This Is MS Multiple Sclerosis Knowledge & Support Community

Multiple Sclerosis (MS) is caused by the immune system that reacts to problems in the intestine (faulty brain-bowel connection). If the gut flora is unbalanced, bad T-cells induced by the gut start to spread in our body through the bloodstream. Here, the over-presence of the segmented filamentous bacteria (SFB) in the gut flora is suspect.

The Vitamin-D metabolism is believed to be the culprit of the gut disorder. When 1.25-D becomes [too] high later in the year [after the summer peak of 25-D], it binds a set of key receptors and displaces the metabolites that are supposed to activate from these receptors [re: Marshall]. Since these receptors transcribe natural anti-biotics created by the body called anti-microbial peptides (e.g. in the gut flora), the high 1,25-D (and its effect on the nuclear receptors) will cause the production of anti-microbial peptides to slow. Bacteria grow and the VDR receptor will get further blocked (by enzymes from these bacteria). While the innate immune system is already weakened [Vitamin D relation], this will turn on the immune system e.g. via the NP-KappaB route.

The immune system response to the bowel infection is believed to be the cause of many diseases including diabetes, rheumatic disorders and late-onset asthma. For people with MS, after many years of CCSVI (venous insufficiency in the draining part of the brain), the blood-brain-barrier (BBB) will be compromised causing the protective tissue to become permeable. Bacteria and viruses infect local brain cells. And then these T-cells enter the brain and do their destructive work. Besides the neurological damage in the local scleroses, people with an unhealthy intestinal flora may also develop a diabetes-related peripheral neuropathy aggravating the neurological symptoms.

While the unbalance of the gut is mainly responsible for the secondary progressive phase, the early Relapse Remitting phase of MS is caused by a reaction of the immune system to virus infection (e.g. Bar-Epstein causing dysfunction of Vitamin D receptor) or a periodic reactivation of the Chlamydia bacteria that may also find a fertile ground behind the partially compromised BBB.

As the disease developed further, I saw the vitamin D go down, from about 40 ng / ml to about 14 ng / ml (x 2.5 for the other unit mmol / l). I've often wondered why that happened as I took a lot of sunshine during the summer. I think now that it is the body itself that regulated the level down, and in fact that this is a reaction for self-protection..

Thinking a bit more about this, it could even be that the "extinction" of new MS cases after 50/60 years of age is due to a much lower level of vitamin D and less seasonal variation...

It may be true that there are many "open ends" on this thread, that this thread is more of an opinion of patients that have no medical training or background, that it is more wishful thinking than based on rigorous science or scientific evidences, etc.

But fact is that this thread contains a credible explanation for so many of our symptoms, that it relates things together in a bigger consistent and coherent picture, that it links back to so many publication in journals and from authors with great reputation. Which makes that it goes beyond doubt, which would make it very difficult to plausibly deny...

The question now is: how do we go ahead? Or to say it with Van Morrison: ... how can we ever come out even, when reality is stark?

I would welcome any views you might have..

http://www.ncbi.nlm.nih.gov/pubmed/20639756
http://www.ncbi.nlm.nih.gov/pubmed/16886667

IT IS CLEAR THAT A COMPLETELY NEW APPROACH IS UNDER DEVELOPMENT HERE FOR PREVENTION AND TREATMENT OF (AUTO)IMMUNE DISEASES BASED ON COMPLETELY NEW INSIGHTS. THE INVOLVEMENT OF VITAMIN D / VDR IN ANTI-INFLAMMATION AND ANTI-INFECTION IS CENTRAL TO THIS DEVELOPMENT.

I think that the vitamin D metabolism lies at the root of many inflammatory diseases, including MS. This article brings things together:
http://www.discoverymedicine.com/Shaopi ... infection/

Of course, MS gives rise to various neurological symptoms and in our brains more (= multiple) sclerosis can be found. It is therefore obvious that the medical world looked at the problem from this viewpoint and called it multiple sclerosis. And also that therapies were developed from this angle. And because they did not know the origin of the disease, it was called autoimmune. But the path has brought us nowhere, on the contrary.

With this new insight, we come (much closer) to the origin of the disease. Although MS gives rise to neurological symptoms and scleroses, the disease is actually a metabolic disorder and would be better described by a different name, for instance chronic bowel disease. The Vitamin D metabolism lies at the heart of the problem, in particular the "contamination" of the vitamin D receptor by intestinal bacteria. And if one thinks about possible therapies, they should start from there.

