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led to the treatment of patients with inappropriate, expensive, and potentially harmful therapies. For example, the claim that metal toxicity causes MS induced some patients to have teeth extracted and amalgam fillings removed. New claims of MS pathogens, when appropriate, should be resolved as quickly as possible.

The MS societies are the most likely organizations to undertake efforts to test the validity of a newly proposed pathogen on an ad hoc basis. Following a potentially credible claim implicating a particular pathogen in MS, the society could oversee a project whereby the investigator making the claim, as well as an expert in the particular pathogen, could review clinical samples. A similar approach could be made in response to other claims related to the diagnosis or the treatment of MS in situations in which a quick confirmation of the results would be of importance to MS patients or the neurological and scientific communities. This approach should reduce costs to patients, researchers, and even the MS Society. The key elements of such a program would be evaluation of credible claims that are judged to have the potential for influencing research strategies or treatments, rapid response, and the generation of replicate data sets necessary to establish reliability of claims.

If the validation experiments were conducted in established laboratories equipped with the necessary expertise and research tools, the costs should be relatively low. These could be supported by a direct payment or small grant supplement provided in advance to investigators who agree to participate in such a program. It might also be possible to offer the possibility of confirming such path-breaking claims prior to their initial publication in order to increase the immediate impact of the discoveries or spare investigators embarrassment should their data be incorrect.

The Amyotrophic Lateral Sclerosis Association has recently tried such an approach in response to a report of enteroviral RNA found in gray matter tissue of the spinal cord of patients with ALS.1 The association provided funds to the author of that paper to replicate the study and expand it. The same blinded samples will also be sent to the Enterovirus Section of the National Center for Infectious Diseases, part of the Centers for Disease Control and Prevention, for independent verification.

REFERENCES

1. Berger MM, Kopp N, Vital C, Redl B, Aymard M, Lina B. 2000. Detection and cellular localization of entero virus RNA sequences in spinal cord of patients with ALS. Neurology.; 54: 20-5.

2. Hohlfeld R. 1999. Therapeutic strategies in multiple sclerosis. I. Immunotherapy. Philos Trans R Soc Lond B Biol Sci.; 354: 1697-710.

3. Lassmann H. 1999. The pathology of multiple sclerosis and its evolution. Philos Trans R Soc Lond B Biol Sci.; 354: 1635-40.



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