Multiple sclerosis is not a top killer, but one in a thousand people in Arkansas are at risk of the disabling disease, which can sabotage a multitude of organs in the body, including the eyes, bladder and muscles.
Lee Archer, 54, who has been in a top neurologist spot ever since the Arkansas Times first started publishing an annual survey of doctors in 1995, devotes nearly three-fourths of his time to treatment of the disease and research. A cure is not around the corner, he said, but "we have come far."
Archer, who got his medical degree from the University of Arkansas for Medical Sciences, where he also did his internship and residency, was honored with the National MS Society's Hope Award in 2003. In 2007, UAMS named him the first recipient of the Major and Ruth Nodini Endowed Chair in Multiple Sclerosis and Related Autoimmune Diseases.
Multiple sclerosis, a disease that is somehow related to a Vitamin D (it's 100 times more common in Arkansas than at the equator), occurs when the immune system goes haywire, sending white cells to attack the myelin that protects nerve connectors in the brain and spine. MS patients have a new weapon to hamper the progress of the disease: The first oral medication was approved in September by the federal Food and Drug Administration. Gilenya works to trap white blood cells to keep them away from the myelin — in Archer's words, like a "Roach Motel — lymphocytes check in, but they don't check out."
There is a genetic element to MS, but environment plays a far more important role, Archer said. (For example, he said, identical twins have only a 40 percent chance of both developing MS.) The disease is thought to be triggered by exposure to a virus, such as Epstein-Barr or Herpes 6: One theory is that a stretch of RNA in the virus is so like that in the human that the body confuses the two. Archer is working with UALR computer experts to look for stretches of genetic material common to both viruses and humans.
Though his focus is on MS, Archer treats stroke and other neurological diseases. He is proud of UAMS' two-year-old telemedicine program, a partnership with neurologists around the state to more quickly and accurately treat stroke on an emergency basis. Doctors with less experience in administering the clot-busting drug tPA, for example, can present their patients to UAMS staff by video conference — in real time — to determine what the course of treatment should be.
Stroke is fourth on the list of deadly diseases, and Arkansas's stroke mortality rate — 58 percent — tops the U.S. rate by 15 percentage points.
"We debate why Arkansas has a higher incidence" of stroke, Archer said, though the state's high obesity rate — Arkansas is the 8th fattest state — and failure to understand the importance of getting high blood pressure under control no doubt contribute. People who abuse drugs — like methamphetamine — are also at higher risk of stroke. Getting control of hypertension and diet "dramatically reduces the incidences of stroke and heart attack," Archer noted.