In this episode of MS-Perspektive International, host Nele von Horsten speaks with David Walzik, PhD student in exercise science at TU Dortmund University and medical student at the University of Cologne, about exercise immunology and what current research can tell us about immune adaptation through movement.

David explains the difference between epidemiological findings and underlying biological mechanisms, and shares results from a recent study comparing high-intensity interval training (HIIT) with moderate-intensity continuous exercise. While both types of exercise mobilized immune cells, high-intensity exercise led to much stronger changes inside the immune cells — with over 1,000 proteins reorganized after just one session.

Photo of David Walzik (Copyright: Niklas Joisten, TU Dortmund, Germany)

They also discuss what this could mean for people living with multiple sclerosis, why flexibility matters when symptoms fluctuate, and why community and support are key to building sustainable exercise habits.

👉 You can read the full interview on the blog, where all questions and answers are available in detail and easy to follow: https://ms-perspektive.de/en/153-exercise

• What exercise immunology is and why it matters

• How exercise affects immune cells

• HIIT vs moderate exercise: what's the difference?

• Can the immune system be "trained" like a muscle?

• What we still need to learn specifically for people with MS

• Why regular movement matters more than perfect training

You don't have to exercise perfectly or intensely to benefit.
The most important thing is to stay active regularly.
Whether it's walking, cycling, strength training, or something else you enjoy — consistency matters more than intensity, especially when living with MS.

📖 Full interview & background:
All questions and answers from this episode are available on the MS-Perspektive blog, including detailed explanations and practical insights: https://ms-perspektive.de/en/153-exercise

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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 time I speak with Dr. Ingrid Klingmann about empowering patient voices in medical research and innovation.

Dr. Klingmann is one of the initiators of EUPATI, a European initiative dedicated to educating patients about the medicines development process. Drawing on her experience as a physician, researcher, and former cancer patient, she explains why informed patients are essential partners in clinical research.

The conversation explores how patient education improves clinical trials, why lay summaries matter, and how digital tools can help patients move from passive recipients to active contributors in healthcare and research.

• Dr. Ingrid Klingmann's journey from family physician to medical research

• Why EUPATI was founded and which gap it fills

• The benefits of patient involvement for research and industry

• How patients can influence clinical trial design

• Why health literacy and education are key to empowerment

• The future of patient involvement in medical research

• EUPATI – European Patients' Academy on Therapeutic Innovation: Home | EUPATI Open Classroom

• More episodes and blog articles: https://ms-perspektive.de/en/152-eupati

Dr. Ingrid Klingmann: Please explore EUPATI and use the resources available. Move away from complaining and toward action. Knowledge builds confidence, and confidence empowers patients to shape their own healthcare journey.

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 of the MS Perspektive Podcast, Nele von Horsten speaks with Paola Escamilla Greenham, MS patient advocate and patient experience designer living in Grenoble, France.

Paola shares how her life with multiple sclerosis reshaped her priorities and led her toward patient advocacy across Europe. She talks openly about her diagnosis, the emotional shock that followed, and why joy has become her guiding principle in daily life. The conversation explores the importance of community, lived experience in healthcare design, and Paola's vision for involving patients more meaningfully in MedTech and Biotech innovation.

We also discuss Paola's journey through the EUPATI program, her work as a business angel, and what empowerment truly means when living with a chronic illness.

This episode offers inspiration, honesty, and a strong reminder: living well with MS starts with listening to your body and choosing what brings you joy.

• Living with MS between Mexico, France, and Europe

• Diagnosis, shock, and patient experience

• Joy, energy, and improvisational theatre

• Patient advocacy and community support

• Lived experience in healthcare design

• Empowerment and future perspectives in MS care

• 🌍 Learn more about EUPATI: https://eupati.eu

• 💼 Connect with Paola on LinkedIn: Paola Escamilla Greenham | LinkedIn

• 📖 Read the full blog article:
  👉 https://ms-perspektive.de/en/151-paola

...

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.

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

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, 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

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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.