The vitamin D metabolism has everything to do with the power of the cells. If the receptors are activated and the cells are well fed, they can move mountains, and they are well armed against intruders. But if they weaken because insufficient fuel is supplied, they will not work properly (including ion pump failure and thus weakening of neuro-transmission), they get easily infected, and eventually they will die a quiet death (apopth.. = controlled cell death).

The angle of attack of the disease would have to shift -besides tackling the vascular narrowings in the neck by angioplasty (re: ccsvi, Zamboni)- from immune-modulating (interferon works immune suppressive while anti-biotics stimulate/support ref: Marshall) to a more direct approach addressing the metabolic problem with the vitamin D receptor. I see two possibilities, that could possibly be used in combination: 1. by using olmesartan to sweep the receptors clean to make sure they can be activated (possibly in combination with anti-biotics), and/or; 2. by using metformin.

The working mechanism of metformin is not well understood, but fact is that it does work very well for diabetes2. As such it has been suggested that metformin may help break down the seal of ultra bad MGmin cholesterol and thus open the gates (GLUTs) of the cells; that it may block the (dysfunctioning?) vitamin D receptor and some other receptors and help in that way; and that it may bind to cell receptors restoring insulin sensitivity to the cells and thus help overcome "subclinical" diabetes, a condition that most adults suffer from; incidently, then we'r back to the first posting of this thread that started by suggesting a double mechanism underlying MS as can be seen from the double peak in the graph of age of onset].

If the vitamin D metabolism is normalised, the cells are properly fed, there will be few to die, the ion pump is better charged and the neuro-transmission improves, and the immune system and many other regulatory pathways will calm down. The innate immune system (our first line of defense) with a direct relationship to vitamin D will return to normal. The stress on our shoulders will literally fade away and you get old slowly and smoothly….

I wish to quote some paragraphs from the magnificent book of Nigel Crisp entitled “Turning the World Upside Down”. The selection of paragraphs is entirely mine, and seen from my own perspective as an MS patients who is desperately longing for a solution. I believe that these extracts when taken together deliver a message that falls within the broader context of what Nigel Crisp had in mind when he wrote the book.

Where Nigel Crisp’s idea behind the title refers to the need to import good medical practices from the poor world to the rich world and export specialists from the rich world to the poor world, exactly contrary to what is the normal direction, I think the title would also be very appropriate if we were to confront the old world of established medical practice with the new world of the Internet e.g. the people, the creativity and ideas on this forum. Medical practice should take some of these ideas on board and specialists should connect to it to pioneer new approaches.

I quote from the book:
The European and American developments have been hugely influential internationally and helped ensure the development of western scientific medicine as a distinctive body of knowledge and practice throughout the world. Over the past century it has become the dominant model globally, carried around the world with colonisation and trade. It has ... allied itself with scientific research and commerce and secured the backing and funding of governments.

At around the same time, the discipline of public health, which has its own long and distinguished history, became largely separated from clinical medicine. In the USA the Rockefeller Foundation’s Welch-Rose Report of 1915 set barriers between the two that last to this day and, whilst the separation was less rigid in the UK and Europe, clinical medicine has continually become more powerful and influential, eclipsing its near relative.

Government is ... linked closely with these other partners of the profession, the scientists and the business men. Health is big business. Pharma and health-related technology companies are among the largest companies in the world, whilst health insurers and private health care companies are a significant and powerful part of some national economies. ..

This economic profile means that health is a significant political and governmental issue and makes for a complicated relationship between business and government... This juxtaposition makes explicit something that may be hidden in other countries where the health system is not so directly the responsibility of government. In virtually every rich country, however, government will have an interest in both protecting its industry, whether it is pharmaceuticals or anything else, and in controlling the cost to its population through regulation, subsidy and other means.

Whilst the mid- and longer term consequences are unknown, it currently seems clear that the era of light touch regulation and of simply trusting the market to get it right is over. There are underlying trends that may make capitalism more, in Geoff Mulgan’s words, “the servant and not the master of humanity”.

The fundamental point is that people have expectations of their government far wider than the purely commercial contract they may have with a health care provider. They expect government to be looking out for them, to ensure their health and, if regulation fails, to step in. This is about a social contract, rather than a commercial one, and about government’s responsibility to act for health as a public good and secure our right to health.

