You and Your Microbiome

During the past year, there has been a lot in the medical press on the "microbiome."   Researchers continue to explore the connection between the microbiome and neurodegenerative disease.  Articles on the microbiome and MS, Alzheimer's, and dementia as well as cardiovascular disease and stroke, are being published in medical journals and discussed in online communities.

You might say 2014 has been the Year of the Microbiome!

But what is it??  Microbiome literally means the "small living community" inside each of us.  It's the word doctors and researchers use to describe your own, unique ecosystem.  You see, we are not just "ourselves", we are also host to a universe of living organisms.  And most of these guests take up residence in our gut.

We have about two pounds of bacteria living inside us.  These bacteria are broken down into four families: the Actinobactera, Bacteroidetes, Firmicutes and Proteobacteria.  http://www.nature.com/nri/journal/v13/n11/fig_tab/nri3535_F2.html

When these families live in balance, the human body functions better.  When these families get knocked out of balance, diseases can be linked.  "Dysbiosis" is when inflammatory bacteria outnumber beneficial bacteria.  Whether the link to specific diseases is causal, or resultant, is yet to be established.  But there's more and more evidence connecting an imbalanced microbiome to inflammation and diseases of "autoimmunity."

Here are some more specifics on what researchers found, when looking at the fecal bacteria in people with MS, and comparing them to healthy controls.  This is Dr. Sushrit Jangi of Brigham and Women's Hospital discussing results of a recent study:

The preliminary data show that there are at least a couple of different genera of bacteria that are different in the gut of MS patients compared with healthy controls. We found that a bug called Methanobrevibacteriaceae *** is enriched in the gut of MS patients and seems to have immunoproliferative properties that drive inflammation. We also found that the population of Butyricimonas ### bacteria is low in MS patients compared with healthy controls. This is an interesting result because these bacteria produce butyrate, which is thought to be immunosuppressive, but we do need to repeat this study in a larger cohort.

So it seems that our work initially supports the idea that the gut in MS patients contains bugs that drive inflammation and are low in the types of bacteria that control inflammation. This is consistent with work in rheumatoid arthritis and inflammatory bowel disease.

This also mirrors the idea that MS is a disease of the western world. If you go to countries like India and parts of Asia, where diets are far more vegetarian, you don't really see MS. However, when these people come to the United States and adopt a more westernized diet, the incidence of the disease goes up. I think this is an exciting premise but it's still too early to say anything about the causality.
http://www.medscape.com/viewarticle/832385

***Methanobrevi bacteria are found to be enriched in those who are constipated.  
https://microbewiki.kenyon.edu/index.php/Methanobrevibacter_Smithii
### Batyricimonas is also low in RA and inflammatory bowel disease.
http://journals.lww.com/neurotodayonline/blog/breakingnews/pages/post.aspx?PostID=316

I included probiotics and eating more plants in the Endothelial Health Program, because I read a lot of research on the link between bacteria, inflammation and the endothelium.  And I wanted to help Jeff.  He was severely constipated when we started the program (sorry, hon!  Is that TMI?)  His serum numbers were off the charts for inflammation.  His meat and animal protein to plant food ratio was far too high in meats, too low in vegetables and fruits.  His just wasn't eating enough living, plant-based foods with phytonutrients and fiber.  I thought there might be a connection, and found it in the endothelium.  Here is a post from 2011, where I explain:

http://ccsviinms.blogspot.com/2011/07/probiotics-and-brain-gut-link-july-7.html

Probiotics, also know as helpful bacteria, are included in the Endothelial Health program, because they affect the lining of our blood vessels in a positive way, by reducing inflammation and regulating NO. A strong endothelium is less permeable, and will keep plasmic particles out of tissue--in the brain and the gut.  This can modify the reaction of immune cells, and reduce what is called the "autoimmune" reaction.  (Although I believe calling this reaction "autoimmune" is a misnomer.  The immune cells are simply doing their job, by responding to foreign particles which should not be in brain or intestinal wall tissue.)

http://www.ccsvi.org/index.php/helping-myself/endothelial-health

What to do?  How can we create a more balanced, happier microbiome, and encourage growth of healthy bacteria?   There are a few things scientifically proven that we can do today, while the researchers continue to look for specific answers.

