and never give up 🙏🏻

[@annmariemoreno3904]

I had MS for 24 years now have secondary MS and on mavenclad 10 mg almost starting 2nd year soon 🙏

[@dragonfire3727]

So how are you in terms of disability?

[@annmariemoreno3904]

@@dragonfire3727 I walk with Walker in house wheelchair in stores appointments ext bladder very weak sleep not that good .

[@mikicrespo4812]

How is it working so far? Has disability increased over the years?

[@kevineeverhart7869]

I'm considering leaving Mayzent for Mavenclad @ 64 years old. How's it going for your after your first course?

[@cherylvl1036]

Thank you so much for this interview Dr. Beaber! Dr. Hauser provides hope for me as a person with aggressive, progressive MS. Even if there’s no cure for me, maybe there will be a cure/treatment for those like me in the near future. This has been my favourite Dr. Beaber video. I found Dr. Hauser’s book on Audible and it will be my next listen.

[@DrBrandonBeaber]

It is definitely a great book. I hope you enjoy it.

[@roberture5903]

Dr Brandon I'm so sorry I'm late replying but I really enjoyed your interview this morning with Dr Hauser. I'm not sure if I spelled that right but it's always an honor to see you come here on KZbin on Wednesdays and today was no exception and it was definitely in honor to hear this doctor talking with you this morning also. Thank you for this wonderful interview you did this morning

[@DrBrandonBeaber]

Thanks. Let me know if you have suggestions for future videos. It is difficult to do videos with interviews because they take a lot of time to arrange, but I think they are worthwhile.

[@roberture5903]

@@DrBrandonBeaber thanks Dr Brandon, I'd love to see you talk with this doctor again because he is awesome to say the least I watched you interview several people on here and you do an awesome job. But I know a lot of work goes into it

[@spicyspacecake]

The audio version is amazing! I loved both….but audio is just wonderful to listen to. I listened to it on my runs…and came to understand so much more about the drug I take (Ocrelizumab)…. Just beautiful Thank you both for a wonderful interview 💕🙏🏼 bang on great!!

[@desiredecove5815]

This was an excellent interview and history almost. #sharingiscaring My grandmother had it in the 70’s - they treated it like a stroke- as they only knew minimal about MS back then. she lived another 45 years- finally diagnosed legit in ‘90 🙏🏻❤️

[@DrBrandonBeaber]

I can only imagine how many people went undiagnosed prior to the advent of MRI.

[@nickiburley985]

I loved the discussion about keeping a focus on patient care despite all the challenges physicians face in attempting to provide help.

[@RobdeKlerk-qg6lc]

Is central sleep apnea common in ms ?

[@__Wanderer]

I find his EBV analysis highly insightful - i think his theory of multiple routes for development is likely correct. I imagine people with MS may be genetically primed to develop the disease with many triggers. Environmental toxins, bacteria / gut dysbiosis, biomimicry myelin effects from external /internal factors as he states - I read somewhere that perhaps people with MS have an immune system that is too "aggressive" - perhaps this was a useful trait for survival in the past for various diseases/viruses but currently with longer lifespans we are seeing our own bodies as being the target after the immune system becomes confused - similar to a cytokine storm where our bodies overreact. I just hope we don't become too myopic on EBV and shut down other potential avenues for MS treatment development.

[@DrBrandonBeaber]

You may be right about a more "aggressive" immune system being selected for in the past. I am going a post a video on this exact topic in a few weeks.

[@__Wanderer]

@@DrBrandonBeaber amazing! Looking forward to it :)

[@lemonpeelangelfish]

Excellent interview thank you Dr Beaber. I feel really exceptionally lucky to have been diagnosed in recent years (2021), rather than when I learnt about MS on my occupational therapy course in 1998-2001. It was very doom and gloom at that time only one treatment available and very little understanding about the disease.

[@DrBrandonBeaber]

Even compared to 2000, we know a lot more about the disease, and there are many more options.

[@1515tj]

Thank you dr. Beaber for all the information you provide. Your work is much appreciated. 🙏 recently diagnosed with ppms.

[@DrBrandonBeaber]

Glad to be of service.

[@4inrev]

This video interview gave so much hope. Thank you for your great work Dr.

[@DrBrandonBeaber]

No doubt there is great hope for the future.