This was seen quite explicitly with the impending failure of the world’s banking system. It will be seen equally clearly if governments fail to deal adequately with health crises in the future.

It matters how we see the world because it determines how we act. People thought and acted differently when they believed that the sun went round the earth and that man was at the centre of the universe. When they began to change their perspective and see that the earth went round the sun it caused havoc with the established beliefs of the day. The Catholic Church and other authorities reacted with outrage and violence.

I don’t want to overstretch the parallel, because there is more to it than this, but the change from seeing doctors at the centre of health – with the whole world of health care revolving around them – to recognise that it is actually the patient who is there, and who has always been there all along (whatever it looked like to us at the time), will change the things we believe and the way we act.

There is a new set of values that underlie these changes that reflect our interdependence, our desire for independence and the now widespread belief in a right to health.

Many people get this also intuitively. They do not need to be told the world is changing. Young people.. pioneers putting these ideas to practice.. These things, taken together, make the process of change unstoppable.

There is already a movement, which needs to become a Movement. There is enormous interest in re-designing professional education to equip health workers to meet the demands of the 21st century. Someone somewhere needs to seize the opportunity and find a way to channel all the insight and creativity into producing a new model or framework for the future. unquote

It has been postulated from animal models for MS and in situ evidence in MS patients that antibodies, activated T cells and proinflammatory cytokines are involved in the destruction of myelin sheaths and loss of oligodendrocytes in active areas.
http://www.ncbi.nlm.nih.gov/pubmed/12974875

The principle function of oligodendrocytes is to provide support to axons and to produce the myelin sheath, which insulates axons.
http://blustein.tripod.com/Oligodendroc ... ocytes.htm

In the above postings, we saw the function of the vitamin D receptor for activating natural anti-biotics called anti-microbial peptides to e.g. restore a healthy bacterial balance in the gut flora. But there might well be another important function of the vitamin D receptor namely to activate the production of myelin oligodendrocytes peptides. Where in fact, a faulty vitamin D mechanism [caused by a "contamination" of the vitamin D receptor by enzymes of the bad gut bacteria] might cause the transcription of myelin oligodendrocytes peptides to slow. With -and that is important for us as well as for diabetes2 patients- demyelination and ultimately axonal death as a result.

In the central nervous system the glia (oligodendrocytes and astrocytes), their receptors and their secreted signalling factors influence neural function. In the peripheral nervous system the Schwann cells and the satellite cells in the DRG are now recognized as “peripheral glia” sharing many of the characteristics with oligodendrocytes and astrocytes in the CNS.
http://www.sciencedirect.com/science/ar ... 770900471X

Hence, a dysfunctioning vitamin D receptor (finding its root cause in the gut) might, besides undernourished and undercharged (ion pump) cells, also cause a direct route to demyelination and axonal death via the reduction of myelin producing oligodendrocytes and/or Schwann cells. In other words, the failing vitamin D metabolism might thus be the culprit for the demyelination...

AMPK induces a cascade of events within cells in response to the ever changing energy charge of the cell. The role of AMPK in regulating cellular energy charge places this enzyme at a central control point in maintaining energy homeostasis.
Insulin-sensitizing drugs of the thiazolidinedione family (activators of PPAR-γ, see below) as well as the hypoglycemia drug metformin exert a portion of their effects through regulation of the activity of AMPK.
Newer therapeutic approaches to the intervention of type 2 diabetes include small molecule activators of SIRT1. In studies in mice overexpression of SIRT1 results in improved glucose tolerance and enhanced insulin excretion in response to glucose administration. Both of these effects of increased SIRT1 action would be beneficial in the treatment of type 2 diabetes.

AMPK is already the target of several classes of drugs used in the treatment of type 2 diabetes including metformin and the thiazolidinediones, TZDs. Given the effects of AMPK and SIRT1 on metabolism, and their convergence in many of these processes, it seems logical to assume that future diabetes therapies will combine both AMPK and SIRT1 activators to lower blood glucose and increase insulin sensitivity.
http://themedicalbiochemistrypage.org/ampk.html

The working mechanism of metformin may, besides effects as lowering blood glucose and increasing insulin sensitivity, involve binding to key nuclear receptors including the vitamin D receptor and enable these receptors. Thus, any future MS therapies may borrow from this line of thinking.

