This Is MS Multiple Sclerosis Knowledge & Support Community

Dr. Lorne Brandes
Have you heard of the Semmelweis reflex? It is defined in Wikipedia as "the automatic dismissal or rejection of scientific information without thought, inspection or experiment."

Although it is not certain who first coined the term, it takes its origin from the story of Professor Ignaz Semmelweis. In 1847, the Hungarian physician discovered that puerperal sepsis (childbed fever), an often fatal infection occurring in women after giving birth, could be prevented if only the attending doctors would wash their hands.

As Louis Pasteur was still years away from developing his germ theory of disease, Semmelweis' admonition was at once rejected and widely ridiculed by his peers. In desperation, he publicly denounced obstetricians as irresponsible murderers. Fearing that he had become insane, his wife, among others, had him forcibly confined to an asylum where he was soon beaten to death by guards.

Not a good end for the man who discovered the antiseptic technique that ultimately saved tens of millions of lives!

With that as background, was the initial response of most neurologists and the Canadian and American Multiple Sclerosis Societies to Professor Paolo Zamboni not a classical example of the Semmelweis reflex?

His paradigm-shifting hypothesis that MS is primarily a vascular, rather than an autoimmune, disease immediately hit a brick wall of uninformed and often violent criticism.

In dismissing his theory, one Canadian MS specialist wanted Dr. Zamboni, who is already treating humans, to go back and do studies in mice, while a blogger venomously denounced his findings as a myth... all without a second of pause or reflection, let alone a single shred of experimental proof to back up such statements.

Happily, in response to the demands of thousands of patients afflicted with MS, who are generally unimpressed with the results of standard immunosuppressive therapies, the MS Societies on both sides of the border did a rapid 180 degree turn from their initial negative stance and are now prepared to jointly fund research proposals testing the Zamboni hypothesis. Good on them.

Central to Dr. Zamboni's theory is the destructive role played by iron from the venous blood that backs up and leaks into the brain as a result of impeded flow at sites of blockage further down in the neck or chest.

There is not a physician or scientist who could disagree with Dr. Zamboni that heavy metal deposition in the brain is toxic, whether it be iron, copper or lead. That said, are there any other data that might specifically support a role for iron in the causation of MS?

As it turns out, there are!

Similar to other neurodegenerative diseases, including Parkinson's and certain forms of dementia, researchers at the University of Calgary and Imperial College, London, have linked the inflammation and nerve destruction in MS to an important, but poorly-understood protein called alpha-synuclein.

Although usually present in a harmless soluble (amorphous) form in cells, a series of alpha-synuclein molecules can join together to form an aggregate that is toxic to the brain. Moreover, larger-sized aggregates, called "oligomers", do the most damage to nerves.

Now, in two recently-published studies, German scientists have demonstrated that, even at low concentrations, oxidized (ferric) iron dramatically increases the aggregation of alpha-synuclein molecules into their most neurotoxic oligomer form.

Voila! We appear to have a newly-discovered mechanism that could explain how leaked iron in brain tissue might promote the development of MS plaques, thereby providing a new level of support for the central theme of Dr. Zamboni's vascular hypothesis.

Somehow, I believe that Ignaz Semmelweis may be smiling...not to mention Paolo Zamboni.