[@lauracarlson9260]

Excellent video- thank you Dr Hauser for this critical information and for Dr Beaber for getting on your channel. I will have my 21 yr old daughter tested for the EBV exposure and if she isn't already positive get the vaccine when available to lessen her chance of picking up MS from my DNA contribution to her makeup. This is the first honest discussion of PIRA being associated with the Bcell killers. Most people don't really understand PIRA and think if new lesions don't form that their MS is managed. It also makes sense the earlier you quell new activity the better your trajectory will be as most attacks happen the first years after diagnosis. BRAVO! thanks to you both

[@DrBrandonBeaber]

Unfortunately it may be a long time until an effective anti-EBV vaccine is available.

[@mybachhertzbaud3074]

I would like to see a study on whether the use of anti-biotics on repeated infections from dental problems and it's use in other areas as well. My history is full of cases of use of antibiotics and the result has been a series of different immunity problems from my gut being wiped out. From Crohns to psoriasis to ppms. I for one, am no longer interested in treatments but prevention so that others never have to go through this nightmare. Keep on it.😁

[@DrBrandonBeaber]

Some people have speculated that antibiotics could disrupt the healthy gut microbiome and increase the risk of autoimmune diseases, but it would be difficult to study this in a formal way.

[@relledom]

A very nice interview, always very touching to listen to one of the thought leaders in MS research. I would like to hear more from Dr Hauser or someone from his team on the current state of repair strategies. The very last part of the interview was a bit too "buzz wordy" for my taste. Some specifics would be appreciated! Thank you, Dr. Beaber, for your work and your interviews!

[@DrBrandonBeaber]

Dr. Ari Green who is also at UCSF does research on clemastine, so maybe I can reach out to him if there is more data available.

[@Dddonalddduckkk]

Thank you for providing such interesting content, Dr. Beaber ❤

[@SuperTalBar23]

Thank you both for your dedication.

[@DrBrandonBeaber]

You're very welcome. Dr. Hauser has truly had an impressive career.

[@victoriaorsson3037]

The last three minutes of the video are so hopeful. 🙏

[@DrBrandonBeaber]

Indeed

[@nonameavailablerlb]

Thank you, great interview! Dr. Hauser is OG. I was at patient at UCSF when I lived in California.

[@MK-fi6mh]

Amazing thank you and long live all you great souls

[@timothycarter9208]

Great video! So given that B cell therapies are not feasible for long term (depletion of plasma cells), what can be done to help patients with decades of disease and severe disability? Doctor just said better therapies and myelin repair at the end of the video, like other commenters I would love to learn more. I suspect that the signals activating the B cell microglia cytokine storm come from the gut. This presents a new realm of therapeutic options involving probiotics and gut microbiome analysis. One article’s headline recently stated: “Engineered probiotic found to ease symptoms in mouse model of MS” by Angie Shapiro PHD August 2023. I suspect that leaky gut/ microbiome imbalance may occur before B cell activation in the pathology of MS. Also another study showed that inflammation (nervous system) occurred before lesions in MS. I wish more attention was given to potential causes of inflammation when treating MS. Thanks again. Great interview!

[@klburke]

Thanks so much Dr. Beaber for bringing this excellent interview to us with Dr. Hauser! It was a banger and full of hope. It really brightened my spirits on this cold snowy Southern Ontario Canadian morning. I know I always say this, but I really appreciate you and all your time, effort and information you share with us MS'ers. You are truly a blessing! Off to order Dr. Hauser's book now!🥰

[@DrBrandonBeaber]

Thanks. I would definitely recommend his book. He has truly lived a remarkable life. I appreciated the memoir more than any other aspect of the book.

[@klburke]

@@DrBrandonBeaber That's great to hear. I ordered the book from Amazon right after I watched your video. I will have it tomorrow! 🥰

[@DrBrandonBeaber]

@@klburke Awesome

[@klburke]

@@DrBrandonBeaber Oh my goodness, I love love love this book. It's a wonderful read and I highly recommend it. And like you, I loved the memoir part of the book the most. Anyone who enjoys reading memoirs would appreciate this book, no MS required lol. Thank you so much for the interview and putting this fabulous book on my radar!

[@ernietollar407]

I had allergy shots as a kid for years... I know can't help but wonder what effect it had on my allergies and immune system ... In the end I out grew athsma naturally as I got bigger lungs entered my teens and played wind instruments. Nose breathing also should be taught to children - the orthodontic societies recognize the harm it has on jaw alignment.

[@thegoodolvet5586]

Two very knowledgeable Doctors in one great video! Thanks for another good one!