The power of the system is huge. Specialists and hospitals have power. And they think from that position of power. They think "we do our job well". And the patients should not get too much involved. Patients are not taken serious in the first place, answers to patients' questions are often evasive.

The ideas and the ideology then came and come with the money. Over time, developments have been monopolised by what is essentially a monolithic structure of immense weight. Deep research is conducted on individual trees all around us, often looking in a wrong direction, whilst sight of the forest has been completely lost.

The research culture is so overwhelming that it suffers from a 'built-in' behaviour to prepare for more research, to sustain the system. Finding a solution would make this huge system collapse, it would thus no longer seem to be a realistic option. And we may lack a sufficient engagement to change the sector from the inside...

The consequence of all this is that specialists are no longer on top of the issue; that the system has become much like a bureaucracy; that entrepreneurial spirit and craftsmanship were lost on the way. Worse, there is a climate of fear from within the organisation where pioneers of new approaches or insights are discouraged; where the pressure from within the system can mount to such a level that any efforts to open new ways collapse under this weight…

But we are fortunate. We live in a time of the Internet. The Internet breaks the traditional rules, the old links, the old lines... The monopoly of information enjoyed by the medical sector disintegrates. We are witnessing an intellectual transformation here that is more sweeping than anything we have seen in the past.

Personally, I believe the modern tools for mass communication and in particular the social fora (e.g. patient fora) will cause a second wave of "Enlightment". The trend can be seen all around us, from developments in the Arab world to happenings just around our own little corners, in our own parks.

Knowledge makes free when it comes in the hands of the masses. This happened in the second half of the 19th century when science, inspired doctors, entrepreneurs and enlightened masses came together causing a first revolution in health care. Now many generations later, when we are seen to be running into the limits of our current system (re: Nigel Crisp's book on Turning the World Upside Down), it seems the scene has been set for a second revolution in the system for health care...

I understand from a local source over here that a discussion about diabetes and MS being the same disease was held in some corners of the medical world in the early 1980's.
Dr. Hans Michael Dosch then, the study’s principal investigator and senior scientist at SickKids in Toronto, had previously concluded in a 1999 paper that there were surprising similarities between diabetes and multiple sclerosis.
http://www.hardickchiropractic.com/inde ... order.html

well, the neurological establishment might have liked the idea that diabetes and MS were the same neurological disorder as that would have offered great prospects for further study etc.. but the reality of course is that it shows now (this thread and others) that it is just the other way around, i.e. that multiple sclerosis

1. just like diabetes, is not a neurological disorder but is a metabolic disease causing some neurological "side" effects
2. where the right condition is prepared by a vascular problem with the drainage of the brain (ccsvi, Zamboni, Schelling).

it is good to see that Dr. Schelling, who suggested the vascular connection of MS already in the early 1980s but then was ex-communicated, will now be rehabilitated:
http://www.isnvd.org/files/ISNVD%202012 ... %20v2).pdf

Western medical profession fails to address the bigger picture

I quote from http://www.ccsvimedication.com/index.html

Western medical profession is based on clinical evidence "not fact."

"Not Enough Scientific Evidence"
• It's common
• It's overused
• It fails to address the bigger picture
• It's an academically accepted dead end
• Lack of evidence is easy to find

Although 5000 years of non western medicine has been documented from various sources, they are largely based on natural treatments and have limited economic appeal within the lucrative healthcare and associated business industry. If you have an illness labelled incurable by western medicine, you don't have reason to question the assessment. There is a good chance you'll get a smiling drug supplier offering you a lifelong solution. People are financially motivated to keep you away from your health. unquote
see e.g. http://www.giiresearch.com/report/kt226 ... arket.html

This very thread on this public forum is an attempt to address that bigger picture. It is now about 1 year ago that it got started. And, as you can see, we found actually fairly quickly (after 3 months or so) that MS has to be taken out of the narrow corner of neurology, thereby challenging the almost dogmatic believe that MS is an auto-immune disease.

On this thread, ample evidence has accumulated and dozens of links to academic literature are provided that show that MS is not an auto-immune disease but rather that MS is a metabolic disorder induced by gut bacteria, possibly in some form of interaction with narrowed neck veins on the draining side of the brain (CCSVI).