1. Work with your own healthcare provider, and find a probiotic solution that fits your lifestyle and needs.  Some people eat yogurt, others prefer fermented foods like sauerkraut, kimchi or kombucha, or some take a probiotic supplement.  Some folks (like me!) enjoy all three.  Jeff finds his supplement is enough.   Each individual needs to discover what works best for them.

2. Eat more plants, eat less meat and animal products.   And stay away from processed foods. The research shows that the more saturated and trans fats, the less balanced the microbiome.  The more fresh vegetable and fruits, the better the microbiome.

3. Watch your bowel movements!  Are you going at least once a day?  If not, you're not moving waste products through your body efficiently, and that build up of noxious or "bad" bacteria may be enhancing inflammation in your body.  If you are having a couple smooth, not runny, bowel movements a day, chances are, your microbiome is pretty happy.  (sorry, was that TMI again??)

4. Stay at a healthy weight.  Obesity is linked to an unbalanced microbiome.


Let's be good hosts to the universe within us all!
Joan

The Endothelium

Update  APRIL 2019
More research continues to come in, linking endothelial dysfunction to multiple sclerosis.  Pub med has hundreds of new papers. 
https://www.ncbi.nlm.nih.gov/pubmed/?term=multiple+sclerosis+endothelial+dysfunction

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When I first began looking into how Jeff's MS was related to his vascular system in 2007,  I read many papers on pubmed which discussed the "endothelium."  A dysfunction in the lining of our blood vessels was implicated in chronic diseases of inflammation and hypoperfusion, such as MS.  I noticed that there were many modern day environmental factors that caused problems with endothelial health and blood flow.  Endothelial dysfunction was linked to diabetes, cardiovascular disease, autoimmune disease and neurodegenerative disease.  

Fast-forward seven years, and there are health stories on the endothelium in the mainstream press every day.  Here's a sampling from just last week----

Tomato Sauce helps fight heart disease   Of 36 patients with heart disease, those taking the pill every day for two months saw their blood vessels widen by 53 per cent.  This was due to improved functioning of the endothelium, the inner wall cell lining of blood vessels, scientists believe. link

How the brain regulates blood flow   Hillman found that the vascular endothelium, the inner layer of blood vessels, plays a critical role in propagating and shaping the blood flow response to local neuronal activity. While the vascular endothelium is known to do this in other areas of the body, until now the brain was thought to use a different, more specialized mechanism and researchers in the field were focused on the cells surrounding the vessels in the brain.link

Eating Strawberries may lower blood pressure   Strawberries are rich in antioxidants, which may lower blood pressure by relaxing the endothelium, the lining inside blood vessels.  Relaxing the endothelium widens the arteries, reducing pressure.link

So, now that we know the endothelium is truly important---how is our current environment impacting our health?   And what can we do about it?
Here's what I wrote in 2007:

                                                            

I truly believe endothelial dysfunction is the disease of modern man, and is responsible for the increasing rates of chronic disease in industrialized nations.

To provide a contrast and by means of example, I present a day in the life of two women, separated by only 200 years in time.

19th Century- Life as it been lived for thousands of years-

You and your husband get up from bed as the sun rises and the rooster crows. You both get dressed and head outside together to milk the cows and feed the livestock. You work the pump at the well, get a drink of water, which comes from a fresh spring underground. The physical exertion of pumping water and carrying it, lifting the feed and milking the cows has worked up a good sweat. You gather some fresh eggs from the henhouse, and head inside to cook breakfast. The meal includes coffee or tea made with spring water, fresh milk from the cow, eggs and toast with apple preserves, jarred last fall.

The children rise, get dressed, eat and are soon out the door to walk to school. Your husband heads off to his work in the barn. There is laundry to be washed and hung on the line and gardening to do. You spend over two hours out doors, in the sunshine.  Again, hard work and more exercise. This is not a life of leisure!

