ALS

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

ALS

Postby gibbledygook » Fri May 28, 2010 8:36 am

Med Hypotheses. 2010 Apr 16. [Epub ahead of print]

A possible haemodynamic mechanism for Amyotrophic Lateral Sclerosis.
Arhart RW.

2117 Belaire Drive, Salt Lake City, UT 84109, USA.

Abstract
The hypothesis proposed in this article is that a haemodynamic mechanism may cause Amyotrophic Lateral Sclerosis (ALS). The hypothesis is synthesized from three separate streams of medical research: (1) multiple sclerosis (MS) research; (2) ALS research; (3) atherosclerosis research. Each research stream was reviewed as prerequisite for proposing the hypothesis. A vascular mechanism for MS was first advanced in the medical literature 130years ago. Seventy years ago researchers knew that the plaques aligned along a central vein, and the wall of that central vein was damaged and leaky. Twenty-five years ago the refluxing blood mechanism was proposed. Zamboni imaged the veins of MS patients in 2007 and saw stenoses, twistings, and membrane blockages in the jugular, azygous, and vertebral veins, and refluxing venous blood upstream of the constrictions. The refluxing blood damages the blood-brain-barrier (BBB) of the veins. Leakage of blood components into the central nervous system then causes the plaques in the brains of MS people. Zamboni dilated the venous constrictions endovascularly, and the MS symptoms and brain plaques diminished dramatically. ALS research has recently revealed that this disease is started by blood-spinal cord-barrier (BSCB) damage. The ALS mutant mouse shows BSCB damage and down regulation of tight junction proteins Occludin and ZO-1 before motor neuron harm. Samplings of ALS patients' spinal cords show downregulation of mRNA for tight junction proteins compared to controls. Atherosclerosis research provides the mechanism for how the refluxing blood breaks the tight junctions between the endothelial cells of the veins. Atherosclerosis research on blood flow effects shows that normal pulsatile laminar blood flow is necessary for maintenance of the tight junctions between endothelial cells. Abnormal flow conditions, such as turbulent, stopped, or reversed flow, cause downregulation of tight junction proteins Occludin and ZO-1. Blood flow (haemodynamic) effects explain the BBB damage in MS and may explain the BSCB damage in ALS. The hypothesis: ALS is caused by constrictions in veins draining the spinal cord and brain, which cause venous reflux, which downregulates tight junction proteins Occludin and ZO-1, which leads to breaks in the tight junctions between endothelial cells in the veins, which leads to leakage of toxic blood components into CNS tissue. The consequences of the hypothesis are discussed. If a venous constriction can be reached endovascularly it can be dilated, and such dilation may constitute cure of ALS. Copyright © 2010 Elsevier Ltd. All rights reserved.

PMID: 20400230 [PubMed - as supplied by publisher]

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3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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Postby Cece » Fri May 28, 2010 8:44 am

Good find!
"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition
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Postby gibbledygook » Fri May 28, 2010 8:50 am

I recall Professor Dake saying that he was looking at abnormal vascular structures in a patient with ALS. I think he mentioned shoulder veins/arteries as being implicated. It's so exciting to see researchers finally looking at haemodynamics for diverse neurological diseases. It would be GREAT if they could advance somewhere with ALS.
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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Postby cheerleader » Fri May 28, 2010 8:57 am

Hey Alex--
We had a thread going on ALS and that paper a couple of weeks ago...
http://www.thisisms.com/ftopict-11752-als.html

The wall moves too fast these days to keep track of anything 8O
Dr. Zamboni looked at ALS patients and didn't find CCSVI, but I do know that there have been studies that have found the cerebral arteries are implicated in beginning the degenerative process in ALS. And Dr. D. did find some vascular/arterial abnormalities in one patient he was looking at...but it's a really, really complicated situation.

What I really want to know is what is your due date? How are you? Inquiring minds, and all that...
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby gibbledygook » Fri May 28, 2010 9:15 am

Hi,

Sorry I can't keep up with all the posting either!!
Yes, I think Prof Dake said it was arterial blockages in the shoulder of an astrophysicist. I do so hope they start checking the possibility that these neurological diseases may have perfectly simple mechanical/structural explanations or contributions.


I'm due to have a c-section on the 24th june but I may have it earlier as the obstetrician was today concerned that the baby may not be growing so well as my tummy was only 32cm rather than 34/35cm. My blood pressure has also collapsed again to 70/30 and he is worried about placental hypoperfusion. On the other hand 2 days ago the ultrasound sonographer gave the baby a very good weight so I'm not sure that either of them have accurate means of determining the baby's weight/growth! I can't wait for it to be over though. Pregnancy has been a heck of a lot tougher than I thought it would be.
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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Postby Rokkit » Fri May 28, 2010 9:47 am

cheerleader wrote:We had a thread going on ALS and that paper a couple of weeks ago...

Cheer, in that other thread you talk about ALS being related to arteries and thus being quite different from CCSVI. But check this comment out in the abstract of that paper:
The hypothesis: ALS is caused by constrictions in veins draining the spinal cord and brain, which cause venous reflux, which downregulates tight junction proteins Occludin and ZO-1, which leads to breaks in the tight junctions between endothelial cells in the veins, which leads to leakage of toxic blood components into CNS tissue.

The plot thickens, eh?
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Postby cheerleader » Fri May 28, 2010 10:36 am

rokkit-- yeah, but it's a hypothesis Dr. Zamboni already explored...and he didn't find any signs of CCSVI in ALS. Neither did Dr. Dake. I don't think the author of this paper knows that other doctors have already explored this connection, and not found any evidence of CCSVI in ALS.

Alex--wow. That is some seriously low BP. Hoping and praying for a smooth delivery for you, and the reward of a beautiful baby after this tough time. Jeff's b-day is June 20th (gemini)--nice time of year to come into the world, summer solstice and all that. Hang in there. xoxo
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby Rokkit » Fri May 28, 2010 11:51 am

Oh. Well, nevermind. :D
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Postby Johnson » Sat May 29, 2010 1:35 am

gibbledygook wrote:Hi,

Sorry I can't keep up with all the posting either!!
Yes, I think Prof Dake said it was arterial blockages in the shoulder of an astrophysicist. I do so hope they start checking the possibility that these neurological diseases may have perfectly simple mechanical/structural explanations or contributions.


I'm due to have a c-section on the 24th june but I may have it earlier as the obstetrician was today concerned that the baby may not be growing so well as my tummy was only 32cm rather than 34/35cm. My blood pressure has also collapsed again to 70/30 and he is worried about placental hypoperfusion. On the other hand 2 days ago the ultrasound sonographer gave the baby a very good weight so I'm not sure that either of them have accurate means of determining the baby's weight/growth! I can't wait for it to be over though. Pregnancy has been a heck of a lot tougher than I thought it would be.

Don't worry so much about measurements, my wife kept our son deep inside. It looked as if it would be a 7 pound baby, but he was 9 (and her just 5'4", 110 lbs before). He was 2 weeks late, and a c-section, but still...
My name is not really Johnson. MSed up since 1993
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