Vascular factors affect MS disease progression

I know, I know.  You'd think it would be obvious by now that the heart and brain are connected, and that vascular health has an impact on MS disease process.   But in the 10+ years I've been following MS research, it seems as though researchers are continually surprised when they learn that cardiovascular comorbidities have an impact on MS progression.

There are two new research papers from Canadian MS specialists, published in the AAN journal Neurology, which have found a connection between blood flow and MS progression.  I am thankful to know that Dr. Helen Tremlett's team continues to look at this connectivity--- but frustrated by the lack of recommendations being made by MS Societies and MS specialists regarding lifestyle interventions like nutrition and exercise.  There is still a huge disconnect.

The first paper found that people with hyperlipidemia (which is an abnormally high content of fats in the blood---measured by LDL cholesterol numbers)  and migraine had an increased MS relapse rate.  
Link to "Comorbidity increases the risk of relapse in MS"

The second paper also looks at cardiovascular comorbidities, like ischemic heart disease and found a link in disease progression and disability.  link to "Effects of physical comorbidities on disability progression in MS"

The Centre for Brain Heath in Canada has recently published an article on this research, in which Dr. Tremlett says---

"Our findings suggest that if you could alter the trajectory of a comorbidity, you may be able to improve outcomes in MS.”
link

And how do patients reduce heart disease, lower their LDL cholesterol, improve vascular comorbidities?   Well, no surprise here.  Researchers don't want to say, they would like funding for more research.

“This suggests that we may need to take a more holistic approach to managing MS and related comorbidities,” says Dr. Zhang. “Effective treatment for each comorbidity may reduce disability risk. We need more research to identify the most appropriate treatment approach for each comorbidity in MS.”

Information for the disability progression study came from health administrative data across Canada, with nearly 30 years of anonymized clinical records providing detailed insight into the relationship between comorbidities present before and after MS symptom onset and disability progression over time.

Dr. Roy Swank published on ALL of this in the 1950s.  And he was routinely mocked by MS neurologists who felt that MS was an autoimmune disease which could not be altered by diet and lifestyle.  But they were wrong.   link

Don't let another 60 years go by.  Take control of your life, your own health today.  Eat a heart healthy, colorful diet full of plants, move as much as you can, get UV rays, decrease stress and increase laughter.  Get good sleep, don't smoke, stay involved in community and learning.  Because science shows that these things can make a difference in your MS disease process.  link

The heart brain connection is real.

Joan

New research on cholesterol clearance and MS

Long-time readers of this blog will remember a variety of posts on fats, lipids, cholesterol and inflammation in multiple sclerosis.  It was Dr. Roy Swank's research on ingestion of animal fats and the changes to the vascular system which first interested me in this connection.  Once again, what is old in MS research is new.

Research published this week from the Technical University of Munich explores how the degredation of myelin leaves a destructive cholesterol residue in the brain, which increases an inflammatory response and blocks myelin regeneration.  It appears that with age, the process of transporting cholesterol out of the brain becomes less efficient.  (Important to state that this research was done on a mouse model of MS.)

"Myelin contains a very high amount of cholesterol," explains Prof. Simons. "When myelin is destroyed, the cholesterol released has to be removed from the tissue." This is performed by microglia and macrophages, also referred to as phagocytes. They take up the damaged myelin, digest it and transport the non-digestible remainder, such as cholesterol, out of the cell by transport molecules. However, if too much cholesterol accumulates in the cell, cholesterol can forms needle-shaped crystals, which cause damage the cell. Using a mouse model, Simons and his team showed the devastating impact of the crystalline cholesterol: It activates the so-called inflammasome in phagocytes, which results in the release of inflammatory mediators, attracting even more immune cells. "Very similar problems occur in arteriosclerosis, however not in the brain tissue, but in blood vessels," says Simons.
link

Although cholesterol synthesis in the brain is considered a different process than cholesterol synthesis in the rest of the body, lower plasma levels of HDL cholesterol have been found to be related to MS.  Cardiovascular researchers have been looking at this fact, in relation to the heart brain connection.  

HDL plasma levels have also been associated with other neurodegenerative diseases such as multiple sclerosis (MS).74 Patients in the acute phase MS have been reported to have lower HDL-C levels compared with those in the remission phase, and they show a higher probability of developing acute inflammatory lesions (assessed by MRI).74–768 Moreover, HDL inhibits cytokine-induced expression of adhesion molecules in endothelial cells.72
link

Why are HDL levels important?  Because HDL, also known as "good cholesterol", contains the transport protein ApoA1---needed to take cholesterol out of the blood and tissue.

Here's more research on low levels of ApoA1 found to be linked to MS severity.  The lower HDL
ApoA1 plasma levels, the more severe the disease. 

ApoA1 was reduced by approximately 25% in patients with relapsing-remitting MS, 50% in those with secondary progressive MS, and 75% in patients with primary progressive MS, the most severe form of the disease. link

Here's a whole blog post from 2013 on "Good" cholesterol and your brain
link

While we wait for researchers to create their cholesterol transport block buster MS drug, or to repurpose things like statins (please, don't go there, so many side effects!)---there are things pwMS can do today, to encourage this process in their own bodies, by increasing your HDL levels with lifestyle.

1. Don't smoke.  Quitting smoking will increase good cholesterol by 10%

2. Lose weight.  Extra weight depletes HDL.

3. Exercise.  Within 2 months of regular exercise, you can increase your HDL by 5%

4. Choose healthier fats for your diet. Avoid transfats and saturated animal fats.  Choose omega 3s and monosaturated fats found in nuts, olive oil, and fish

5. Add fiber to your diet--lots of fresh fruits and vegetables, legumes and oats

6. Limit alcohol consumption.

link

7. Check your vitamin D, magnesium, calcium and zinc levels--make sure they are in balance.
link

Keep an eye on the latest MS research.  

It continues to affirm the heart-brain connection, and the importance of living a vascularly healthy life.

Be well,

Joan