[@DrBrandonBeaber]

:)

[@flybyadebiwood5789]

I have been binge watching yours and Dr Bosters channels since my diagnosis in 2021. This interview was truly exceptional. Thank you. I learned some new things and also got a good dose of hope! It’s so encouraging knowing brilliant minds like Dr Hauser and you are working on helping us and encouraging others to go into this field. Perhaps my exceptional 7 year old grandson will join the ranks one day to help find a cure and improve the lives of us living with MS. Thank you. This was one of the best shares with the online MS community.

[@DrBrandonBeaber]

No doubt there are young brilliant people who will someday put us all to shame and do things we never thought possible.

[@epwright9]

My concern with b-cell depleting treatments is that it can, for some patients, me being one, deplete immunoglobulins and basically wipe out the immune system. This happened to me and I ended up in the hospital with sepsis and almost died. How do we improve these drugs to not do that?

[@DrBrandonBeaber]

No doubt these drugs (an all immunosuppressants have significant risk). I discuss it in this video: kzbin.info/www/bejne/n6jaZamYgt17d6c One strategy is to monitor immunoglobins and give the drugs less often to allow b-cell repletion.

[@euenfheiejrj]

I became neutrophic on ocrevus so I had to stop.

[@Wyomi]

@@DrBrandonBeaber How does one know they have replenished enough B cells? It has been over ten month since my last infusion and my count is still zero. Considering not taking any drugs going forward.

[@DrBrandonBeaber]

@@Wyomi B-cell repletion is highly variable from person to person.

[@AQtoo]

Thank you Brandon, keep the good work. Unfortunately some organizations in Texas that say they offer help and support to people with MS actually they work against those who have MS. Yet your videos are uplifting.

[@DrBrandonBeaber]

Thanks. What organizations in Texas?

[@AQtoo]

@@DrBrandonBeaber it is the MS society, been having really rough week with them, been sending me the wrong information for simple matter.

[@ericag2233]

Excellent wisdom and perspective.

[@DrBrandonBeaber]

Indeed Dr. Hauser has wisdom in abundance.

[@daniellespinks-earl1311]

Thank you ❤ Dr Hauser is not only fascinating to listen to but a wonderful human being.

[@DrBrandonBeaber]

Indeed

[@AnnetteAnne]

Thank you so much for this interview! It brings so much hope. Thank you for your continual work Dr Beaber, dr Houser!

[@zoranagavrilovic9403]

What a wonderful person

[@Robin-me8fe]

Thanks to both of you.

[@tonnyncellist5910]

Very interesting. Thank you both!

[@kristianderson6672]

Thank you for this interview !!

[@luisfernando-mm3jt]

Nice work thanks for this

[@mballer]

Have you tried using grounding/earthing with your patients?

[@daveIsMyName311]

I really like this one. Thank you Dr. Beaber 🙂

[@DrBrandonBeaber]

:)

[@hurkuy]

I was in phase 3 trial for Evobrunitib for 65 weeks, suddenly found out FDA didn’t approve the medication (I was only told 2 days ago by my neurologist and my neuro took all my medication). I’m shocked, so disappointed and confused. I was doing so well on Evo, what are your thoughts about this trial? Relapsing rates shouldn’t be the only criteria for comparison to 2 drugs. My numbness was gone, my sleep got better ( I used to have insomnia), my migraine was gone.. My neuro wants me to start on Ocrevus now I’m not even sure if transitioning to Ocrevus after Evo a good idea. So disappointed.

[@DrBrandonBeaber]

Sorry to hear this. I believe the whole publication is not out yet, but I will review on the data in detail once it is.

[@hurkuy]

@@DrBrandonBeaberCan’t wait to hear your opinions about Evobrunitib’s trial and everything about it. 🙏🏻

[@dragonfire3727]

So basically it stopped your ms all together, it sucks now it seems all BTKi inhibitors are in danger of failing because of relapse rates

[@ellie698]

Wonderful interview 🙏🏻

[@astridgeerinck452]

Very interesting interview thanks to both!!!!!!!!

[@cesaredo]

Cheers for the cure 🎉. Great interview Dr. B. ❤

[@majesticblue92]

MRI $34k??? Whats goin on?

[@DrBrandonBeaber]

This is truly crazy

[@chrystineuman3084]

I hope and pray Dr. Hauser is correct! 🙂

[@lararose9106]

Hi Dr. Brandon i have MS snce 2 years and im in a wheelchair from chronic disabling vertigo of unknown origin. Sorry off topic but i was prescribed amantidine for dizziness and fatigue because antivertigo drugs dont work for me and im against ssris. I have mild tremor but i would like to know the side effects from ur experience in terms of weight gain vertigo withdrawel skin issues etc..

