Welcome! This blog contains research & information on lifestyle, nutrition and health for those with MS, as well as continuing information on the understanding of the endothelium and heart-brain connection. 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 auto-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
Wednesday, May 17, 2017
MS is vascular
MS is caused by a breakdown of cerebral endothelial cells. The loss of these vascular cells, which line all 60,000 miles of our blood and lymph vessels, is why the blood brain barrier becomes open, how immune cells are called in creating inflammation, why the coagulation cascade occurs increasing fibrinogen, what allows for death of neurons, what causes MS to progress.
For those who hate medical language, find it confusing, and like easy to understand explanations, I wrote up a simple post on the endothelium and how it works here: link
I'm not the only one saying the endothelium is central to MS.
A new paper, edited by MS neurologist Lawrence Steinman at Stanford University states the following:
Endothelial cells (ECs) in the CNS form a unique blood–brain barrier (BBB) that is broken down in multiple sclerosis (MS). New therapies are sorely needed to restore BBB function in this disease.
Disruption of the blood–brain barrier (BBB) is a defining and early feature of multiple sclerosis (MS) that directly damages the central nervous system (CNS), promotes immune cell infiltration, and influences clinical outcomes. There is an urgent need for new therapies to protect and restore BBB function, either by strengthening endothelial tight junctions or suppressing endothelial vesicular transcytosis.
This paper is a collaborative review from Columbia University, UC Irvine, Stanford and the Albert Einstein College of Medicine. You can read the abstract here:
I really don't know how else to say it. Your endothelium is important. I've been blogging about this scientific reality since my first post on this blog. Hundreds of my posts are about endothelial cells, why they are important, why they die, how to maintain them. Obviously, I didn't do the research, I just put it together.
Yes, I am gratified that universities acknowledge the importance of the endothelium in MS. But so much of this remains a continued search for industry funding and "pharmacologic enhancement" rather than a search for the etiology, or cause of MS. Or an understanding of how the endothelium is damaged by a variety of lifestyle, vascular and disease factors.
I wanted to understand how to protect and strenghten the endothelium, which is why I originally contacted Dr. John Cooke, a researcher at Stanford University who had published a book on nitric oxide and lifestyle measures to heal the endothelium in cardiovascular disease. He is now at Houston Methodist, heading up a lab which is creating endothelial cells from stem cells, for use in regenerative medicine. He's getting there! link
Below are the interventions we discussed, which I compiled for Jeff and others with MS. The endothelium can heal by using these strategies. Jeff has done really, really well following this program. I have also heard from other people with MS who are employing these measures, and finding health and stability. Please talk to your own doctors before beginning any lifestyle program, to make sure it is right for you. I am not a doctor. But I trust people like Dr. Cooke.
The International Society for Neurovascular Disease recently had their 7th annual conference. This year, the President of the ISNVD was Dr. Stephen Alexander. I originally met Dr. Alexander online and later in person at the first meeting of the group which would become the ISNVD, back in 2009 in Bologna, Italy. Dr. Alexander is an endothelial researcher who studies endothelial cells in MS and inflammation. He and his fellow researcher, Dr. Alireza Minagar, have published many papers on the vascular connection to MS.
This is their paper, which caught my attention ten years ago:
Multiple Sclerosis as a Vascular Disease
Their most recent effort is a chapter included in the book "Inflammatory Disorders of the Nervous System" called "Emerging Roles of Endothelial Cells in Multiple Sclerosis Pathophysiology and Therapy"
The complex pathogenesis of MS can only be appreciated when and if vascular contributions are recognized as a significant part of MS etiology. Indeed, many novel therapies for MS target the mechanistically relevant vascular inflammatory features of these conditions and implicate cerebrovascular endothelial cells (CECs) as the “failing gatekeeper” of the blood-brain barrier (BBB). link
And yes, CCSVI is a factor. When blood flow is disturbed, due to venous hypertension or stenotic blood vessels, there is a lack of shear stress over endothelial cells, and they die. Endothelial cells need constant moving blood. Here is a paper from Dr. Alexander on Venous Endothelial Injury in Diseases of the CNS. https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-219
While researchers continue to put together the pieces and find pharmacological means to strengthen the endothelium, there are things you can do today to help yourself.
I know, I repeat myself. A lot. Because this is important.
Heal the endothelium, heal the vasculature, heal the body.
The brain’s blood vessels are lined with endothelial cells that are wedged tightly together, creating a nearly impermeable boundary between the brain and bloodstream.