The autoimmune theory of MS; Doctors ask, "Have we got it horribly wrong?"

June 28, 2011 at 9:37am

Have we got it horribly wrong? 

 The fact that an opinion has been widely held is no evidence whatever that it is not utterly absurd; indeed in view of the silliness of the majority of mankind, a widespread belief is more likely to be foolish than sensible.

Bertrand Russell*

"The Pathogenesis of MS revisted."  

The Full paper is available here (this is one to print out and share.)

http://www.rcpe.ac.uk/journal/issue/journal_32_4/3_pathogenesis_of_MS.pdf                        

Here is a review of this critical paper in an issue of the New Scientist from 2002

New Scientist vol 176 issue 2369 - 16 November 2002, page 12 

It's not surprising there's no cure for multiple sclerosis. Researchers have been studying the wrong disease for over a century, argue a few rebels.  

THE century-old assumption that multiple sclerosis is an autoimmune disease is under attack. Treatments based on the autoimmune theory have failed so miserably, say a group of doctors, that it is time to look for other explanations.

In a lengthy review to be published next week in The Journal of the Royal College of Physicians of Edinburgh, the three neurologists dispute the received wisdom that the disease wreaks its havoc when immune cells attack and destroy myelin protein, which insulates nerves and helps them conduct signals. Instead, they back an emerging theory that MS is caused when support cells called astrocytes malfunction, perhaps as a result of genetic and environmental triggers.

 (NOTE:  One well-documented environmental cause of astrocyte malfunctioning is hypoxia, or low oxygen in the brain)

Many mainstream MS researchers contacted by New Scientist have poured scorn on the review. But a few agree it's time for a rethink.

Peter Behan and Abhijit Chaudhuri at the University of Glasgow and Bart Roep of the Leiden University Medical Centre pull no punches in their attempts to demolish the prevailing theory. They begin by attacking the animal experiments that have underpinned the autoimmune theory since the late 19th century.

Back then, researchers discovered that if they injected nerve or brain tissue into an animal, its immune system would attack the nervous system. They called this experimental allergic encephalomyelitis, and before long adopted EAE as the "animal model" of multiple sclerosis.

This, say the heretics, was a big mistake. In their view, EAE is completely different from MS. "There are huge differences, and they've been skipped over," Behan told New Scientist.

For instance, EAE either kills animals or leaves them with permanent disabilities. "It doesn't come and go like MS," he says. Animals with EAE also suffer severe nerve inflammation, whereas in MS inflammation is usually mild, if present at all.

Despite this, virtually all treatments for MS have been tested on EAE. Little wonder then, says Behan, that the treatments do not work for people. "Not a single human has been cured using these approaches," he says.

However, steroids and other immunosuppressants do work for a brain disease called acute disseminated encephalomyelitis, a rare result of infections. Behan thinks ADEM, not MS, is the human equivalent of EAE.

He also argues that the fact that traces of white blood cells are found at some sites of nerve and brain damage in MS patients does not prove they caused the damage. The same traces are found after strokes and neurodegenerative diseases.

Israel Steiner, a neurologist at the Hadassah University Hospital in Jerusalem, agrees that EAE has blocked "effective progress" for decades. He thinks alternative theories should be put to the test. "I definitely believe it's high time to reconsider the entire field. It has not led us into understanding the disease or to a better therapy for patients," he says. "Many people in the community who do not have a vested interest in the autoimmune hypothesis share my views, but I'm not sure they would like to step out."

Almost 10 years since this review was written, and EAE is still used to create pharmaceuticals for MS.  When will this insanity end?

Joan