Fresh fruits and vegetables are eaten in season and canned and jarred for off season.  There isnʼt much meat, but an occasional fish from the stream or chicken from the henhouse. Grains are whole, and you add flaxseed to the bread. Root vegetables and greens are plentiful. Mealtime is spent together as a family. After dinner, and after the dishes pots and pans are cleaned, the family sits together and reads or plays board games. Soon the sun sets and itʼs time for bed. Everyone is tired from the dayʼs activities and ready to sleep.

21st Century--Our Modern Life

You rise in the dark to the incessant buzz of the alarm clock. Itʼs a quick shower in chlorinated and fluoridated city water and blow dry before heading to the kitchen to make a pot of coffee. You get your water from the tap and microwave a breakfast sandwich of processed ham and cheese to go. You check your e-mail on the laptop and holler to wake your husband and the kids and hurry them up- thereʼs no time to waste! They get dressed, grab their backpacks and eat their microwaved breakfasts as everyone piles into the van.

Itʼs off to school where you drop them at the door. Then you get back on the freeway to sit in traffic. Love those fumes! Youʼre starting to get a headache. Trapped on the road, you try to make good use the time by calling clients and checking your phone. Your stress levels are now through the roof of the van. You get to the office late and have to deal with everything that has been piled on your desk. No time for the gym, and lunch is going to be a bag of peanut M&Ms and a can of Coke. You never see the light of day, except through your office windows. By the time you get home, itʼs dark and the kids are fighting over the Playstation.

You still need to make dinner. Your husband has texted you, heʼs running late and will miss dinner...again.

You pile the kids back in the van and head to a fast food place. Itʼs drive through and the kids donʼt mind. Youʼre famished and get a double cheeseburger, since you skipped lunch, how could it hurt? You get everyone home and get the kids doing their homework. Itʼs nine pm before you know it, and your husband finally gets home. He walks in and just wants to sit in front of the TV, heʼs exhausted. You get the kids bathed and into bed. Itʼs 11pm before you fall into bed, head pounding. You have trouble sleeping, and it seems like by the time you finally drift off, the damn alarm is ringing again!

I do not mean to over-romaticize or idealize the lives of men and women from centuries ago. Theirs was a very different experience, and it was physically and emotional demanding. People got sick then, very sick, and many died premature deaths. But not many suffered from chronic diseases. Our modern lifestyle is much easier in many ways-- we have automated appliances to do our labor, vehicles to transport us, and conveniences our great, great grandparents could only have dreamed of. 

Our modern lifestyle has disrupted many natural and hormonal patterns; such as the circadian rhythm. We no longer use the sun to tell us when to rise and set. And doctors are seeing a deficiency of vitamin D (the sunshine vitamin made by our skin when exposed to sunlight) linked to many diseases. Not coincidentally, lack of vitamin D is one of the causes of endothelial dysfunction.

                                                                        +++++++++++

More science continues to come in, and we've learned how endothelial dysfunction is linked to slowed cerebral blood flow and inflammation. Some of the modern lifestyle/environmental factors which have been linked to endothelial dysfunction are:

1. Lack of UV rays, low nitric oxide and low Vitamin D

2. Lack of exercise and sedentary living

3. Higher stress and cortisol release

4. Lack of REM sleep and regular circadian rhythms

5. Too much glucose and refined sugar

6. Eating transfats and processed foods

7. Toxins, pesticides and heavy metals in air and food

8. Lower intake of whole foods, fruits and vegetables

And not coincidentally, when countries become industrialized or "westernized", rates of chronic diseases rise. 

Nevertheless it was the Industrial Revolution (with the widespread use of refined vegetable oils, refined cereal grains, and refined sugars)14,65 and the Modern Age (with the advent of the “junk food” industry, generalized physical inactivity, introduction of various pollutants, avoidance of sun exposure, and reduction in sleep time and quality coupled with increased chronic psychological stress)14,38,65,146,152,153,160 that brought about the most disruptive and maladaptive changes, which may have serious pathophysiological consequences.  link

Take care of your endothelium and it will take care of you.

For more information:

http://ccsvi.org/index.php/helping-myself/endothelial-health

Joan

Why do women have higher MS rates? S1PR2 and the Endothelium

In the news---researchers find another connection of MS to blood vessels.  
New research from the Washington University School of Medicine outlines how higher levels of the blood vessel receptor protein S1PR2 in women might be creating higher MS rates in women. 

