Genetics

Progressive multiple sclerosis has long puzzled scientists, but new research is shedding light on why some people move into worsening disability while others remain stable for decades. This study uncovers a genetic variant in HIF1A—a gene that helps cells manage stress and iron—that appears to protect against the slow-burning inflammatory activity known as smoldering inflammation. By connecting genetics with MRI, spinal cord pathology, neurofilament biomarkers, and treatment response, the findings paint an encouraging picture: our genes may influence not just how MS evolves, but also how well patients respond to therapy. This discovery opens the door to more personalized, biologically informed approaches to managing MS.