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.

In this very personal episode, I open the doors behind the microphone and share what truly shaped 2025 – a year of endurance, motherhood, advocacy work, sleep deprivation, and two weekly podcast shows in German and English.
I also share what will change in 2026 – with a focus on sleep, gentle growth, an English talk format, books, and fast-track MS knowledge for the community.

https://ms-perspektive.de/EN/147-review-2025

You will hear about:

• why I do a yearly review and why reflection matters

• 2025 in one word: endurance

• family milestones – daycare and school beginnings

• building a home instead of moving again

• work highlights: Patient Council & AI Whitepaper on Shared Decision Making

• what AI can and cannot replace

• 57 German & 54 English episodes in 2025 – and the price I paid

• the joy of the German "Kamingespräch" format – and plans to launch an English version

• lessons learned about boundaries, friendships, and MS

• what I will prioritise in 2026 (sleep, health, books, course, newsletter)

MS-Perspective is now listened to in 80+ countries.
Guests so far came from:

🌎 North America
🌍 South America
🌍 Europe
🌍 Africa
🌏 Australia
…plus expats from the Middle East

➡️ In 2026 I hope to welcome first interview guests from Asia as well.

• AI Whitepaper on Shared Decision Making → 250822_AI_SDM_Whitepaper_english.pdf

• German podcast archive → Alle Folgen vom Podcast sortiert nach Themenbereichen

• English podcast episodes → Alle Folgen vom Podcast sortiert nach Themenbereichen

• Episode on sleep / fatigue → The Power of Sleep and Exercise in Managing MS

• Episode on pregnancy & MS → Pregnancy, childbirth, and breastfeeding with multiple sclerosis

• Newsletter sign-up → Newsletter mit positiven Impulsen zur Multiplen Sklerose (MS)

• MS course waiting list (coming soon)

• About the host → Wer ist Nele Handwerker von MS-Perspektive? Mehr über mich...

I would love to hear what you wish for the English podcast in 2026.
Send me a message anytime:

Instagram: → Nele von Horsten (geb. Handwerker) (@ms.perspektive) • Instagram photos and videos
Email: → nele@ms-perspektive.com

Please consider leaving a rating or review – it helps others with MS find this podcast more easily.

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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.

This episode was supported by Sanofi S.A.

In this episode, I speak with Dr. Klarissa Hanja Stürner about chronic smoldering inflammation in multiple sclerosis (MS)—a slow, often hidden process that may drive disease progression even when relapses and MRI activity appear stable.

Dr. Stürner explains how chronic inflammation behind the blood–brain barrier differs from acute relapse-related inflammation, why it is so difficult to detect with current imaging, and which warning signs people with MS should take seriously. We also discuss PIRA (Progression Independent of Relapse Activity), the role of microglia and macrophages, and why new treatment approaches such as BTK inhibitors are considered a promising step forward in MS research.

This episode offers a clear, evidence-based, and hopeful perspective for anyone who wants to better understand MS progression beyond relapses.

📝 Read the full article on the MS-Perspective blog for a detailed written summary of the conversation: https://ms-perspektive.de/EN/146-dr-stuerner

• What chronic smoldering inflammation in MS means

• Differences between acute relapses and smoldering inflammation

• Inflammation behind the blood–brain barrier

• Why MRI often fails to detect these processes

• Clinical red flags for progression without relapses

• PIRA explained in simple terms

• The role of microglia and macrophages in MS

• BTK inhibitors as a new therapeutic approach

• Current challenges and future directions in MS research

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Many thanks to Dr. Stürner for the insightful interview and this positive outlook on the present and the future.

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.

Living with multiple sclerosis means making daily decisions that go far beyond medication. Mental health, lifestyle, rehabilitation, empowerment, and access to care all play a crucial role in how well people live with MS.

In this special episode from ECTRIMS 2025, I bring together insights from six international experts who presented new research on well-being, mental health, lifestyle interventions, and patient empowerment in MS.

You'll hear what is already evidence-based, what looks promising but needs more research, and—most importantly—what you can realistically take from this research into your everyday life with MS.

👉 You can also read the full blog article with all details and references here:
https://ms-perspektive.de/EN/145-mental-health

Christoph Heesen (Germany)
What actually works when it comes to mental health support in MS?
This presentation reviews psychotherapy, mindfulness, self-management, and multidisciplinary rehabilitation—and why mental health care should be a standard part of MS treatment.

