Biopsies Reveal Nature Of Brain Lesions Early In MS Progress

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

Biopsies Reveal Nature Of Brain Lesions Early In MS Progress

Postby frodo » Fri Dec 09, 2011 4:27 pm

I am not sure if this belongs into the CCSVI section, but for sure this questions the current MS model

Source: http://www.medicalnewstoday.com/releases/238870.php


Working together, researchers at Cleveland Clinic and Mayo Clinic have for the first time examined early multiple sclerosis (MS) brain lesions in the cerebral cortex. These lesions are thought to be critical to MS progression and the researchers found that the lesions are distinctly different than previously speculated, giving clues to better disease management.

The long-accepted theory has been that MS begins in the myelin on the inner layers of the brain, also known as white matter. However, the findings of this collaborative study show the opposite -- that the disease likely can move from the outer (cortical) layers of the brain toward the white matter, offering new insight into the progression of MS.

"For patients, the key idea of this research is that we have discovered an entirely new concept of how MS may start," said Richard Ransohoff, M.D., Director of the Neuroinflammation Research Center of the Department of Neurosciences at Cleveland Clinic's Lerner Research Institute, who co-led the study. "This research shows that a non-inflammatory form of MS is much less likely, and the prevailing research path has been going in the right direction."

While the causes of MS remain undetermined, it is thought to be a disease in which the body's immune system attacks and destroys its own myelin, a fatty insulator of the crucial nerve fibers that are responsible for communication between different sections of the brain.

However, in autopsy tissues of MS patients, lesions in the cerebral cortex show demyelination without inflammation, raising a challenging issue: if cortical lesions form entirely without inflammation, then cortical demyelination would not be explainable by current theories of MS nor treatable by current MS therapies.

The present study, published in the New England Journal of Medicine, was a collaborative effort by Dr. Ransohoff, also a staff neurologist at the Mellen Center for Multiple Sclerosis Treatment and Research at Cleveland Clinic's Neurological Institute, and by Claudia Lucchinetti, M.D., of the Mayo Clinic's Department of Neurology.

The study involved examination of 563 brain biopsies resulting in the diagnosis of inflammatory demyelinating disease of the central nervous system, with 138 being determined to have sufficient cortex for study. Of these, 77 cases provided long-term follow-up data, with 58 cases (75 percent) going on to develop verified MS. The vast majority of biopsies were performed at community hospitals with the brain tissue being sent to the Mayo Clinic for neuropathological consultation services. Dr. Lucchinetti leads the National MS Society's MS Lesion project housed at the Mayo Clinic. This study was funded in part by that project as well as the National Institutes of Health.

MRI neuroimaging studies in early multiple sclerosis can't detect cortical lesions but have revealed cortical abnormalities, suggesting that the cortex may be damaged near the time of disease onset. The current research shows that the cortex harbors inflammatory lesions accounting for MRI indicators of damage.

"The next step in this research is to study the lesions to uncover new molecular targets for treatment. We also need to push forward to develop imaging techniques to view these cortical lesions," said Dr. Lucchinetti. "In that way, effects of treatment can more easily be measured."
User avatar
frodo
Family Elder
 
Posts: 610
Joined: Wed Dec 02, 2009 4:00 pm

Advertisement

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby MrSuccess » Fri Dec 09, 2011 5:45 pm

Also known as Trauma ..... from the OUTSIDE >>>>> to the INSIDE.

I quote :

" The long-accepted theory has been that MS begins in the myelin on the inner layers of the brain , also known as white matter. However, the findings of this collaborative study show the opposite--- that the disease likely can move from the outer [ cortical ] layers of the brain toward the white matter, offering new insight into the progression of MS "

So the apple bruise starts with an external blow ? Who would have guessed ? :twisted:



MrSuccess
User avatar
MrSuccess
Family Elder
 
Posts: 883
Joined: Fri Sep 18, 2009 3:00 pm

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby Loriyas » Fri Dec 09, 2011 7:17 pm

This seems to me to be a hugely significant finding! Thank you for posting this.
Loriyas
Family Elder
 
Posts: 583
Joined: Sun Apr 02, 2006 3:00 pm
Location: Naples, FL

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby Cece » Fri Dec 09, 2011 7:35 pm

However, in autopsy tissues of MS patients, lesions in the cerebral cortex show demyelination without inflammation, raising a challenging issue: if cortical lesions form entirely without inflammation, then cortical demyelination would not be explainable by current theories of MS nor treatable by current MS therapies.

Hey, I have an alternate theory: CCSVI-induced venous congestion and endothelial dysfunction of the blood-brain barrier and hypoxic damage to gray and white matter. Treatable by venoplasty.