[@DrBrandonBeaber]

The side effects of anti-vertigo drugs such as meclizine? Or amantadine?

[@lararose9106]

@@DrBrandonBeaber amantidine Dr. Because upon examination i had mild tremor in hands upon extension but its because i didnt sleep for 2 days straight plus neck tension from a disc. So i was gven amantidine for tremors fatigue and mainly dizziness. I dont usually have tremors. And the dizziness isnt from MS the neuro said.

[@lararose9106]

@@DrBrandonBeaber Hi Dr. Brandon can u plz make a vid about ms fatigue i was gven amantidine for vertigo but i dont really get the connection and the side effects seam worrisome. I messaged u yesterday but im not sure of the time difference. Waiting for ur reply whenever possible😊🙏

[@DrBrandonBeaber]

@@lararose9106 Thanks for the suggestion

[@Sobuenoo]

Broke my heart when I realized my government did this to me for personal gain

[@DrBrandonBeaber]

??

[@Sobuenoo]

@@DrBrandonBeaber havent harmful chemicals to the cns such as color red 40 been allowed in our food with no knowledge. It’s a cycle to keep you sick then you end up with a disease like ms and others than your letting concoctions be practiced within hoping for a better way. Never comes.you know what im saying sir.

[@euenfheiejrj]

Assuming this is some anti vax statement.

[@BernardAsagai]

Would love to be on a clinical trial for these drugs in brazil.

[@lauracarlson9260]

I've heard the theory that other major challenges to our immune system could be a trigger like EBV is- for some it may be some of the Covid variants. It may just take time for this to play out-

[@JonnyEdwin]

Is MS with many lesions but mild symptoms considered a mild case or is someone with few lesions but more severe symptoms considered mild? I'm a little confused on what would be considered a mild case.

[@DrBrandonBeaber]

The symptoms are more important in my opinion, but I suppose this is in the eye of the beholder.

[@lararose9106]

Hey there i too have MS and sometimes as patients we dont know what to thnk but as Dr Brandon said ur symptoms r the most important. Always report anythng u feel is new. Dont worry about the number of lesions. Only u can tell what symptoms r bothersome so u can let ur neuro know what symptomatic meds u can take🙂 God bless u

[@lararose9106]

Just wanted to add one more thng! Dont underestimate lifestyle changes like ur diet vitamins and physiotherapy as well as keeping calm and taking care of our mental health. We need to eat sleep well and stay hydrated. I need to change my whole lifestyle too many ppl slowed and even stopped the disease progression from such changes!

[@lauracarlson9260]

My husband how Ulcerative Colitis which is manages through a strict diet. As it is also an autoimmune disease he thinks that MS could be managed the same way. What do I say to him? I feel I eat "well" but won't restrict myself from food that isn't proven to impact MS progression- like while our household is gluten free (neither my husband or daughter can have it) if that is all that is available I may have something with gluten a couple times a month. As I now am diagnosed with Osteopenia (now proven to be associated with MS) I have a little glass of milk every day as well as the prescribed weekly supplement while some with MS say "no dairy!" What is the MS diet recommendation? how much does microglia impact our progression with MS? Could it be one of the causes of MS? I know we are different in gut chemistry than those without MS...but why and what came first

[@DrBrandonBeaber]

This is a complicated topic, but you may appreciate this playlist on nutrition and MS: kzbin.info/www/bejne/eZbcZqCrjK91qZI There is no single definitely proven diet for MS.

[@lauracarlson9260]

@@DrBrandonBeaber I've tried to explain this many times but he encourages me to push the boundaries...his gastro Dr insists that you need drugs to manage UC as well and he is managing it through diet and lifestyle and his Dr just shrugs. For the last 5 years his insides keep looking better with every colonoscopy. Terry Wahl has been pushing the diet approach for years and I liked your recent interview her. He has issues with her approach- in the details- but thinks she is on the right path. Change your microbiome and change your health

[@luisfernando-mm3jt]

34000 $ for brain and spine ? ....Caneco

[@MelinaP-wy3qd]

Hsct is the answer

[@virtualpilgrim8645]

16:16 progressive ms

[@thigmotrope]

I'm really glad B-cell therapy has helped so many. but it ruined 2023 for me. anti-CD20 mAb therapy is contraindicated for MS patients with IBD. (2021 Vol 14 1-20) please don't sleep on this fact