This Is MS Multiple Sclerosis Community: Knowledge & Support

So can any of us invent/manipulate the facts or is that always going to be exclusively your domain?

Both Nash et al. and we seem to agree that HSCT might be an effective therapy for multiple sclerosis (MS) patients in the so-called inflammatory stage of the disease. These patients appear to benefit from the intense immunosuppression and the reprogramming of their immune system (Muraro et al., 2003; Martin, 2007). The benefit for these patients has been clinically shown and is documented in MRI studies. Thus the most promising MS population for a therapy study with HSCT might be patients in early disease stages with an aggressive disease course who do not respond to the approved or applied immunomodulatory or immunosuppressive treatments. Such studies are conducted in the United States (HALT MS) as stated in the comment by Nash et al. The glass may be half full for these patients.

On the other hand the glass appears to be half empty for patients with long-standing, progressive MS and a high EDSS score. The patients included in our study belong to this group. Presumably, in this so-called neurodegenerative phase of disease, attempts to affect the peripheral immune system do not hinder or prevent clinical progression nor do they reverse existing clinical deficits. This has been shown in the transplanted patients examined in our manuscript (Metz et al., 2007), but also for other therapies such as Campath-1, an antibody causing the depletion of T cells (Coles et al., 1999). The continuing cerebral atrophy in MRI studies described after HSCT (Inglese et al., 2004) may have its correlate in the ongoing axonal damage and demyelination after HSCT seen in our study or could have been due to the drugs used for immunoablation as part of the HSCT procedure (Chen et al., 2006).

What is your definition of "work" and are we to believe, with absolutely no documentation, that you believe CCSVI does work for progressive patients?

(snip)

But the gist of my argument on this one is that it's not sure that rebooting isn't helpful in progressive MS and that there is no proof that CCSVI IS helpful in progressive MS, which is what I think you were hinting or what would have been your point?

(snip)

Do you honestly think that serious science would ever buy into it regardless of how many people are convinced that it helped them, but without real studies?

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Apparently I need to look at the abundance of studies on immune ablation before I speak to that again. Interesting. The impression I'd had is that doctors are pretty much setting off dynamite to take out the immune system and that m.s. has continued...this is wrong, then?

The present study analyses autopsy material from five multiple sclerosis patients who received autologous stem cell transplantation. A total of 53 white matter lesions were investigated using routine and immunohistochemical stainings to characterize the demyelinating activity, inflammatory infiltrates, acutely damaged axons and macrophages/microglial cells. We found evidence for ongoing active demyelination in all of the five patients. The inflammatory infiltrate within the lesions showed only very few T cells and CD8+ cytotoxic T cells dominated the T cell population. B cells and plasma cells were completely absent from the lesions. High numbers of acutely damaged axons were found in active lesion areas. Tissue injury was associated with activated macrophages/microglial cells. The present results indicate that ongoing demyelination and axonal degeneration exist despite pronounced immunosuppression. Our data parallel results from some of the clinical phase I/II studies showing continued clinical disease progression in multiple sclerosis patients with high expanded disability system scores despite autologous stem cell transplantation.

Personally, I think your personal experience is wonderful and I hope it continues forever. I really do.

Still, putting MS and CCSVI aside for a moment, is what you're referring to the kind of "science" that you want the rest of your world based on? Do you honestly think that serious science would ever buy into it regardless of how many people are convinced that it helped them, but without real studies?