Oh! Dr. Arata has a poster
http://www.eventscribe.com/2014/ISETCIO ... sp?BCFO=-1
"Alterations in hypothalamus pituitary adrenal axis following central venous balloon dilation"
I don't think that link is going to go to the poster, only to the main page. I will copy it over.
Alterations in Hypothalamic Pituitary Adrenal Axis Following Central Venous Ballon Dilation
Authors:
Michael A. Arata, MD – President, Synergy Health Concepts
Abstract:
Purpose
Chronic cerebrospinal venous insufficiency (CCSVI) has been described as a condition resulting from impaired CNS venous drainage in multiple sclerosis (MS) patients. Venous balloon angioplasty (BA) has been performed as a treatment for CCSVI, although a direct link between venous obstruction and CCSVI has not been conclusively demonstrated. In addition, the dysfunction of hypothalamus pituitary adrenal (HPA) axis has been reported in MS patients, correlating with disease activity. Although MS patients undergoing treatment of CCSVI report improvements in quality life, the effect of this intervention on the HPA axis is unknown. The purpose of this study was to determine whether BA induces alterations in the HPA axis, indicated by changes in levels of ACTH and Cortisol.
Material and Methods
Eighty-eight patients underwent treatment of central venous BA for CCSVI correction. Serum samples were taken at baseline and 30 minutes after the completion of the procedure. ACTH and Cortisol were measured using electrochemiluminescence immunoassay. The change in serum ACTH and Cortisol levels was assessed using Wilcoxon signed rank test was used to assess whether the median differed from 0 using 2-sided test with the α level of 0.05. All statistical analysis was conducted using SAS 9.2.
Results
Central venous BA treatment results in a statistically significant reductions in both ACTH and cortisol (P<0.01). The distribution in change of ACTH and cortisol shifted towards negative and significantly away from 0 with median and first, third quartile of -6.15 (-10.25, -2.25) and -4.15 (-6.9, -1.6) respectively. These changes are counter to the stress mediated increase in ACTH and cortisol levels expected following an invasive procedure.
Conclusions
Reductions in serum ACTH and Cortisol post-BA intervention indicates alterations in the activities of the HPA axis. These hormonal changes can be used as surrogate markers of BA clinical efficacy. This pilot study has potential implications for the treatment of HPA axis dysfunction in pathological states other than MS. Further studies should investigate the long-term endocrine impact of CCSVI treatment.
There was a decrease seen in ACTH and cortisol when comparing baseline pre-procedure and 30 minutes post-procedure.
If MS patients are different than regular patients, then the expected increase in ACTH and cortisol might not apply to MS patients. But if MS patients react as expected to angioplasty elsewhere and react differently to angioplasty of CCSVI, then that difference would seem to be attributable to the treatment of the CCSVI.
It would also be helpful information to see if there were long-term changes in ACTH and cortisol. 24 hours post, 1 week post, 1 month post, 1 year post? All that we have to go on is 30 minutes post, and it's not clear if that is a result of the CCSVI procedure specifically or if MS patients would react in this unexpected way to any angioplasty procedure including elsewhere in the body. It's still interesting.
There seems to be a dearth of CCSVI-related anything at ISET this year, so kudos and appreciation to both Dr. Siskin and Dr. Arata for their continued involvement.