S1PR2 is a receptor which signals the endothelium (the cellular lining of our blood vessels).  It tells the endothelium which cells and molecules can pass through into tissue.  In the case of MS--this process affects the brain and spine.  An overexpression of this receptor may be behind MS.

The research, conducted at Washington University School of Medicine in St. Louis and published in the Journal of Clinical Investigation, found higher levels of a blood vessel receptor protein called S1PR2 in both female mice and women who were vulnerable to MS. What's more, S1PR2 was even higher in the parts of the brains of the women and mice that MS usually affects.

"It was a 'Bingo!' moment –- our genetic studies led us right to this receptor," senior author and associate professor of medicine at Robyn Klein, M.D., Ph.D., said in a statement. "When we looked at its function in mice, we found that it can determine whether immune cells cross blood vessels into the brain. These cells cause the inflammation that leads to MS."

Among the female mice, Klein and her team found 20 genes in areas of the brain typically affected by MS that were active at different levels than in male mice. Previous research had identified S1PR2 as a protein that dictates the ease with which cells and molecules pass through the walls of blood vessels. In the new research, S1PR2 was found to also regulate which cells cross from the blood vessels into the brain, which could allow the inflammatory cells that lead to MS to enter the central nervous system, according to the press release.

The highest levels of S1PR2 in human brain tissue samples were in two female MS patients who had "relapsing and remitting MS", meaning their symptoms flared irregularly.

http://www.huffingtonpost.com/2014/05/08/multiple-sclerosis-women_n_5288927.html

Vascular researchers have been studying the role of the overexpression of S1PR2 in inflammation:

The endothelium, as the interface between blood and all tissues, plays a critical role in inflammation. Sphingosine-1-phosphate (S1P) is a bioactive sphingolipid, highly abundant in plasma, that potently regulates endothelial responses through interaction with its receptors (S1PRs). Here, we studied the role of S1PR2 in the regulation of the proadhesion and proinflammatory phenotype of the endothelium.

http://bloodjournal.hematologylibrary.org/content/122/3/443.abstract

+++++++++++++++++++++++++++++++++++++++++++

What can cause this overexpression of S1PR2?

Obesity and hypoxia (or low oxygen environments) are linked to higher levels of S1PR2.    http://www.ncbi.nlm.nih.gov/pubmed/24212262
Adipose tissue is linked to higher levels--  This might explain the connection to women.

S1PR2 is overexpressed during hypoxic stress
http://www.ncbi.nlm.nih.gov/pubmed/17710232

S1PR2 is over expressed during reperfusion, after an ischemic event.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269189/

We would experct to see these high levels of S1PR2 in those having relapses, if the hypo perfusion/reperfusion injury theory of MS is correct.
http://ccsviinms.blogspot.com/2013/09/multiple-sclerosis-hypoperfusionreperfu.html

In fact, the hypoxic conditions we see in CCSVI, due to slowed venous return and hypoperfusion of the MS brain- with the resulting reperfusion injury- could well be linked to the overexpression of this protein.

++++++++++++++++++++++++++++++++++++

While pharmaceutical companies look for ways to regulate S1PR2 and strengthen the endothelium---there are lifestyle modifications which can accomplish this--- for free.

If you are new to this page, please consider the Endothelial Health Program, and talk to your own physician about changes you can incoporate into your own lifestyle, to help strengthen your blood brain barrier.   http://www.ccsvi.org/index.php/helping-myself/endothelial-health

And when neurologists tell you MS has nothing to do with cerebral blood flow, hypoperfusion and the endothelium, you can point them to yet another study which contradicts this claim.  

There is most certainly a vascular connection to MS.

Heal the endothelium, heal the blood brain barrier, heal the brain.

Joan

How Hypoxia creates Inflammation--New England Journal of Medicine

November 29, 2011 at 9:44am

Found a great paper in the New England Journal of Medicine that discusses how hypoxic environments, like high altitudes, can create inflammation and signal the immune system in the brain.  It was written by some specialists in high altitude and hypoxia, researchers at the University of Colorado in Denver.