Marcia Finlayson (Canada)
Why promising interventions often never reach everyday care—and how research design must change so that well-being programs become accessible, affordable, and sustainable for people with MS.

Rebecca Maguire (Ireland)
Many people with MS hide their diagnosis or symptoms. This talk explores how concealment affects mental health, help-seeking behavior, and long-term well-being—and what support is needed.

Silvia Poli (Italy)
Insights from the Living Well Program show how personalized, goal-based approaches can restore meaning, motivation, and a sense of control—especially for people with progressive MS.

Miguel Angel Robles Sanchez (Spain)
How nurse-led, empowerment-focused programs improve knowledge, confidence, and engagement with care—and why peer learning matters in long-term MS management.

Arianne Gravesteijn (Netherlands)
Long-term results from a lifestyle intervention targeting diet, physical activity, sleep, and stress show sustained improvements in anxiety, fatigue, psychological impact, and general health over 24 months.

Across all six presentations, one message stands out:
Living well with MS is multifaceted, modifiable, and supported by growing evidence.

Mental health, lifestyle habits, empowerment, and personalized goals are not "extras"—they are essential parts of MS care today and in the future.

👉 Read the full accompanying blog article with detailed explanations and practical takeaways:
https://ms-perspektive.de/EN/145-mental-health

If you found this episode helpful, please subscribe, share it with others living with MS, and help spread evidence-based information that empowers.

This podcast shares research insights and lived perspectives. It does not replace individual medical advice.

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Hear 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.

In this episode, wheelchair padel athlete and clinical research expert Kristen Paskins shares how she rebuilt her confidence after suddenly losing her mobility in 2022. Traveling alone with a wheelchair for the first time — to attend the EUPATI training in Madrid — became a turning point in her journey toward independence, advocacy, and self-discovery.

You can read through the interview on my blog: https://ms-perspektive.de/EN/144-kristen

We talk honestly about the emotional and practical realities of traveling with a wheelchair, including airport challenges, accessibility barriers, fears, resilience, and the unexpected wins that come from stepping outside your comfort zone. Kristen also explains how disability sport helped her reclaim joy and identity, and why patient advocacy has become one of her strongest missions.

A key part of the conversation is the global Rights on Flights campaign led by disability advocate Sophie Morgan, which fights for equitable and safe air travel for people with mobility impairments. Kristen shares her experience, why reporting incidents matters, and how collective voices can drive meaningful change.

Links mentioned in the episode:
🎥 Documentary "Sophie Morgan's Fight to Fly" (Channel 4):
https://www.channel4.com/programmes/sophie-morgans-fight-to-fly

🌍 Rights on Flights – Report air travel incidents & join the movement:
https://rightsonflights.com/

In this episode, you'll learn:
• How Kristen lost her mobility and rebuilt her independence
• The emotional impact of traveling alone for the first time
• Practical tips for accessible travel and navigating mobility assistance
• Why airports remain the biggest challenge for wheelchair users
• How Rights on Flights is pushing for systemic change in aviation
• The importance of community and disability sport
• What Kristen wishes she'd known earlier in her journey
• Her message to anyone afraid to travel with mobility challenges

Whether you live with MS, FND, or another condition affecting mobility, Kristen's story offers strength, understanding, and the reassurance that life can open up again — sometimes in ways you never expected.

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Hear 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.

In this episode of MS-Perspektive International, host Nele von Horsten talks with Dr. Riley Bove, Associate Professor of Neurology at UCSF, about how menopause impacts MS. They explore hormonal changes in perimenopause, why menopausal and MS symptoms overlap so strongly and what this means for diagnosis and daily life.

You can read through the cleaned transcript of the interview on my blog: https://ms-perspektive.de/EN/143-riley-bove

Dr. Bove explains the benefits and risks of hormone therapy, including the importance of the "window of opportunity", and shares findings from recent studies using biomarkers like neurofilament light chain. She also offers practical advice on symptom management, lifestyle strategies and how women with MS can use midlife as a health checkpoint.

In this episode you'll learn:

• Which hormonal changes happen in perimenopause

• Why menopause can mimic MS progression

• How hormone therapy may help – and when to be careful

• What biomarkers tell us about brain aging in MS

• Which lifestyle strategies support women in this phase

Dr. Riley Bove: People are welcome to contact me by email via UCSF and to visit our lab website at bovelab.ucsf.edu. There, you can find more information about our research, publications and ongoing studies related to women's health, menopause and MS.

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