But the metabolism is highly complex all the way down

I quote from: http://www.wired.com/magazine/2011/12/ff_causation/

Our stories about causation are shadowed by all sorts of mental shortcuts. Most of the time, these shortcuts work well enough. They allow us to hit fastballs, discover the law of gravity, and design wondrous technologies. However, when it comes to reasoning about complex systems—say, the human body—these shortcuts go from being slickly efficient to outright misleading…

The mental approach to causality is often effective, which is why it’s so deeply embedded in the brain. However, those same shortcuts get us into serious trouble in the modern world when we use our perceptual habits to explain events that we can’t perceive or easily understand…

The reliance on correlations has entered an age of diminishing returns. At least two major factors contribute to this trend. First, all of the easy causes have been found, which means that scientists are now forced to search for ever-subtler correlations, mining that mountain of facts for the tiniest of associations. Is that a new cause? Or just a statistical mistake? The line is getting finer; science is getting harder. Second—and this is the biggy—searching for correlations is a terrible way of dealing with the primary subject of much modern research: those complex networks at the center of life.

While correlations help us track the relationship between independent measurements, such as the link between smoking and cancer, they are much less effective at making sense of systems in which the variables cannot be isolated. Such situations require that we understand every interaction before we can reliably understand any of them. Given the byzantine nature of biology, this can often be a daunting hurdle, requiring that researchers map not only the complete cholesterol pathway but also the ways in which it is plugged into other pathways.

Unfortunately, we often shrug off this dizzying intricacy, searching instead for the simplest of correlations. It’s the cognitive equivalent of bringing a knife to a gunfight.

These troubling trends play out most vividly in the drug industry. Although modern pharmaceuticals are supposed to represent the practical payoff of basic research, the R&D to discover a promising new compound now costs about 100 times more (in inflation-adjusted dollars) than it did in 1950. (It also takes nearly three times as long.) This trend shows no sign of letting up: Industry forecasts suggest that once failures are taken into account, the average cost per approved molecule will top $3.8 billion by 2015. What’s worse, even these “successful” compounds don’t seem to be worth the investment. According to one internal estimate, approximately 85 percent of new prescription drugs approved by European regulators provide little to no new benefit. We are witnessing Moore’s law in reverse.

.. we must never forget that our causal beliefs are defined by their limitations. For too long, we’ve pretended that the old problem of causality can be cured by our shiny new knowledge. If only we devote more resources to research or dissect the system at a more fundamental level or search for ever more subtle correlations, we can discover how it all works. But a cause is not a fact, and it never will be; the things we can see will always be bracketed by what we cannot. And this is why, even when we know everything about everything, we’ll still be telling stories about why it happened. It’s mystery all the way down.

We should not fall into the vitamin D trap

Vitamin D and the Vitamin D Receptor (VDR) play an important role in the endocrine system, and I might add in some Western medical policies e.g. those with regard to vitamin D supplementation. But do we oversee the full picture? Have we sufficiently appreciated the possible implications on the long-term e.g. why is the peak of rheumatic onset in Mexico two decades earlier than in Canada? Have we sufficiently understood the consequences of defects in the VDR signaling transduction linked to bacterial infection and chronic inflammatory responses?
http://superhumangear.wordpress.com/201 ... nd-cancer/
http://ods.od.nih.gov/factsheets/VitaminD/
http://www.ncbi.nlm.nih.gov/pubmed/20639756

In the article below, vitamin D research is discussed in light of the hypothesis that the lower average levels of vitamin D frequently observed in autoimmune disease are not a sign of deficiency. Instead, it is proposed that these lower levels are actually the result of chronic infection with intracellular bacteria that dysregulate vitamin D metabolism by causing VDR dysfunction within phagocytes.
http://www.ncbi.nlm.nih.gov/pubmed/19758226

Together with an increasing amount of evidence from scientific studies (reported in postings above), I believe the culprit of MS are ligands from commensal bacteria from the gut that stick to and block receptors of all sort of cells which leads to dysfunction of all sort of endocrine mechanisms. For example, if the VDR gets blocked, the insulin will not sense the brisk movements of the receptor and cellular feeding will be impaired or slowed, leading for instance to an ion pump that is not sufficiently charged to maintain its equilibrium and impaired motor functions as a result.