In persons with mountain sickness, for example, levels of circulating proinflammatory cytokines increase, and leakage of fluid ("vascular leakage") causes pulmonary or cerebral edema.  Increased serum levels of interleukin-6, the interleukin-6 receptor, and c-reactive protein--all markers of inflammation--were increased in healthy volunteers who spent 3 nights at an elevation higher than 3400 m.  The development of inflammation in response to hypoxia is clinically relevant.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930928/

All it took to create higher levels of serum inflammation in healthy people was 3 nights.

My husband Jeff came home from the Sundance Film Festival in Salt Lake City in his first, soon to be diagnosed MS flare.  His serum inflammation numbers were through the roof.  And that's how this journey began for us.   

Slowed perfusion and collateral circulation created by truncular venous malformations can create a low oxygen environment in the brain and start the inflammatory process.  Understanding the link to the high levels of MS diagnosis in new residents to Colorado would be a great place to start.

Joan

Dr. Philip James on CCSVI

June 23, 2011 at 9:20am

Dr. Philip James has been studying MS for the past 30 years in Dundee, Scotland.  He has long been speaking out about the vascular connection to MS, and the importance of oxygenation of the central nervous system.  Here is a recent quote on his interpretation of where MS research "went wrong."

 "The recent publicity given to the work of Professor Paolo Zamboni has highlighted a growing disaffection with the concept of ‘auto’ immunity which has dominated MS research and treatment for more than half a century. Zamboni trained as a vascular surgeon specializing on problems of leg veins, which often leak as we age, allowing red blood cells into the surrounding tissues. When the red cells break down they liberate iron which causes damage to the walls of veins and the surrounding cells. Similar damage was found in the veins in the centre of the typical ‘plaques’ of multiple sclerosis as long ago as 1863.

However, the use of an animal model for MS research after WW2 led to the concept of auto immunity where, it is claimed, the immune system attacks normal tissue. Despite sixty years of research there is no evidence of this and it remains just a theory. What is certain is the damage in MS involves veins and inflammation and Professor Zamboni has focused on these proven observations. He noticed, when using ultrasound scanning of the neck in a Multiple Sclerosis patient, that blood flowed the wrong way in a vein and also that the vein appeared to be constricted.

After more investigations he has used the same procedure used to stretch arteries in the heart to relieve the vein constrictions. Several patients have found the procedure beneficial, greatly reducing their symptoms although stretching the veins will not affect existing scarring. There has been no indication of why the veins constrict, although increased ‘reactivity’ of blood vessels has been reported before in MS patients.

Professor Zamboni’s work has highlighted the importance of the blood-brain barrier. Oxygen is responsible for the genetic control of inflammation and lack of oxygen has been shown in affected areas in MS patients by brain imaging. Neurologists are likely to remain sceptical of vein stretching until a ‘controlled’ study is done in which a sham procedure is used and compared to a group of matched patients who have the real procedure undertaken."

- Philip B James MB ChB DIH PhD FFOM

Emeritus Professor of Medicine University of Dundee

Honorary Medical Adviser MS Therapy Centres.

Bromelain---how pineapple can reduce inflammation

March 7, 2011 at 11:13am

Another one of my favorite supplements is bromelain.    

It is a natural anti-inflammatory and a proteolytic enzyme--meaning it eats up proteins.

Bromelain is a mixture of protein-digesting (proteolytic) enzymes found in pineapples (Ananas comosus). Pineapple has been used for centuries in Central and South America to treat indigestion and reduce inflammation. Bromelain, which is derived from the stem and juice of the pineapple, was first isolated from the pineapple plant in the late 1800s. The German Commission E approved bromelain to treat swelling and inflammation following surgery, particularly sinus surgery.

Bromelain can be useful in treating a wide range of conditions, but it is particularly effective in reducing inflammation associated with infection and injuries.

Be sure to read up on contraindications before taking, since bromelain does interfere with some medications:

http://umm.edu/health/medical/altmed/supplement/bromelain

Here is research from Duke University that shows why Bromelain tamps down inflammation:  it's all about decreasing the number of neutrophils that respond to a site of injury.  Neutrophils are a special type of white blood cell that is called in after injury to tissue.  They kill infectious agents and are defenders, but they also contribute to inflammation, and could potentially lead to restenosis, by leukocyte adhesion to injured blood vessels.

