Research News with Dr. Boris Kallmann

In this episode of the MS Perspective Podcast, we focus on chronic smoldering inflammation in multiple sclerosis (MS) – a process that can drive slow disease progression, even when relapses no longer occur.

I speak with Dr. Boris Kallmann, neurologist and MS specialist, about how these subtle changes develop, how they can be recognized in everyday clinical practice, and which treatment options are available today – and may become available in the near future.

👉 You can also read the full interview on my blog, where this episode is available as a written article.

• This episode is the English translation of the original German interview.

• The conversation was translated carefully to preserve medical accuracy and meaning.

• This episode was supported by Sanofi S.A.
  The content reflects independent editorial work.

• What chronic smoldering inflammation means in MS

• Why MS can progress slowly without relapses

• How neurologists recognize subtle, long-term changes

• The importance of listening closely to patients' experiences

• Using digital tools and smartphones to monitor disease progression

• Realistic therapy goals when progression is present

• The three key pillars of MS management:

  • lifestyle and physical activity

  • symptom management

  • immunomodulatory therapies

• New therapeutic approaches and insights from clinical trials

• BTK inhibitors: how they work, what makes them different, and why they are promising

• What "non-inferiority" in clinical studies really means

• Possible side effects and the need for careful monitoring

• Why new therapies may initially be used in specialized MS centers

• Challenges in rural healthcare and the importance of collaboration

• What the future of MS treatment may look like in the next five years

📖 You can also read the full interview on my blog for a detailed, structured version of the conversation: https://ms-perspektive.de/en/150-boris-kallmann

MS is highly individual – and so are the ways people experience progression. Staying informed, observing changes over time, and working closely with experienced healthcare providers can make a meaningful difference.

What can your mouth tell us about multiple sclerosis?

In this episode of the MS-Perspektive Podcast, Professor Dr. Ashutosh Mangalam, immunologist and microbiome researcher at the University of Iowa, shares fascinating insights into the oral microbiome and multiple sclerosis. While most MS research focuses on the gut, this conversation highlights why oral bacteria and their metabolites may also play an important role in inflammation, immune regulation, and disease activity.

We talk about what the microbiome is, how the oral microbiome differs in people with MS, and why beneficial bacteria are reduced while potentially harmful ones increase. Professor Mangalam explains the relevance of microbial metabolites such as hypotaurine, discusses whether saliva could become a future biomarker for MS monitoring, and why oral health and regular dental care matter for people living with MS.

The episode also explores how combining oral, gut, and blood-based markers could support more personalized MS care in the future.

you can read the interview here: https://ms-perspektive.de/EN/149-ashu-mangalam

• What the microbiome is and why it matters in MS

• The role of the oral microbiome in relapsing-remitting MS

• Dysbiosis: loss of beneficial bacteria and rise of pathogenic species

• Microbial metabolites and inflammation

• Saliva as a potential biomarker for MS monitoring

• Oral health, dental care, and lifestyle factors

• Personalized MS treatment using microbiome-based markers

• Future directions in MS and microbiome research

Prof. Dr. Ashutosh Mangalam: MS should not define you. A healthy lifestyle, social support, and staying positive truly matter. I have great respect for what people with MS go through every day.

From a researcher's perspective, it is incredibly important for us to listen to patients, understand their real challenges, and work on questions that can truly improve quality of life. That is what motivates my work.

Nele von Horsten: Thank you so much, Ashu, for this insightful and hopeful conversation.

See you soon and try to make the best out of your life,
Nele

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Click here for an overview of all podcast episodes published so far.

In this episode, Prof. Dr. Heinz Wiendl discusses why disease progression can occur even when relapses are well controlled and MRI scans appear stable. The conversation focuses on how subtle changes can develop over time, how they can be recognized earlier, and what this means for people living with MS.

This episode was supported by Sanofi S.A. and is an English translation of the original German interview.

You can find the full blog article with all questions, answers, and additional context here:
👉 https://ms-perspektive.de/en/148-heinz-wiendl/

• why disease progression can occur even when relapses are well controlled

• how often this affects people and why most patients remain stable

• what progression independent of relapse activity (PIRA) means in everyday practice

• the importance of invisible symptoms such as fatigue, cognitive changes, bladder dysfunction, and spasticity

• why commonly used scales often fail to capture subtle but relevant changes

• what MRI can reveal, where its limits lie, and why it should not be interpreted in isolation

• why long-term observation over months matters more than day-to-day fluctuations

• how patients can actively contribute by observing and documenting changes

• what current research tells us about silent inflammatory processes and endophenotypes

• why reliable biomarkers are still missing and what research is focusing on

• the therapeutic idea behind BTK inhibitors and which patient groups may benefit

• a realistic and hopeful outlook on future developments in MS care

Prof. Dr. Heinz Wiendl:
I believe my most important message is this: we can be hopeful.
The developments of recent years show that we are far from reaching the end of the road. On the contrary, we have learned that progress continues — new therapies are being developed, and our understanding of the disease is steadily improving.

At the same time, there are still cases that are frustrating, because patients are not treated early or effectively enough, or because the disease course is particularly challenging.
That is precisely why we must continue to do research, continue to improve, and continue to refine our approaches.

My hope is that in five years' time, we will be able to say: now everyone truly benefits from these advances.

And I hope this sends a positive signal — one of courage and optimism for the future.

I would like to thank Prof. Heinz Wiendl for this insightful interview and for his encouraging outlook on current developments and future perspectives.

See you soon and try to make the best out of your life,
Nele

For more information and positive thoughts, subscribe to my newsletter for free.

Click here for an overview of all podcast episodes published so far.