But we must always ask ourselves the question: is this vitamin D/VDR all there is? Is it justified to focus entirely on the vitamin D/VDR? Or should we take a broader look? I think we should look broader as I will show in the next posting..

There may be other dysfunctioning metabolic pathways

Besides the VDR, other receptors may get blocked and not be able to transcribe or activate peptides e.g. as a precursor for oligodendrocytes and Schwann cells. The consequence is that myelin is not sufficiently maintained and slowly disintegrates (demyelination). This may happen across a wide area (peripheral neuropathy), much wider than the spots of the slerosis. This failure is identical to that in diabetes2, which explain the overlap of symptoms of MS and diabetes2.

However, in MS patients, the BBB is partially broken by the many year of CCVSI (vascular narrowings) and the accumulation of toxins and iron allowing bacteria and viruses and T cells to enter the brain. But it also possible that specific cells in the compromised endothelium (the inside of the vessel walls) fail to transcribe/activate oligodendrocytes. With demyelination as a results in the local areas where we have our scleroses.

Therefore, our demyelineation may be caused by a. ligands from gut bacteria that block the formation of oligodendrocytes (also seen in diabetes2); and b. a dysfunction of the (damaged) endothelium. As our nerve function is impaired by the serial link of local and wider area problems, the problems add up. The double peak in the graph of age of onset would indeed suggest such underlying mechanism.

http://en.wikipedia.org/wiki/Oligodendr ... ursor_cell Oligodendrocyte precursor cells in nervous tissue cells precede oligodendrocytes, and may also be able to generate neurons and astrocytes. The principal function of oligodendrocytes is to provide support to axons and to produce the Myelin sheath, which insulates and lowers the effective capacitance of axons.

http://www.ncbi.nlm.nih.gov/pubmed/9731705 no enhancement of reporter activity in the presence of both hormones was observed. .. to further examine the possibility of cross-talk between the TR- and VDR-signaling pathways

http://www.nature.com/neuro/journal/v14 ... .2702.html RXR-γ is a positive regulator of endogenous oligodendrocyte precursor cell differentiation and remyelination and might be a pharmacological target for regenerative therapy in the CNS.

http://www.jneuroinflammation.com/content/4/1/18 15d-PGJ2 may represent a deleterious factor in the natural remyelination process in MS

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2577427/ nuclear TPR signalling (thromboxane A2 receptors ) can stimulate CREB phosphorylation and myelin gene transcription and increase cell survival.

A possible metabolic problem: the inhibition of prolactic secretion

The predominant theory today is that MS results from attacks by an individual's immune system on the nervous system and it is therefore usually categorized as an autoimmune disease. There is a minority view however that MS is not an autoimmune disease, but rather a metabolically dependent neurodegenerative disease. I find these words in the patent application under the link below.

I quote A method for treating demyelinating diseases such as MS comprised of administering to an individual afflicted with a demyelinating disease a medicament that induces prolactin secretion. Prolactin secretion stimulates oligodendrocyte precurser cells, which remyelinate demyelinated nerve cells. The medicament is administered at a dosage sufficient to induce prolactin secretion resulting in a hyperprolactinemia. Estrogen, estradiol, estriol, histamine H2-receptor antagonists such as cimetidine, and vitamin D can be administered in conjunction with the prolactin-inducing medicament to further promote the remyelination of the nerve cells.
http://www.faqs.org/patents/app/20080286234

And there is a possible relation with the gut and pancreas: Vasoactive intestinal peptide also known as the vasoactive intestinal polypeptide or VIP is a peptide hormone containing 29 amino acid residues that is produced in many tissues of vertebrates including the gut, pancreas and suprachiasmatic nuclei of the hypothalamus in the brain.[1][2] VIP stimulates contractility in the heart, causes vasodilation, increases glycogenolysis, lowers arterial blood pressure and relaxes the smooth muscle of trachea, stomach and gall bladder.
http://en.wikipedia.org/wiki/Vasoactive ... al_peptide