Bromelain, a mixture of proteases derived from pineapple stem, has been reported to have therapeutic benefits in a variety of inflammatory diseases, including murine inflammatory bowel disease. The purpose of this work was to understand potential mechanisms for this anti-inflammatory activity. Exposure to bromelain in vitro has been shown to remove a number of cell surface molecules that are vital to leukocyte trafficking, including CD128a/CXCR1 and CD128b/CXCR2 that serve as receptors for the neutrophil chemoattractant IL-8 and its murine homologues. We hypothesized that specific proteolytic removal of CD128 molecules by bromelain would inhibit neutrophil migration to IL-8 and thus decrease acute responses to inflammatory stimuli. Using an in vitro chemotaxis assay, we demonstrated a 40% reduction in migration of bromelain- vs. sham-treated human neutrophils in response to rhIL-8. Migration to the bacterial peptide analog fMLP was unaffected, indicating that bromelain does not induce a global defect in leukocyte migration. In vivo bromelain treatment generated a 50-85% reduction in neutrophil migration in 3 different murine models of leukocyte migration into the inflamed peritoneal cavity. Intravital microscopy demonstrated that although in vivo bromelain treatment transiently decreased leukocyte rolling, its primary long-term effect was abrogation of firm adhesion of leukocytes to blood vessels at the site of inflammation. These changes in adhesion were correlated with rapid re-expression of the bromelain-sensitive CD62L/L-selectin molecules that mediate rolling following in vivo bromelain treatment and minimal re-expression of CD128 over the time period studied. Taken together, these studies demonstrate that bromelain can effectively decrease neutrophil migration to sites of acute inflammation and support the specific removal of the CD128 chemokine receptor as a potential mechanism of action.

http://www.ncbi.nlm.nih.gov/pubmed/18482869

Bromelain is included in the Endothelial Health Program, and Jeff's been taking it for 2 years.  My Mom takes it for her sinus congestion and dizziness issues, my father in law takes it for COPD,  and they think it's the bees' knees.

Here's the Endothelial Health Program-

http://www.ccsvi.org/index.php/helping-myself/endothelial-health

I love finding natural healing in medical research papers.  It reinforces my deeply held belief that we creatures and this planet were specifically designed for each other. 

Joan

New Study on "Disturbed Blood Flow"

July 6, 2010 at 8:04pm

Here's a report on a new scientific study which shows how disturbed blood flow changes the vessel wall, due to inflammation and endothelial dysfunction. This study was done on arteries, but this principal would function the same way in a vein wall which is narrowed or blocked and blood flow becomes erratic due to refluxive flow.

"Scientists have previously observed that atherosclerosis occurs preferentially in branched or curved regions of arteries, because of the "disturbed flow" branches and curves create. Constant, regular flow of blood appears to promote healthy blood vessels, while low or erratic flow can lead to disease.

The standard laboratory model of atherosclerosis has scientists feeding a high-fat diet to mice with mutations in a gene (ApoE) involved in removing fat and cholesterol from the blood. Even then, atherosclerosis usually takes a few months to develop. In these models, clogs in a mouse's arteries tend to appear in certain places, such as the aortic arch, but flow patterns are set up at birth and thus are poor gauges of cause and effect, Jo says.

"We have developed a model where we disturb blood flow in the carotid artery by partial ligation, and atherosclerosis appears within two weeks," he says. "This rapid progression allows us to demonstrate cause and effect, and to examine the landmark events at the beginning of the process."

Jo says that endothelial cells, which form the inner lining of blood vessels, are equipped with sensors that detect changes in fluid flow.

"Disturbed flow is what causes the endothelial cells to become inflamed," he says"

So, how would this affect patients with CCSVI? If there is an area of the vein that is exposed to this disturbed flow, the lining of the vein will become worse, the longer the vein has this condition. Which might explain why MS continues to progress as patients age, even after there are no more inflammatory lesions in the brain, and the immune system seems to back down.  The stenosis becomes worse and worse. Blood flow becomes more disturbed, and it creates a vicious cycle.