The autoimmune theory of MS does not explain this finding, but CCSVI does explain it.
Cece
Family Elder
 
Posts: 8990
Joined: Mon Jan 04, 2010 4:00 pm

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby frodo » Sat Dec 10, 2011 2:46 am

MrSuccess wrote:Also known as Trauma ..... from the OUTSIDE >>>>> to the INSIDE.

So the apple bruise starts with an external blow ? Who would have guessed ? :twisted:

MrSuccess


They are not saying that the cause is an external blow, nor that it is related to trauma. Just that external lesions appear before inner ones. For me the most interesting part is the absence of inflammation. This questions the whole autoimmune theory.
User avatar
frodo
Family Elder
 
Posts: 610
Joined: Wed Dec 02, 2009 4:00 pm

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby euphoniaa » Sat Dec 10, 2011 4:20 am

Just an FYI - This topic is also being discussed in the General Discussion Forum, where cheerleader started a thread titled: "New definition of MS from Mayo, Cleveland, and Yale"

general-discussion-f1/topic18674.html

That thread has some other links in it also. :smile:

(Edited a typo)
Dx'd with MS & HNPP (hereditary peripheral neuropathy) 7/03 but must have had MS for 30 yrs before that. I've never taken meds for MS except 1 yr experiment on LDN. (I found diet, exercise, sleep, humor, music help me the most.)
User avatar
euphoniaa
Family Elder
 
Posts: 680
Joined: Sat Jul 15, 2006 3:00 pm
Location: midwest U.S.

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby Cece » Sat Dec 10, 2011 8:41 am

There is a general discussion forum?????
:-D
Thanks for the heads-up. It's interesting research. Much like the Australian autopsy case study where a new lesion had appeared but no inflammatoin was present.
Cece
Family Elder
 
Posts: 8990
Joined: Mon Jan 04, 2010 4:00 pm

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby MrSuccess » Sat Dec 10, 2011 11:47 am

frodo - read into it as you wish. I see it this way ..... they are saying in this study that ms lesions are found on the OUTER layer of the brain. No doubt .... NEAREST to the Blood Brain Barrier ....... . Now isn't that interesting ? ..... :idea: Location location location ....

I can read. They make no mention of trauma. Not yet ... not so far .....

The human body is amazing . We have within us an incredible tool . The immune system. If this system fails ...... :sad: ....... things go wrong ..... terribly wrong .....

Trauma and it's relation to MS ...... have a long history. I suggest you research this.

The inflammation needed to trigger the BBB breach ..... takes place in the neck , spine , or back [ spinal cord ] . CCSVI certainly explains and proves this. As does TRAUMA.

Reduced bloodflow OUT of the brain .... in my opinion ..... puts ABNORMAL pressures upon the BBB. The BBB then becomes breached. The immune system then activates to repair the foreign substance. The ensuing battle ..... produces a scar. Depending on how many of these " battles" take place..... [ multiple ] and scars [ sclerosis] ...... ..... :?: :?: :?:

MrSuccess is of the opinion that pwMS .... have autoimmune systems that are working just fine ..... thank you very much. To try to subvert this system of natural defence ... by chemical applications ...... is going in the wrong direction.

Dr.Zamboni's stunning discovery has now allowed a great many of pwMS to have their body's natural blood flow systems restored. I suspect the BBB is ..... no longer under attack. :idea:


It's a theory Frodo .... only MY theory ..... but it's no better nor worse than all the others being floated ..........



MrSuccess
User avatar
MrSuccess
Family Elder
 
Posts: 883
Joined: Fri Sep 18, 2009 3:00 pm

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby Jugular » Sat Dec 10, 2011 12:33 pm

"The next step in this research is to study the lesions to uncover new molecular targets for treatment. We also need to push forward to develop imaging techniques to view these cortical lesions," said Dr. Lucchinetti. "In that way, effects of treatment can more easily be measured."


Uhggg! Shouldn't the next step be trying to get a handle on what's causing the lesion based on where it's occurring and what it looks like? I guess they'd rather keep molecularly toying with the end product. Micro-imaging is a wonderful tool, but it still requires one not to lose the forest from the trees. I think the end product of such navel gazing inevitably results in pharmacological therapies that treat symptoms rather than causes - usually at a huge price.
User avatar
Jugular
Family Elder
 
Posts: 375
Joined: Mon Dec 21, 2009 4:00 pm

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby MrSuccess » Sat Dec 10, 2011 2:52 pm

it's quite interesting to read who what and where , the NMSS is funding in the search for answers to MS. $ 25,000 here ..... $ 60,000 there .

I fully expect someone somewhere to be funded research dollars , to find out if 2 ply toilet paper is more / or less .... effective than 3 ply toilet paper ..... in helping pwMS manage their daily symptoms . :twisted:

The NMSS needs to get their head out of their a** ..... and start funding an immediate large CCSVI Trial. MRI's are expensive. As is IVUS.