Prolactin also acts in a cytokine-like manner and as an important regulator of the immune system. Prolactin has important cell cycle related functions as a growth-, differentiating- and anti-apoptotic factor. As a growth factor binding to cytokine like receptors it has also profound influence on hematopoiesis, angiogenesis and is involved in the regulation of blood clotting through several pathways. In summary, "more than 300 separate actions of PRL have been reported in various vertebrates, including effects on water and salt balance, growth and development, endocrinology and metabolism, brain and behavior, reproduction, and immune regulation and protection". Prolactin acts in endocrine, autocrine, and paracrine manner through the prolactin receptor and a large number of cytokine receptors.[2]
Pituitary prolactin secretion is regulated by endocrine neurons in the hypothalamus, the most important ones being the neurosecretory tuberoinfundibulum (TIDA) neurons of the arcuate nucleus, which secrete dopamine to act on the dopamine-2 receptors of lactotrophs, causing inhibition of prolactin secretion. Thyrotropin-releasing factor (thyrotropin-releasing hormone) has a stimulatory effect on prolactin release.
http://en.wikipedia.org/wiki/Prolactin

Towards a different approach

We run here into an overwhelming complexity of the endocrine system, with links from everything to everything and issues that go across the boundaries of medical disciplines, with weak and very subtle -often presumed- correlations (see above posting on "But the metabolism is highly complex all the way down"). To unravel the disease in this way may show to be a daunting if not impossible task. This approach based on clinical evidences and deep research on very specific issues is perhaps not the way to go. Moreover, a cause is not a fact, and it never will be; the things we can see will always be bracketed by what we cannot.

In stead, we should carry out a meta analysis of the facts and try to build the bigger picture from there. We need to find plausible explanations for the factual observations seen among big populations studies, for results of very powerful epidemiological studies (these are not misleading) establishing facts such as the observations from the Faraoe Islands on MS or the onset of rheumatic disorders at different lattitudes, for the double peak in the graph of age of onset of MS, for the relationship to sun exposure and - presumably - vitamin D, the date of birth and period of pregnancy and the lattitude during childhood, for the lower incidence of MS in coastal areas, and I go on like that for while. And then to take things from there and perhaps inject some results of deep research where appropriate. This thread is an attempt to do just that.

The Internet is changing things. Knowledge spreads. I like to refer to it as a new wave of Enlightment... See for instance: The Linked World, How ICT is transforming societies cultures and economies
http://pressoffice.telefonica.com/docum ... Ingles.pdf

This wave will also embrace the medical world. The monopoly on information has already fallen apart..
I quote from p23: Disruptive innovations enabled by ICT often rely on common ownership of knowledge. The health care field provides numerous examples of how ICT is changing the balance of power and expertise due to increasing access to knowledge. Advances in ICT, combined with advances in genomics, nanotechnology, robotics, molecular diagnostics, and micro-fluidics, are driving a shift in health care away from a centralized model that puts the physician at its core to a more decentralized approach centered on the patient.

“Patients Like Me” is a networking site that was establishedto collect data directly from individuals with similar ailments. Individuals put their own individual symptom-related data into the network and also record any medicines or supplements they are taking, the doses, their reactions, and other pertinent medical information.

The groups are testing the results of various medicines and dosages through the internet in patient self-organized clinical trials that would not be officially available through government, drug company, or lab-sponsored trials for years. This experiment is the real-world application of the theoretical construct that market economics can be overcome by social production. The concept represents both huge power and huge risk. The experiment is opening up research that heretofore has been kept secret. Such patient-to-patient exchanges of information change the very nature of intellectual property and knowledge ownership in the health care field. In this case, it is not just a company’s interest in protecting proprietary data in which it has invested significant time and money that works against “sharing for free.” University researchers want to preserve ownership of their knowledge to get tenured teaching spots or to advance their reputations and governments have public safety-related responsibilities with stringent efficacy standards to maintain.
etc.. unquote

Things in MS simply can not continue to happen as they do, they have to change. I started reading the book of Gene Sharp: from dictatorship to democracy. The book is the model for the revolutions in the Arab world. Its subtitle seems very appropriate for us in more than one meaning: A Conceptual Framework for Liberation.

On this forum, we have compared our situation with the Arab Spring. And perhaps we need our little revolution too. The conditions for that seem to line up. The first revolution in the health care system occured in the 19th century when information was spread and different parties connected... And maybe we need a crisis too... or maybe crisis can be averted. I do not know what is better for us, because the latter could also hide things.

When? That is difficult to predict, I do not have a crystal ball.. But for sure this year things will start to happen...
I trust that our moral values ​​will prevail in the end..