Here's the article--

http://www.sciencedaily.com/releases/2010/06/100623140922.htm

This study might also explain why exercise and diet are so important in keeping blood flowing---

here, again, are the cardiovascular recommendations for living a heart healthy life. I honestly believe that pursuing endothelial health can help pwMS, as well.  Always check with your doctor before beginning a new health routine.

***Eat a heart healthy diet! Lots of good leafy greens, fruits and veggies. Limit saturated fats (like red meat) and stick to lean, white meat protein. Fish is a terrific choice. Stay clear of man made fats and anything the has too many ingredients (like overly processed foods.) No fructose corn syrup or transfats. Eat a good, whole food diet- like the Best Bet Diet or Dr. Swank's MS Diet.

***Move as much as you are able. Exercise- whether it is a stationary bike, seated exercise, water aerobics or yoga- is good for your circulatory system and will keep blood flowing.

***Try to limit stress. Cortisol, the hormone released when we stress out, closes down blood vessels (called vasoconstriction) Prayer and meditation can really help. Laughter actually opens blood vessels up! Try to find joy everyday...with your children, pets, funny movies, good books.

***Alcohol is OK...but only small amounts. A glass of wine opens up blood vessels a bit...but any more than one drink becomes constrictive.

***Get some sun on your face. Vitamin D helps the body utilize oxygen and is a vasodilator. If you have no sun in your area, try a sun lamp and take a vitamin D supplement.

***No more smoking. Sorry. Cigarettes are vasoconstrictors- they close up blood vessels and can make stenosis worse.

Joan

Hypoperfusion (decreased blood flow) in MS

December 31, 2009 at 10:53am

Before 2009 comes to a close, I'd like to share more research on the decrease of blood flow in the MS brain. There are many researchers around the globe using new MRI technology to study slowed perfusion in MS brains.

I would like to break down this one medical research paper for you, to show you how these researchers' findings can be linked what Dr. Zamboni has discovered.  I will quote sections from the paper- and then we will discuss.

Hypoperfusion of the cerebral white matter in multiple sclerosis: possible mechanisms and pathophysiological significance

This work was supported by MS Anders (Amsterdam, The Netherlands).

Jacques De Keyser1,2, Christel Steen2, Jop P Mostert2 and Marcus W Koch2

1Department of Neurology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel,Brussels, Belgium

2Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

http://www.nature.com/jcbfm/journal/v28/n10/full/jcbfm200872a.html

from the abstract:

"A number of recent studies using perfusion magnetic resonance imaging in both relapsing and progressive forms of MS have shown a decreased perfusion of the NAWM, which does not appear to be secondary to axonal loss."

This means that in normal appearing white matter (NAWM) in MS brains, there is a slowing of blood flow which does not appear to be caused by axonal death. Something else is causing the slowed blood flow FIRST-because it shows up before we see lesions.

"The classic teaching is that MS is a T-cell-mediated autoimmune disorder of the central nervous system. However, a number of pathophysiological observations cannot be simply explained on the basis of autoimmune mechanisms. First, the progressive (neurodegenerative) component of the disease continues despite intense immunosuppressive interventions that effectively stop inflammatory disease activity (Coles et al, 1999; Metz et al, 2007; Roccatagliata et al, 2007; Samijn et al, 2006). Second, pathologic studies have shown that some demyelinating lesions develop without a preceding inflammatory reaction (Barnett and Prineas, 2004; Gay, 2007, 2006; Guseo and Jellinger, 1975; Lucchinetti et al, 2000). Third, another intriguing finding difficult to explain by autoimmune phenomena is the finding of a diffuse cerebral white matter hypoperfusion, which is the subject of this review."

The prior thought has been that MS is a t-cell mediated disease, autoimmune..we've all heard this. HOWEVER, the researchers wonder, how can the autoimmune hypothesis explain what we (many other researchers) are observing?

1. Even when suppressing the immune system, damage continues in the MS brain

2. Demyelinating lesions appear BEFORE inflammation

3, There is a slowing down of blood flow in cerebral white matter in MS brains