As Dr.Zamboni has stated ..... his great discovery needs to be further explored in a well funded Clinical setting . The BNAC would be ideal. Or Stanford. Better yet .... BOTH. :idea:

All of these CCSVI or MS study's are certainly bringing focus to the problem.

Best of all .......... the study discussed in this thread featured the fact that it was published in the New England Journal of Medicine.

Can we ask for more than that ? :-D


MrSuccess
User avatar
MrSuccess
Family Elder
 
Posts: 883
Joined: Fri Sep 18, 2009 3:00 pm

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby marcstck » Sun Dec 11, 2011 3:44 am

(Also posted this in the general board)

Actually, the researchers found that there is inflammation in the cortex and in the meninges that surrounds it. You can hear it right from the horse's mouth (from the researcher leading the project) in a video found here:

http://newsblog.mayoclinic.org/2011/12/05/ms-study/

The most extensive article I have found so far on this research can be found here (you may have to register for the site to access the article. It's well worth it, this is one of the most valuable sites for MS research):

http://www.medscape.com/viewarticle/755146

from the above article:

Using cortical tissue obtained during brain biopsy for other reasons, researchers found that cortical lesions were "frequent, inflammatory, and strongly associated with meningeal inflammation."

"Our study shows the cortex is involved early in MS," Claudia F. Lucchinetti, MD, co-lead author of the study and a neurologist at the Mayo Clinic College of Medicine, Rochester, Minnesota, told Medscape Medical News. "The cortex in some cases may even be the initial target."


The question of from whence the observed inflammation arises still has not been answered, but inflammation is an indicator of immune activity, so immunomodulating drugs would still have some effect, as has been seen over the last 15 years or so. Let's not lose sight of the fact that extreme immunosuppression (à la HSCT, or Campath therapy) shows a dramatic degree of decrease in disease activity. Not saying the autoimmune model of the disease is correct, but this particular research doesn't put a stake in its heart…
User avatar
marcstck
Family Elder
 
Posts: 560
Joined: Tue Jan 03, 2006 4:00 pm

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby Squeakycat » Tue Dec 13, 2011 1:44 am

marcstck wrote:The question of from whence the observed inflammation arises still has not been answered, but inflammation is an indicator of immune activity, so immunomodulating drugs would still have some effect, as has been seen over the last 15 years or so. Let's not lose sight of the fact that extreme immunosuppression (à la HSCT, or Campath therapy) shows a dramatic degree of decrease in disease activity. Not saying the autoimmune model of the disease is correct, but this particular research doesn't put a stake in its heart . . .

[Emphasis added]


As you note Mark, inflammation is one of the signs of immune system activity. The immune system responds to infection and injury in a number of ways and inflammation is one of them. Causing our temperature to rise is another. Killing and removing infectious agents or injured tissue is another.

I don't think any of us question that there is immune system activity in MS or that blocking it limits the collateral damage it may be causing. But that is not to say, as the auto-immune theory posits, that the immune system has gone amuck and is attacking the body for no reason.

There are sometimes good reasons for suppressing the immune system when it over-reacts to a real problem as happens when there is Systemic Inflammatory Response Syndrome (SIRS) or Disseminated Intravascular Coagulation (DIC). If you don't thwart the excessive immune reaction, you pretty quickly have a dead patient.

But it seems to me that what the proponents of the auto-immune theory are arguing is that the immune system itself, unprovoked by injury or infection, has gone astray and is doing things that it shouldn't and therefore our focus should be on blocking those components that seem to be most active.

It would be reasonable to fight MS by blocking the immune system until we can figure out what is causing it to react and addressing that root cause if that's all the drugs did.

But they don't. They systemically block the action of parts of the immune system targeted by drugs. That puts patients at risk for things like PML, or just a collection of nasty side effects that impact quality of life. I would think it reasonable to assume that there has to be greater risk with greater immune suppression.
User avatar
Squeakycat
Family Elder
 
Posts: 410
Joined: Fri Dec 04, 2009 4:00 pm
Location: Yehud, Israel

Re: Biopsies Reveal Nature Of Brain Lesions Early In MS Prog

Postby DougL » Wed Dec 14, 2011 12:39 pm

Cece wrote:There is a general discussion forum?????
:-D



LOL
User avatar
DougL
Family Elder
 
Posts: 364
Joined: Mon Jul 11, 2011 3:00 pm


Return to Chronic Cerebrospinal Venous Insufficiency (CCSVI)

 


  • Related topics
    Replies
    Views
    Last post

Who is online

Users browsing this forum: No registered users