Welcome! This blog contains research & information on lifestyle, nutrition and health for those with MS, as well as continuing information on the understanding of CCSVI and cerebral hypoperfusion. This blog is informative only--all medical decisions should be discussed with your own physicians.

The posts are searchable---simply type in your topic of interest in the search box at the top left.

Almost all of MS research is initiated and funded by pharmaceutical companies. This maintains the EAE mouse model and the immune paradigm of MS, and continues the 20 billion dollar a year MS treatment industry. But as we learn more about slowed blood flow, gray matter atrophy, and environmental links to MS progression and disability--all things the current drugs do not address--we're discovering more about how to help those with MS.

To learn how this journey began, read my first post from August, 2009. Be well! Joan

Thursday, May 14, 2015

"Neuroprotection" and Ibudilast

The latest MS drug trials all have a new target.  The new buzzword in MS drug development is "neuroprotection."  What does this mean, and why the switch?

Neuroprotection simply means protecting neurons by reestablishing blood flow and perfusion after a loss of oxygen to the brain.  We see these drugs are currently marketed to those who suffer from stroke.

Neuroprotective agents are used in an attempt to save ischemic neurons in the brain from irreversible injury.[2]    http://emedicine.medscape.com/article/1161422-overview

I wrote about this subtle shift from drugs which modulate the immune system to drugs which address blood flow in 2013.  Here's that post:
http://ccsviinms.blogspot.com/2013/08/medications-for-ms-addressing-blood.html

What MS researchers are now doing is working with pharmaceutical companies to test and prescribe new drugs which address the damage caused by slowed blood flow.  And these drugs are called "neuroprotective."

Which is exactly what Dr.  Robert Fox is doing now with Ibudilast.
How does ibudilast work?   
It relaxes blood vessels and increases blood flow by inhibiting phosphodiesterases and releasing nitric oxide from the endothelium.

Dr. Fox has been working on a clinical trial for those with progressive MS, using Ibudilast (MN-166) which has been prescribed to treat stroke and asthma patients for two decades-

Ironically, ibudiblast has already been studied in a phase II trial involving 292 patients with relapsing MS and was found to decrease relapses.

However, Dr. Fox's trial will only be looking at progressive MS.  This way, people with relapsing remitting MS can still be sold expensive immune modulating drugs, and the researchers do not have to change their EAE story line.  

When Dr. Zamboni discovered the link to slowed venous return, hypoperfusion and MS, he opened up a new way of looking at the MS disease process.  Although neurologists and MS specialists will not say this, he has changed how they are studying the MS disease process and how they are developing drugs to treat MS.

And, not coincidently, one such researcher is Dr. Robert Fox.  In 2010,  Dr. Fox, a neurologist, received money from the MS Society to study CCSVI, a vascular disorder.   A medical student in his lab discovered never before seen venous malformations in the jugular veins of cadavers of people with MS.  And in 2011, the results of this study cause quite a stir at ECTRIMS.


Some results from the first 13 cadavers were presented during a platform session at ECTRIMS by Case Western University medical student Claudiu Diaconu. He confirmed that venous structures in the brain and brainstem appear to be far more complicated and variable than previously thought.
In fact, the postmortem study revealed the presence of a novel venous valve that had not been described in anatomy textbooks.
Perhaps the most important finding was that most of the stenoses identified in the study were not associated with vessel wall thickness or circumference.
As a result, Diaconu said, cerebrospinal vein scans in live patients "should focus on identifying intraluminal abnormalities, not just vessel wall narrowing or thickening.

What Diaconu found, and Dr. Fox knows---"intraluminal abnormalities with possible hemodynamic consequences were higher in MS patients compared to healthy controls."  
http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=137778&XNSPRACHE_ID=2&XNKONGRESS_ID=150&XNMASKEN_ID=900

"Hemodynamic consequences from intraluminal abnormalities" simply means they found a mechanical reason for the slowed blood flow, also known as hypoperfusion, which exists in MS.  Blockages inside the veins.

This hypoperfusion and ischemia in MS is a fact.  But neurologists and MS specialists cannot make any money treating venous malformations, or understanding how to improve perfusion with nutrition, exercise and lifestyle adjustments.  Understanding the heart brain connection won't benefit them, or their labs.

That's right.  Dr. Robert Fox will never tell you that ibudilast is a post stroke treatment, already approved and shown to relax blood vessels, increase blood flow, oxygenation and perfusion in the brain.  And it helps people with RRMS, as well as progressive MS.  He will tell you it is "neuroprotective" and blood flow doesn't matter....

I am so sick and tired of this charade.  I hope everyone can understand this.  Medicalese is being used to keep people in the dark regarding the MS disease mechnisms.

Hypoperfusion and slowed blood flow are realities in MS.  

Make sense?

Joan









13 comments:

  1. this is so very good... Thank you so much for your hard work!

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    1. you're welcome, Casey! Hope it can be of some help for people---all of the medicalese can be confusing, and misleading, too

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  2. this is so very good... Thank you so much for your hard work!

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  3. This comment has been removed by the author.

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  4. Is this means changing Neurologist to Vascular surgeons!

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  5. YES! Makes great sense! As always, thank you Joan.

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  6. It's crazy because they think I'm in the early stages of MS, and I've recently noticed my jugular vein area has some sort of stenosis that I can feel vibrate. I haven't gone to get it checked out yet but I think MS is related to blood flow. I know the MRI looks different for stroke or other vascular disorders, but I wonder whether the effects of demyelination are perhaps actually induced vascularly. I would always think that when one of my hands would tingle, it looked paler and as if the blood supply was cut off...
    Anyway need to check out this potential stenosis further. Will stay posted to your developments!

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  7. Thinking this may also be why they have recommended yoga as being helpful! Blood flow baby! ;)

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  8. Thinking this may also be why they have recommended yoga as being helpful! Blood flow baby! ;)

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  9. It's crazy because they think I'm in the early stages of MS, and I've recently noticed my jugular vein area has some sort of stenosis that I can feel vibrate. I haven't gone to get it checked out yet but I think MS is related to blood flow. I know the MRI looks different for stroke or other vascular disorders, but I wonder whether the effects of demyelination are perhaps actually induced vascularly. I would always think that when one of my hands would tingle, it looked paler and as if the blood supply was cut off...
    Anyway need to check out this potential stenosis further. Will stay posted to your developments!

    ReplyDelete
  10. It's crazy because they think I'm in the early stages of MS, and I've recently noticed my jugular vein area has some sort of stenosis that I can feel vibrate. I haven't gone to get it checked out yet but I think MS is related to blood flow. I know the MRI looks different for stroke or other vascular disorders, but I wonder whether the effects of demyelination are perhaps actually induced vascularly. I would always think that when one of my hands would tingle, it looked paler and as if the blood supply was cut off...
    Anyway need to check out this potential stenosis further. Will stay posted to your developments!

    ReplyDelete
  11. Hi Vanessa---if you are indeed in the early stages of MS, do all you can to keep moving and live your best, healthiest life. There is research coming in that shows that people who exercise, eat whole foods, maintain a healthy weight, do not smoke, get good sleep, get UV rays and vitamin D and deal with stress--have slower MS progression and maintain mobility for longer. The science is in! Yoga is terrific, so is any cardiovascular esercise which gets your heart pumping. As we all learn more about the vascular connection to MS, there is so much you can do for yourself to stay well! Be encouraged. all best, Joan

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